Date of Conferral

2015

Degree

Doctor of Education (Ed.D.)

School

Education

Advisor

Kathleen H. McKee

Abstract

Most nurses receive limited formal education regarding end-of-life (EOL) care, which affects their ability to meet dying patients' needs. Guided by Bandura's social learning theory, this explanatory correlational study examined the relationships between critical care nurses' personal and professional characteristics and their perceived knowledge and self-efficacy when providing EOL care at an academic medical center. Convenience sampling was used to recruit participants from the eligible adult, pediatric, and neonatal critical care nurses for this study. The 67 participants completed the End-of-Life Professional Caregiver Survey (EPCS) to assess EOL care knowledge and self-confidence. Total EPCS scores revealed only moderate levels of EOL knowledge and self-confidence. The Fisher's exact test indicated that higher EPCS scores were significantly associated with nurses' age and completion of advance directive. A 3-day workshop was designed to address deficits related to EPCS scores and advance directive completion, while educating younger nurses to gain confidence in their EOL discussions. Additional research is recommended to distinguish between nurses' actual knowledge and perceived knowledge about EOL care, the long-term effects of EOL care education on the quality of patient care, nurses' levels of moral distress and burnout, and nurses' communication skills with patients and other health care providers. The result of this research promotes positive social change through EOL education to improve the confidence of nurses working with dying patients and their families, as well as to understand the challenges of communicating difficult decisions regarding EOL care.

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