Congress Abstracts 2003

164

IMPROVING ONCOLOGY NURSES’ ATTITUDES AND KNOWLEDGE OF PALLIATIVE CARE. Polly Mazanec, MSN, ACNP, AOCN^®, Hospice of the Western Reserve, Cleveland, OH; Susanne Vendlinski, MSN, CNS, OCN^®, University Hospitals of Cleveland, Cleveland, OH; and Amy Petrenek, BSN, RN, Ursuline College, Pepper Pike, OH.

Patients with advanced cancer experience multiple complex symptoms at the end of life. Traditionally, nursing education has not adequately prepared nurses to manage these symptoms. The purpose of this project, which was funded by the Oncology Nursing Foundation, was to determine the impact of an educational intervention on nurses’ attitudes toward and knowledge of palliative care and how that, in turn, affected their ability to manage end-of-life symptoms. Additionally, the timeliness and numbers of referrals to hospice were also evaluated. Educational content was guided by a framework of the essential nursing competencies for end-of-life care (AACN, 1997) and the End–of-Life Nursing Education Consortium (ELNEC) training program. The project used a convenience sample of 77 RNs from two in-patient divisions of a large midwestern comprehensive cancer center. The intervention consisted of an eight-month intensive nurse-nurse consultation with the oncology staff nurses and the palliative care advanced practice nurse. A palliative care seminar, covering pain and symptom management and communication skills, was presented. Nurses who indicated a desire to become “palliative care resource nurses” for their divisions participated in a two-day clinical experience with a large community-based hospice. Project methods included use of two written surveys from the City of Hope National Medical Center, “RN End-of-Life Knowledge Assessment” and “End-of-Life Attitudes Survey”; in-patient chart review of pain assessment documentation; and an analysis of the number of hospice referrals and the length of stay of these referrals, pre- and post-intervention. Data analysis is underway, consisting of descriptive statistics and comparisons (t tests) of the findings of the pre- and post-intervention knowledge and attitude surveys, hospice referral data, and frequency of pain assessment documentation. Qualitative analysis of nurse consultation notes is being done to identify common themes and further educational needs. Preliminary findings of themes include inadequate pain and symptom management, patient barriers to pain management, fears associated with hospice referral, and the challenges of integrating hospice/palliative care into an acute care oncology unit.