An Innovative End-of-Life Nursing Education Consortium Curriculum That Prepares Nursing Students to Provide Primary Palliative Care.

Research has demonstrated that patients facing serious, life-limiting illnesses and their families benefit from receiving palliative care. Increasingly, however, specialty palliative care has limited resources. Prelicensure nursing students who are educated to provide primary palliative care to patients with serious illness and at the end of life can fill that gap. This article describes the development and implementation of an innovative online nursing curriculum that prepares students with essential primary palliative nursing knowledge and skills.

Providing Palliative Care Education: Showcasing Efforts of Asian Nurses.

Most of the world's population lives in Asia. Prevention and detection of cancer, as well as ensuring equitable access to cancer care for all Asians remains a major public health issue and requires governmental involvement and dedicated resources. Palliative care, a medical and nursing specialty, promotes holistic attention to suffering and provides compassionate and interdisciplinary care to the most vulnerable in all societies-those with serious illness. It is nurses who provide the majority of care for patients with cancer, as no other healthcare professional spends more time at the bedside or out in the community assessing and managing these patients and their families. The purpose of this article is to showcase nursing leaders throughout Asia who are receiving palliative care education, educating their colleagues in this care, improving clinical practice, participating in the development of healthcare policies, and advocating for this care.

Promoting Palliative Care Internationally: Building Leaders to Promote Education, Practice, and Advocacy.

In February 2000, nine nursing educators, practitioners, and researchers met in Nashville, Tennessee, to develop a palliative care curriculum specifically for nurses. The following month, 22 advisors from nursing organizations across the United States convened in Washington, DC to review the recommended curriculum development and dissemination plans for end-of-life care throughout nursing schools, hospitals, hospices, home care, and geriatric settings. The Robert Wood Johnson Foundation provided funding for curriculum and competency development and for six national train-the-trainer courses to be held from 2001 to 2003. The curriculum entitled the End-of-Life Nursing Education Consortium was designed to meet the needs of nurses caring for patients with serious and complex illnesses at the end of their lives. This work, beginning in 2000 with the development of the End-of-Life Nursing Education Consortium curriculum, has been taught in every state across America and in 91 countries around the world and has been translated into eight languages. Over 21,400 trainers have returned to their institutions and educated over 642,000 colleagues.

Providing Palliative Care to Patients with Cancer: Addressing the Needs in Kenya.

Cancer is the third highest cause of death in Kenya, preceded by infectious and cardiovascular diseases, and in most cases, diagnosed in later stages. Nurses are the primary caregivers, assessing and managing these patients in the clinic, in inpatient settings, and in rural and remote communities. While cancer rates remain high, the burden to the patient, the caregiver, and society as a whole continues to rise. Kenya's poverty complicates cancer even further. Many Kenyans are unaware of cancer's signs and symptoms, and limited diagnostic and treatment centers are available. Despite these barriers, there is still hope and help for those in Kenya, who suffer from cancer. The World Health Organization has stated that palliative care is a basic human right and nurses providing this care in Kenya are making efforts to support cancer patients' ongoing needs, in order to promote compassionate palliative care and prevent suffering. The purpose of this paper is to address the palliative care needs of patients with cancer in Kenya by providing education to nurses and influencing health-care policy and education at micro and macro levels. A case study weaved throughout will highlight these issues.

CARES: AACN's New Competencies and Recommendations for Educating Undergraduate Nursing Students to Improve Palliative Care.

Nurses spend the most time of any health care professional caring for patients and families dealing with the challenges of serious illness. The demand for nursing expertise in palliative care is growing as more people are living with chronic, life-limiting illnesses. Nursing faculty must prepare future nurses to meet this demand. The new American Association of Colleges of Nursing Palliative Competencies And Recommendations for Educating undergraduate nursing Students document, released February 2016, identifies the 17 competencies that all undergraduate nursing students should achieve by the time of graduation. This historic document is a revision of the 1998 American Association of Colleges of Nursing Peaceful Death document and is now the guiding framework for undergraduate nursing education. In an effort to support nursing faculty and prepare nursing students to deliver quality palliative care, an innovative, interactive on-line undergraduate End-of-Life Nursing Education Consortium (ELNEC) curriculum is under development and will be released in January 2017. This new curriculum will meet the competencies and recommendations for achieving those competencies outlined in the Competencies And Recommendations for Educating undergraduate nursing Students document.

