Impact on Nursing Students’ Knowledge Through Integration of an End-of-Life Course in the Undergraduate Curriculum

Saturday, March 28, 2020: 8:30 AM

Laly Joseph, DVM, DNP, CNE, RN-C, MSN, ARNP, ANP-BC
Philips School of Nursing @ Mount Sinai Beth Israel, New York, NY, USA

Purpose: Nurses play a key role in caring for patients with serious illness in today’s complex health care system. Improving care in the final phase of life has been an important medical and societal goal during the last two decades, yet the amount of content that deals with the wide range of end-of-life (EOL) issues continues to be minimal in nursing schools. Therefore, it is imperative that future nurses be prepared with the knowledge and skills to meet the needs of patients and families across the lifespan, the illness trajectory, and health care settings. The purpose of this evidence-based study was to examine the impact of a palliative care course on nursing students’ knowledge towards providing EOL care.

Methods: A quantitative, quasi-experimental study with a pre-test and post-test was used to analyze the differences in the scores. The sample consisted of junior students (n=80) enrolled in the Adult Health I course. The instrument used to collect data for this study was the Palliative Care Quiz for Nursing (PCQN), which measures students’ knowledge of end-of-life care. Students had to complete the End-of-Life Nursing Education Consortium (ELNEC) Undergraduate online curriculum designed specifically for nursing students, which meets competencies and recommendations of the new American Association of Colleges of Nursing (AACN) CARES Document. The course consists of six one-hour modules. The topical outline for this course included; Introduction to palliative care nursing, communication, pain management, symptom management, loss, grief and bereavement, and final hours of life. Students were also required to complete the PCQN before and after completing the ELNEC course. Completion of the quiz was voluntary, and students were informed that participation or non-participation would have no effect on their grades for Adult Health 1 course. There was no identifying information on any of the forms and return of the completed quiz was considered to imply individual consent.

Results: From the pre-test results, most students answered questions in a negative form as “False” or “I don’t know” to many philosophical and principles of palliative care. Consequently, pain and symptom management received more true answers because they were related to direct nursing care. Hence, psycho-social and spiritual care received most “I don’t know” choices during the pre-test when compared to the post-test. There were significant differences between the true and false answer choices when the total scores from the pre-test and post-tests were compared.

Conclusion: These results showed that students need additional support or a specific course to ascertain knowledge for end-of-life care, because most students may have never encountered an EOL event. After completion of the ELNEC course, students chose more true answers to many questions that they were not sure about prior to the course. This study will provide an example of a school of nursing responding to the Institute of Medicine and the AACN’s recommendations for end-of-life care to be incorporated into nursing curricula. Nursing students who are more knowledgeable may be more sensitive to the needs of patients undergoing end-of-life care, which allows for better patient advocacy.

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