Development of a palliative superuser educational curriculum to improve nurses' comfort and knowledge in the provision of end-of-life-care

Patients who are receiving comfort-directed care at the end of their lives will be cared for by nurses throughout their hospital stay. Providing bedside end-of-life care requires specialty assessment, communication, and intervention skills. Nurses who provide bedside end-of-life care in the acute care setting may not receive specialty palliative care training as part of their undergraduate education. To address this an educational curriculum was designed by members of the Palliative Care team and a Palliative Superuser training program was developed. Guided by the Comfort ALways Matters (CALM) framework the course focused on specialized assessment and symptom management, holistic approaches to patients and their caregivers, and communication instruction. Course description is a four-hour workshop presented by certified registered nurse practitioners from the inpatient palliative care team. Nurses who complete the superuser training will act as mentors to their peers and will continue to receive educational updates every two months. A goal of training ten percent of nurses in the acute hospital setting was set. Individual class size is limited to 10 attendees to facilitate small group discussion. Program availability was advertised by email and flyer to the managers of all inpatient units. Nurses who expressed interest and volunteered to attend were chosen by their managers and enrolled in the class. Pre- and post- testing of nurses who volunteered for the training revealed improvement in knowledge, confidence, and comfort in providing end of life care after completing the initial training session. Early positive results of the QI initiative suggested that ongoing training will be valuable to the institution and the patients.