Assessment of Rural Nurses' Educational Needs in Providing Evidence-based End-of-Life Care

Abstract

Many organizations such as the Institute of Medicine, the World Health Organization and the National Consensus Project for Quality Palliative Care have identified the need for equitable access to palliative and end-of-life care (Ferrell, Coyle, & Paice, 2015). However, in many rural areas of the world, including rural Wyoming, patients at end-of-life are cared for in acute care settings where nurses have not received specialized training and education on evidence based end-of-life care. The aim for this DNP project was to assess rural registered nurses' perceptions of competencies important in end-of-life nursing practice (Coyne & White, 2011). A 32-item survey developed by White and Coyne (2011) was adapted for use in a rural critical access hospital to determine content priorities and educational needs of generalist nurses in a rural setting, regarding providing palliative and end-of-life care. A purposive sample of 16 nurses in a rural critical access hospital in Wheatland, WY, who care for patients at end-of-life, completed the survey. Only one-third of the nurses surveyed reported receiving any type of end-of-life care education in the prior two years. Similar to findings from the study completed in 2011 in an urban area, symptom management, talking to patients and families about death and dying, and pain control were the highest ranking core competencies. Nurses who did report receiving education in end-of-life care still felt inadequately prepared to talk to patients and families about dying, and this needs assessment identified that educational gaps are evident regarding provision of end-of-life nursing care in rural settings. The information gleaned from this survey will be used to design an educational program to disseminate evidence based practice guidelines regarding providing quality end-of-life care using ELNEC (End-of-Life Nursing Education Consortium) modules based on the findings of the needs assessment survey