Journal of Hospice & Palliative Nursing最新文献

The End-of-Life Nursing Education Consortium (ELNEC) curricula prepare nurses to provide high-quality, evidence-based palliative care to patients with serious illness and their families. The original ELNEC program has been adapted to include nursing subspecialties and online learning modules, reaching nurses and students worldwide. This systematic literature review described the outcomes of nursing knowledge, attitudes, practice changes, and patient outcomes in studies that used ELNEC as a primary intervention. A comprehensive search was focused on literature documenting completion of ELNEC trainings and associated outcomes for nurses, nursing faculty, and nursing students. The analysis included 28 articles spanning the ELNEC curricular categories, reflecting diverse aims, designs, and data collection methods. The findings revealed significant enhancements in knowledge of palliative care among nursing students and nurses, as well as a notable positive shift in attitudes toward caring for seriously ill and dying patients. The ELNEC modules can be utilized by nurses in academic and clinical settings, across lifespan stages, to develop the knowledge, skills, and attitudes necessary to deliver primary palliative care to the growing population of seriously ill individuals globally. However, findings also indicate a need for studies that apply rigorous methods using valid and reliable assessment instruments aligned with nursing competencies.

The Massachusetts Nursing Task Force was established to promote the integration of primary palliative nursing competencies in nursing education across the state. A statewide survey revealed that only 23% of baccalaureate nursing programs felt their students were well-prepared in this area. Moreover, there was limited integration of evidence-based resources due to curriculum constraints, lack of faculty time, and financial limitations. To address these challenges, the Massachusetts Nursing Task Force implemented a 2-pronged approach: an End-of-Life Nursing Education Consortium train-the-trainer workshop for faculty and the development of a free, peer-reviewed online nursing resource library aligned with national competencies. The resource library, launched in 2023 and grounded in Kolcaba's Holistic Theory of Comfort, offers diverse materials to facilitate the incorporation of palliative nursing education into existing curricula. Future goals include wider dissemination of these resources, improved assessment of palliative nursing in curricula and practice settings, and expansion of this initiative beyond the state level to advance palliative nursing knowledge and practice.

As the global burden of chronic and life-limiting illnesses continues to rise, the demand for high-quality palliative care-and by extension, well-prepared palliative care nurses-is greater than ever. This article explores the current landscape of palliative care nursing education in various regions of the world, highlighting key international initiatives, innovations, and persistent challenges. Major global efforts advocating for universal palliative care access and the integration of palliative care education into nursing curricula have laid important groundwork. Regional successes, including structured certification programs, national frameworks, community-based trainings, and culturally tailored approaches, showcase adaptive educational models responsive to local needs. Despite progress, significant barriers remain, including limited resources, insufficient faculty training, variability in educational standards, and lack of policy support in many low- and middle-income countries, which hinder consistent implementation. By comparing global strategies and identifying areas for development, this article underscores the need for collaborative, context-sensitive solutions to strengthen palliative care nursing education worldwide.

Nursing educational programs are expanding clinical learning opportunities to encompass the hospice/palliative/supportive sphere of care, as outlined in the American Association of Colleges of Nursing Essentials to prepare practice-ready nursing graduates. This article outlines one school's journey to integrate end-of-life clinical experiences across the curriculum, starting with beginning nursing students using a peer-assisted learning model at an inpatient hospice facility. Pairing senior and beginning nursing students using the peer-assisted learning model together in the hospice setting requires specific and differentiated objectives and goals for each set of students. Students appreciated feeling welcomed in this specialty setting, engaging in hands-on care, and deepening their understanding and comfort with end-of-life care. Faculty valued an environment that offered a unique way for students to develop tangible and power skills and required less faculty oversight. Using this educational structure, hospice nurses are in a unique position to model best practices and engage nursing students in a setting that excels in providing holistic, patient-centered care. Lessons learned and implications for practice are provided, including reflective journal assignments mapped to competency-based education subcompetencies.

