Ranse K, Delaney L, Ranse J, Coyer F, Yates P. (2018). End-of-life care in postgraduate critical care nurse curricula: An evaluation of current content informing practice. Poster presented at the ANZICS/ACCCN Intensive Care Annual Scientific Meeting, Adelaide, 11th - 13th October.

1. End-of-life care in postgraduate critical care nursing curricula:
An evaluation of current content informing practice
Dr Kristen Ranse1, Ms Lori Delaney2, Dr Jamie Ranse1, Assoc Prof Fiona Coyer2, Prof Patsy Yates2
1. Griffith University, 2. Queensland University of Technology
BACKGROUND
• The provision of end-of-life care is a significant
component of work for critical care nurses.
• In a national survey of Australian critical care nurses,
only 44% of participants reported that their
postgraduate nursing education included end-of-life
care content relevant to the critical care context [1].
• The inclusion of end-of-life care content in critical
care curricula is needed to address the complexity of
this area of practice.
OBJECTIVE
To identify and describe end-of-life care content in
postgraduate critical care nursing courses in Australia.
METHODS
Participants
In August 2015, a search of the internet identified a nursing academic or educator
from each of the 17 Australian education providers found to be offering a
postgraduate critical care nursing program.
Data collection
Between November 2015 to August 2016, an individual structured telephone
interview was undertaken with each participant. The format of the interview was
structured into two parts. Part 1 collected participant demographic information and
information pertaining to the individual critical care program characteristics. Part 2
explored the end of life content areas included in the postgraduate critical care
nursing program.
Data analysis
Data obtained was manually entered into a Microsoft Excel spreadsheet for analysis.
Data was summarised by calculating median and interquartile range for continuous
variables, and frequency and percentage for categorical variables.
RESULTS
• Participants representing 13 individual education providers
completed a telephone interview (response rate 76%)
• Critical care programs were offered either fully online (n = 5) or via
blended delivery which include online and face to face teaching
intensives (n = 8)
• Significant variation in student numbers existed with two
education providers graduating 5 students and one program
graduating 450 students per annum (median 25; IQR 15 – 85).
• Almost all participants agreed or strongly agreed (92%) that end of
life content was important in postgraduate critical care nursing
curriculum, with participants agreeing or strongly agreeing (77%)
that more time should be allocated to end of life content.
• The majority of programs addressed content related to legal and
ethical issues and organ donation.
• The content least commonly addressed pertained to the work of
the nurse in providing direct clinical care to patients at end of life.
RECOMMENDATIONS
Education
• Targeted educational initiatives need to be implemented that
address the care and inclusion of the family and physical care of the
patient.
Practice
• Identification of end of life practice champions amongst clinicians in
critical care units, to support critical care nurses engaged in delivery
of end of life care.
Research
• Research to obtain consensus in regard to priority curricula content
areas and the associated educational outcomes, informing
development of a national approach to end of life in critical care
curricula in Australia.
Table: End of life content areas in Australian postgraduate critical
care nursing curricula (n = 13)
CONCLUSION
The inclusion of end-of-life care content in critical care curricula is needed to address the complexity of this area of practice. The findings of
this study can assist in appropriately targeting the development of resources needed to enhance end-of-life content in critical care curricula,
improving preparation of nurses to deliver skilled comprehensive care to patients at the end of life and their families.
n %
Legal/ethical considerations
Legal/ethical issues related to EOL care 10 77
Enduring power of attorney/guardian 6 46
Advanced care directives/plans 6 46
Coronial inquests 5 38
Euthanasia 3 23
Organ donation
Determination of death 12 92
Organ donation after brain death 12 92
Communication
Communication with family 10 77
Spiritual/cultural support 8 62
Nursing roles in family meetings 7 54
Communication with patient 6 46
Care of self 6 46
Providing emotional support 3 23
Clinical care
Use of sedation 7 54
Essential nursing care 6 46
Multidisciplinary roles 6 46
Pharmacology 6 46
Modifying the clinical environment 5 38
Symptom management 5 38
Physical changes at EOL 4 31
Respiratory management 3 23
Care of the body after death 3 23
Withdrawal/withholding treatment 2 15
1. Ranse K, Yates P, Coyer F. Factors influencing the provision of end‐of‐life care in critical care settings: development and testing of a survey instrument. Journal of Advanced Nursing 71 (3), 697-70