The End of Life Nursing Education Nursing Consortium project.

In 2000, the City of Hope Medical Center and the American Association of Colleges of Nursing (AACN) developed the End-of-Life Nursing Education Consortium (ELNEC)-Core curriculum to educate nurses and other healthcare professionals on end of life care, so that attention to the dying could be improved and their unique needs addressed. Since its inception, over 19,500 nurses and other professionals have attended the ELNEC train-the-trainer courses. Upon course completion, the participants, often nurse educators, returned to their schools, healthcare systems, and communities and introduced the ELNEC content into nursing curricula, annual competencies, and new employee orientation. In 2005, the national ELNEC Project Team concluded that an international curriculum should be developed. The first ELNEC International course was launched in 2006 in Salzburg, Austria. Since that time, trainers have come from 85 countries world-wide, and the curriculum has been translated into eight languages. In 2015, three international courses will be presented: in Beijing, China, Kipkaren, Kenya, and Salzburg, Austria.

Promoting palliative care worldwide through international nursing education.

Many challenges exist when providing international education to those who care for people at the end of life. Though issues related to culture and language may vary, the one commonality that crosses all nations is that its people die. In general, societies seek to provide the best care they are trained to give. Many have few resources to provide this care well. Traditions of the past influence norms and dictate policies and procedures of the present. Since its inception in 2000, the End-of-Life Nursing Education Consortium Project has provided palliative care education to nurses and other members of the interdisciplinary team in six of the seven continents. This article describes the efforts of this project to improve education around the globe, with the goal of providing excellent, compassionate palliative care, irrespective of location, financial status, political views, religion, race, and/or ethnicity.

End-of-life care education in acute and critical care: the California ELNEC project.

Acute and critical care nurses care for an increasingly aging population in the last stages of life. Unfortunately, many of these nurses do not have adequate education to care for this population. The End-of-Life Nursing Education Consortium (ELNEC) developed a critical care course, and in 2007 the Archstone Foundation provided a grant to educate critical care nurses in California. From 2007 to 2010, 388 participants completed the course and rated it very effective at improving end-of-life care education in their institution. After completing the national ELNEC-Critical Care train-the-trainer course, these participants taught more than 2900 classes in the ELNEC modules to their colleagues. Participants also revised policies and made system changes in their workplaces to provide better care to dying critical care patients and their families. The ELNEC/Archstone program improved acute and critical care nurses' end-of-life care education and, ultimately, practice and serves as a model for future educational efforts.

Expanding palliative care nursing education in California: the ELNEC Geriatric project.

In the past decade, the Robert Wood Johnson Foundation's 2002 report Means to a Better End: A Report on Dying in America Today and other studies brought attention to deficiencies in care of the dying in the USA. Palliative care's mandate is to promote a 'good death' through expert symptom management and compassionate care that addresses the psychosocial needs and dignity of persons at the end of life. The End-of-Life Nursing Education Consortium (ELNEC) Geriatric 'train-the-trainer' project was launched in 2007 to increase the knowledge and educational skills of nurses and unlicensed staff providing end-of-life care for older adults in nursing homes, skilled nursing facilities, long-term care, and hospices. From 2007 through 2009, 351 California-based nurses and nursing home staff attended one of four ELNEC Geriatric courses. This paper describes programme development, implementation, follow-up evaluations, and examples of participants' use of the ELNEC Geriatric curriculum.

Advancing palliative care in Kenya.

