AACN - ELNEC - Fact Sheet

The End-of-Life Nursing Education Consortium (ELNEC) project is a national education initiative to improve palliative care. The project provides undergraduate and graduate nursing faculty, CE providers, staff development educators, specialty nurses in pediatrics, oncology, critical care and geriatrics, and other nurses with training in palliative care so they can teach this essential information to nursing students and practicing nurses. The project, which began in February 2000, was initially funded by a major grant from The Robert Wood Johnson Foundation (RWJF). Additional funding has been received from the National Cancer Institute (NCI), the Aetna, Archstone, and California HealthCare Foundations, Open Society Institute, and the Oncology Nursing Foundation.

To date, over 10,070 nurses and other healthcare professionals, representing all 50 US states, plus 63 international countries have received ELNEC training through these national courses and are sharing this new expertise in educational and clinical settings. ELNEC Trainers are hosting professional development seminars for practicing nurses, incorporating ELNEC content into nursing curriculum, hosting regional training sessions to expand ELNEC’s reach into rural and underserved communities, presenting ELNEC at national and international conferences, and improving the quality of nursing care in other innovative ways. Over the next few years, ELNEC Trainers will touch the lives of millions of people facing the end-of-life.

The ELNEC project is administered by the American Association of Colleges of Nursing (AACN), Washington, DC and the City of Hope, Los Angeles, CA, and the esteemed faculty includes a national cadre of nurse leaders.

KEY ELNEC FACTS

People in our country deny death, believing that medical science can cure any patient. Death often is seen as a failure of the health care system rather than a natural aspect of life. This belief affects all health professionals, including nurses. Despite their undisputed technical and interpersonal skills, professional nurses may not be completely comfortable with the specialized knowledge and skills needed to provide quality palliative care to patients. The ELNEC project gives nurses the knowledge and skills required to provide this specialized care and to positively impact the lives of patients and families facing serious illness or the end of life.

The curriculum was developed through the work of nationally recognized palliative care experts with extensive input from an advisory board and reviewers. The curriculum is revised regularly based on participant recommendations and new advances in the field, and is modified for each distinct audience. The curriculum focuses on core areas in end-of-life care reflecting AACN's 1998 publication Peaceful Death: Recommended Competencies and Curricular Guidelines for End-of-Life Nursing Care. This document outlines specific aspects of professional nursing care considered requisite for each graduate.

ELNEC-Core content is divided into eight modules: Nursing Care at the End of Life; Pain Management; Symptom Management; Ethical/Legal Issues; Cultural Considerations in End-of-Life Care; Communication; Loss, Grief, Bereavement; and Preparation for and Care at the Time of Death.

Participants receive a comprehensive 1,000+ page syllabus, palliative care textbook, and a wealth of resources and strategies to teach this content to others. Teaching materials are furnished in hard copy as well as on a CD so nurse educators can use them efficiently for their own instructional purposes.

ELNEC-CORE: The initial RWJF grant included a total of eight ELNEC-Core courses, held between 2001-2004. The courses were designed to meet the unique needs of several specific groups of nursing educators: 900 baccalaureate and associate degree nursing faculty are ELNEC trainers, representing 65% of baccalaureate nursing programs nationally.

Based on post course surveys, the ELNEC team estimates that the 900 faculty trained in ELNEC reach an estimated 50 students in the first year post-ELNEC training or a total of 45,000 students. This estimate is from the first year 12-month post-course surveys. Approximately 6300 nurses who provide education at various levels within the organization and in diverse clinical settings (i.e. advanced practice nurses (APN’s), continuing education providers, professional nursing organization educators, institution-wide staff development educators, unit-specific educators, community educators, etc) have been trained to date. ELNEC-Core is used to train staff nurses, advanced practice nurses, undergraduate and graduate nursing faculty, administrators, and researchers who work in acute care settings (i.e. medical-surgical and oncology units), clinics, homecare, hospice and palliative care settings. Several national ELNEC-Core courses are held each year.

Although the initial RWJF grant ended in 2004, a grant from the National Cancer Institute (NCI) began in 2002 to meet the special needs of faculty teaching in graduate nursing education programs. Between 2003-2006, four NCI-funded ELNEC-Graduate train-the-trainer courses were held. A total of 400 graduate nursing faculty, representing every state in the United States and 285 out of 438 (65%) graduate nursing programs attended ELNEC-Graduate.

The NCI began funding the ELNEC-Oncology training program in August 2003. This program trained oncology nurses, who were members of the Oncology Nursing Society (ONS), to disseminate palliative care education through their local ONS chapter to improve care of cancer patients and their families. At the conclusion of the four-year grant, 264 oncology nurses, representing 141 out of 222 (64%) ONS chapters attended a national ELNEC-Oncology course.
NOTE: While the ELNEC-Oncology and ELNEC-Graduate courses have concluded, oncology and graduate nursing educators now attend ELNEC-Core courses.