Undergraduate nursing students require adequate primary palliative care education in their formal education to prepare them to care for the growing population of individuals living with serious illness and their families. This paper aggregates results from 3, nationwide cross-sectional, descriptive, needs assessment studies and one single-institution needs assessment study to explore faculty perceptions and the integration of primary palliative care content in undergraduate nursing programs in the United States. Each study's design and needs assessment survey are described, followed by aggregated results from 137 respondents related to faculty demographics, nursing program details and primary palliative care integration, and faculty perceptions of primary palliative care education. Results from the local needs assessment are presented independently. Findings identify strengths related to faculty perceptions and preparedness. Key curricular gaps and opportunities in primary palliative care education pertain to alignment with competence expectations, supporting the need for academic-practice partnerships.

In the year 2000, leaders with the American Association of Colleges of Nursing joined with Dr. Betty Ferrell and her colleagues at City of Hope to address gaps in how nurses are educated to care for patients at the end-of-life and their families. The collaborators launched a far-reaching train-the-trainer initiative, the End-of-Life Nursing Education Consortium (ELNEC), which resulted in competencies, guidelines, and nursing curricula developed to prepare nurses to provide evidence-based, skilled, and compassionate palliative care. The 25th anniversary of ELNEC celebrates the tremendous efforts of the stakeholders in academia and practice, who share a commitment to transforming nursing education and elevating health care across settings. To date, more than 1.7 million nurses have been educated with the ELNEC curriculum, and more than 1200 undergraduate and 440 graduate schools of nursing offer ELNEC training in palliative end-of-life care. The remarkable academic-practice partnership at the heart of ELNEC has dramatically changed nursing care for patients with serious illnesses and their families in the United States and globally.

Palliative care is a critical component of high-quality healthcare, yet graduate nursing education has historically underemphasized its integration into advanced practice and scholarly training. This article outlines an innovative, evidence-informed approach to embedding palliative care education throughout graduate nursing curricula, aligned with national guidelines. This exemplar model demonstrates how primary and specialty palliative care can be woven into core coursework, clinical training, and interdisciplinary collaboration to build clinical, ethical, and leadership competencies. Strategies include simulation-based training, reflective writing, interprofessional intensives, and leadership development through scholarly presentations and quality improvement projects. These multimodal methods are grounded in national standards, emphasizing communication, symptom management, ethical decision-making, and culturally responsive care. Faculty partnerships, national resources, and curricular tools support implementation across a range of academic programs. Integrating palliative care throughout graduate nursing education fosters a workforce equipped to deliver person-centered, compassionate care for individuals with serious illness and their caregivers. The curriculum model presented offers a replicable framework for nursing programs seeking to expand their capacity to meet the growing global demand for palliative care.

This project aimed to address a gap in nurses' awareness of spiritual care and comprehensive spiritual support of patients in a breast oncology clinic at a National Cancer Institute (NCI)-designated Comprehensive Cancer Center through interdisciplinary collaboration with chaplaincy. Measures of nurses' comfort and understanding of spiritual care were assessed at baseline and monthly, utilizing a validated tool. Following education, nurses screened patients during their initial visit to the breast surgical oncology clinic who were experiencing moderate to severe distress for related existential themes of distress using an assessment tool and referred them to chaplaincy or social work based on the screening results. Nurse-initiated chaplain referrals increased significantly during the study period, with the most common distress themes being stress, hopes/fears, and assistance/help. Patient acceptance of referrals averaged 18.7% for chaplaincy and 33.1% for social work. By enhancing nurses' understanding of spiritual care and the role of chaplaincy, the clinic was able to improve the provision of comprehensive spiritual support, contributing to holistic patient care. Due to spirituality being a component of quality of life, this approach is transferable to other clinical settings. Future research could explore the impact of chaplain interventions on patient distress and quality of life for patients and caregivers.