BACKGROUND: Life-threatening illnesses such as HIV/AIDS, malaria, tuberculosis, and other disorders are prevalent in the developing world, including Kenya. OBJECTIVE: The aim of this project was to assist in the development of palliative care throughout Kenya by enhancing the knowledge and skill of faculty members in palliative care so they could integrate this content into existing nursing curricula. METHODS: In an effort to develop palliative care throughout the country, experts from the Kenya Hospices and Palliative Care Association and the Kenyatta National Hospital invited faculty from the End-of-Life Nursing Education Consortium with the United States to adopt the content of its training program to address the needs of nurses and other health care professionals in Kenya. This curriculum was delivered to nursing faculty from throughout Kenya during a 5-day training course that incorporated presentations, case studies, exercises, and other teaching methods. RESULTS: The course participants completed daily course evaluations in which they rated each session on a scale of 0 = not helpful to 5 = very helpful. All of the sessions were rated very favorably, with scores for all sessions across the 5 days ranging from 4.57 to 4.91. CONCLUSION: End-of-Life Nursing Education Consortium provided educational and other support to faculty teaching in nursing schools in Kenya so they could advance palliative care efforts in this country. IMPLICATIONS FOR PRACTICE: Nurses working in the United States can share their expertise and learn immense lessons from colleagues in developing worlds.

The preparation of oncology nurses in palliative care.

OBJECTIVES: To address the opportunities for oncology nurses to prepare for and provide palliative care support to cancer patients and families. DATA SOURCES: A review of the literature as well as synthesis of the experiences of the End-of-Life Nursing Education Consortium over the past 10 years (2000-2010) were considered in summarizing implications for palliative care education in oncology. CONCLUSION: Cancer patients and their families across the cancer trajectory experience serious physical and psychosocial symptoms and spiritual concerns. Oncology nurses have contributed to the evolving field of palliative care, and the continued education of oncology nurses in this specialty is essential to quality care for patients and families IMPLICATIONS FOR NURSING PRACTICE: The need for palliative care in oncology will intensify in the future, and effective strategies for education are necessary to prepare the nursing workforce for the effective and compassionate care that patients and families deserve.

Appraisal of The Pediatric End-of-Life Nursing Education Consortium training program.

Major deficiencies continue to exist in pediatric palliative and end-of-life nursing education. The End-of-Life Nursing Education Consortium (ELNEC)-Pediatric Palliative Care (PPC) train-the-trainer curriculum was developed to create a nursing education program to improve care for children and their families confronted with life-threatening illnesses (www.aacn.nche.edu/ELNEC). Two ELNEC-PPC training programs were held in August 2005 and August 2006. The purpose of this article is to present data from the precourse and 12-month postcourse follow-up of participants who attended the two courses. Findings from these assessments demonstrate a positive link between educational initiatives and clinical outcomes.

End-of-life nursing education consortium: 5 years of educating graduate nursing faculty in excellent palliative care.

Since January 2001, over 4,500 nurses, representing all 50 U.S. states and the District of Columbia, have attended 1 of 50 national End-of-Life Nursing Education Consortium (ELNEC) train-the-trainer courses. Of the 4,500 nurses who have attended a national ELNEC course, 300 graduate nursing faculty members participated in one of four National Cancer Institute (NCI) grant-funded courses, ELNEC-Graduate, that focused on the needs of faculty teaching graduate nursing students. These nursing faculty members represent every state in the United States and 278 (63%) out of 438 graduate nursing programs. The final NCI-funded ELNEC-Graduate course took place in June 2006. Due to the continued need for this education, additional courses were offered at the 2007 American Association of Colleges of Nursing (AACN) master's conference, and another course was presented in February 2008 at the same AACN meeting. The purpose of this paper is to describe the history of the ELNEC-Graduate project and to demonstrate its impact in empowering graduate nursing faculty members to improve their teaching methods and strategies regarding end-of-life (EOL)/palliative care education. Because of ELNEC-Graduate, graduate nursing faculty members are better equipped to provide this education to their students so that these students are prepared to care for patients and their families experiencing EOL/palliative care issues.