ELNEC-PEDIATRIC PALLIATIVE CARE: Adapted from the ELNEC-Core curriculum, a pediatric-specific course, ELNEC-Pediatric Palliative Care was developed by 20 pediatric palliative care experts and piloted in 2003. Since its inception in August 2003, nine national courses have been provided across the US to date. Six other courses, in collaboration with the Association of Pediatric Oncology/Hematology Nurses (APOHN) have been provided. To date, over 1300 nurses have attended one of these train-the-trainer courses. The Aetna Foundation partially-funded the August 2005 and 2006 courses. In 2009, the curriculum was up-dated to include enhanced perinatal and neonatal content.

ELNEC-CRITICAL CARE: Also adapted from the ELNEC-Core curriculum, a critical care-specific course has been developed for nurses who work in intensive care, coronary care, burn, dialysis units, emergency departments and other clinical areas encompassing critical care. This course debuted in 2006 with 3 additional train-the-trainer programs provided in 2007. In January 2007, April 2008, and January 2009, a national ELNEC-Critical Care course was offered to California nurses only and funded by the Archstone Foundation. To date, over 750 critical care nurses have attended one of the eight national training programs.

ELNEC-GERIATRIC: The California HealthCare Foundation (CHCF) provided funding for the development of the ELNEC-Geriatric curriculum and two train-the-trainer courses. The curriculum addresses the unique needs of geriatric nurses who work in long-term care and skilled nursing facilities, and hospices that service these facilities. Nurses from acute care settings, clinics, and homecare also find the training helpful to their practice of caring for the elderly in these settings. Undergraduate and graduate nursing faculty find the course, its supplemental teaching materials and case studies invaluable to their current lectures. In addition, the curriculum includes supplemental teaching strategies for educating unlicensed personnel that work with geriatric patients and their families. Currently, over 530 geriatric nurses and other interdisciplinary team members have attended one of 6 national courses. The Archstone Foundation funded the May 2008 and 2009 train-the-trainer courses, with future funding support for 2010 ELNEC-Geriatric courses.

ELNEC’s primary aim is to educate nurses to improve end-of-life care. While our initial efforts, launched in 2000, were focused in the United States, many ELNEC trainers have had opportunities to travel internationally and provide this education to nurses and other healthcare providers throughout the world. Currently, ELNEC trainers and faculty have traveled to six of the seven continents, representing 63 countries. Many trainers have provided ELNEC educational courses, while others have gone as consultants to work with educators, health administrators, and community leaders to improve care of the dying in their countries. It is estimated that over 1750 nurses and other healthcare providers have received ELNEC training internationally. Some are working on translating ELNEC into other languages and adapting it to increase the relevance to other cultures. For example, ELNEC has already been translated into Russian where nursing administrators and faculty are using the curriculum in Eastern Europe. ELNEC is also translated in Spanish (Core and Pediatric Palliative Care versions) and is being widely disseminated in Mexico, Central America, and parts of South America. Lastly, ELNEC-Japanese is available, due to the many efforts of ELNEC trainer, Sayaka Sakamoto-Takenouchi.

In October 2006, the 1st Salzburg Medical Seminar Series for Nurses in Palliative Care took place in Salzburg, Austria. Four ELNEC faculty members taught ELNEC to 38 Eastern European nursing leaders in education and clinical practice from 14 Eastern European countries. Due to the tremendous success of the first seminar, ELNEC faculty were invited to present this training program again in April 2008. Thirty-nine nursing faculty and administrators attended this course. Both courses were supported by the Open Society Institute, with representation from 23 Eastern European countries.

In July 2007, four ELNEC faculty members traveled to Tanzania to provide ELNEC training to nurses and other members of the interdisciplinary team in Africa. Thirty-eight nurses, representing 6 African countries were selected to attend this training (Tanzania, Rwanda, Kenya, Zanzibar, Zambia, Malawi). The Oncology Nursing Foundation sponsored this endeavor.

ELNEC trainers receive invitations to speak at international meetings. Some of the major international presentations include:
Sigma Theta Tau International (STTI) Congress: 2003 in Ireland, 2005 in Kona, Hawaii, and 2007 in Vienna, Austria
Global Caring Nurses Foundation: 2004 in Manila and Debu, Philippines
International Cancer Nursing Seminar: 2002, 2004, 2006, 2008: Tokyo and Osaka, Japan
Neonatal, Flight and Emergency Nurses Conference: 2005 in Christchurch, New Zealand
European Association of Palliative Care (EAPC): 2006 in Venice, Italy and 2007 in Budapest, Hungary

For more information on ELNEC trainers’ efforts to disseminate ELNEC internationally and for a listing of efforts by country, go to: https://www.aacn.nche.edu/ELNEC/Global.htm

For more information on the ELNEC project, please refer to the website, www.aacn.nche.edu/elnec or contact
Pam Malloy at (202) 463-6930, ext. 238
or by email at: pmalloy@aacn.nche.edu