Statewide efforts in promoting palliative care.

BACKGROUND: In 2002, Means to a Better End: A Report of Dying in America Today, a Robert Wood Johnson Foundation (RWJF) report, was issued that included grades for each state on their ability to provide end-of-life care. Most states, including California, rated as mediocre and the report called for extensive efforts at a state level to improve the quality of palliative care. OBJECTIVE: The purpose of this paper is to describe implementation and evaluation of a comprehensive statewide effort to improve end-of-life care education for 350 California nurses as an example of state-level change as recommended by the RWJF report. DESIGN: Funded by the Archstone Foundation (Long Beach, CA), this effort was based on the End-of-Life Nursing Education Consortium (ELNEC) "Train the Trainer" project, a national educational initiative to improve end-of-life care by providing training to nurses (www.aacn.nche.edu/ELNEC). ELNEC is a partnership between City of Hope, Duarte, California, and the American Association of Colleges of Nursing, Inc., Washington D.C. SETTING/SUBJECTS: Three courses were held from October 2005 through March 2007 in which 350 nurses from various clinical settings across California applied and participated in the training program. MEASUREMENTS/RESULTS/CONCLUSION: In order to be accepted in the course, participants agreed to follow-up for 12 months postcourse in order to evaluate the impact of their attendance on their institutions' commitment to palliative care. This paper reports findings from this California effort as an example of a state-intensive effort and to encourage other statewide palliative care initiatives in order to improve care for the dying.

Oncology End-of-Life Nursing Education Consortium training program: improving palliative care in cancer.

PURPOSE/OBJECTIVES: To describe an evaluation of the oncology version of the End-of-Life Nursing Education Consortium (ELNEC-Oncology) training program, which is designed to provide oncology nurses with the knowledge and materials necessary to disseminate palliative care information to their colleagues in local chapters of the Oncology Nursing Society (ONS). DATA SOURCES: Participant reports. DATA SYNTHESIS: 124 nurses representing 74 ONS chapters attended the first two courses. Dyads of ONS members from local chapters applied to attend ELNEC and completed surveys regarding their goals and expectations for implementing end-of-life (EOL) education and training after completion of the program. Participants educated more than 26,000 nurses after attending the program, including 7,593 nurses within their ONS chapters and 18,517 colleagues within their workplaces. Barriers to implementation included a lack of funding and time constraints. Participants sought additional palliative care learning opportunities, including attending other workshops, subscribing to palliative care journals, and becoming involved in committees focused on palliative care. CONCLUSION: The ELNEC-Oncology program is a national collaboration with ONS that provides oncology nurses with the tools and expertise to effectively disseminate palliative care content to colleagues within their local chapters and work settings. IMPLICATIONS FOR NURSING: EOL care information remains critical to the science of oncology nursing, and ELNEC-Oncology provides an effective strategy for disseminating the information.

End-of-life nursing education consortium for pediatric palliative care (ELNEC-PPC).

Pediatric nurses must often care for children with life-threatening illness. Although the child may be a neonate with multiple organ failure, a young adolescent diagnosed with HIV, or a 7-year-old child involved in a serious bicycle accident, pediatric nurses are an essential part of the interdisciplinary team that plans, organizes, implements, and manages the care of these children and their families. To date, more than 600 pediatric nurses have attended a national End-of-Life Nursing Education Consortium-Pediatric Palliative Care (ELNEC-PPC) training program. Many of these nurses have returned to their institutions dedicated to making a difference in the palliative care provided to children and their families. Because pediatric palliative care education is so important, many trainers have incorporated ELNEC-PPC into their nursing orientation, annual competencies, and undergraduate and graduate nursing education. They are developing standards of care and serve on key hospital/hospice committees, such as policy, education, clinical care, and ethics committees. This article showcases various activities of ELNEC-PPC trainers and demonstrates their commitment to improve pediatric palliative care not only in their institutions but also on local, state, national, and international levels.