The End-of-Life Nursing Education Consortium (ELNEC) project is a national education initiative to improve end-of-life care in the United States. 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 end-of-life 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 4,750 nurses, representing all 50 states 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 end-of-life 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 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-SuperCore 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 are selected using a competitive application process, and receive a comprehensive 1,000 page syllabus, textbooks 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 Trainers represent each US state and the District of Columbia. Nursing faculty and clinicians from other countries around the world have also attended ELNEC.
Six ELNEC Projects
- ELNEC-SuperCore: The initial RWJF grant included a total of eight ELNEC-Core courses with the first held in January 2001. The courses were designed to meet the unique needs of several specific groups of nursing educators:
- a total of 722 baccalaureate and associate degree nursing faculty are ELNEC trainers
- 802 nursing continuing education providers and clinical staff development educators have completed ELNEC training
Using the ELNEC-Core curriculum, three courses were held specifically for RN’s who work in the state of California. These courses, funded by the Archstone Foundation, were held in October 2005, February 2006, and March 2007 with a total of 343 in attendance.
- ELNEC-Graduate: Although the initial RWJF grant ended in 2004, a grant from the National Cancer Institute (NCI) began July 1, 2002 to meet the special needs of faculty teaching in graduate nursing education programs. The first of four ELNEC-Graduate NCI-supported courses occurred in June 2003. To date, a total of 367 graduate nursing faculty, representing every state in the United States and 285 out of 438 (65%) graduate nursing programs have attended ELNEC-Graduate. The final NCI-funded ELNEC-Graduate course took place in June, 2006. Due to the continued need and requests for this education, a course was offered at the 2007 and 2008 AACN Master’s Conference.
- ELNEC-Oncology: The National Cancer Institute also began funding the ELNEC-Oncology training program in August 2003. This program trains oncology nurses, who are 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. To date, 264 oncology nurses, representing 141 out of 222 (64%) ONS chapters have attended. The last NCI-funded course was held in September 2006. Though the NCI grant has been completed, ELNEC-Oncology was presented at the 2006 ONS Institutes of Learning with 82 oncology nurses participating. The ELNEC Project Team will continue to collaborate with ONS to offer future ELNEC-Oncology courses for its members.
- 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. This national course has been offered annually, beginning in August 2003 with over 560 nurses in attendance, representing 46 states plus the District of Columbia. The Aetna Foundation partially-funded the August 2005 and 2006 courses. National train-the-trainer programs are offered to pediatric nurses annually.
- 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 November 2006 with 3 additional train-the-trainer programs provided in 2007. In January 2007 and April 2008, a national ELNEC-Critical Care course was offered to California nurses only and funded by the Archstone Foundation. To date, 459 critical care nurses have attended one of the five national training programs, representing 33 states, the District of Columbia, and Canada. The sixth national ELNEC-Critical Care train-the-trainer course will be provided in October, 2008 in Washington, DC. The Archstone Foundation will fund two future ELNEC-Critical Care Courses—1 in 2009 and 1 in 2010.
- ELNEC-Geriatric: The California HealthCare Foundation (CHCF) provided funding for the development of the ELNEC-Geriatric curriculum and two train-the-trainer courses. The pilot course was held in February 2007 in Long Beach, CA for California nurses only. Eighty-two participants from 50 cities/towns across the state of California, representing 37 various geriatric institutions and organizations attended this first course. 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 and 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, 368 geriatric nurses have attended one of 4 national courses. The Archstone Foundation funded the May 2008 train-the-trainer course, with future funding support for 2009 and 2010 ELNEC-Geriatric courses.
International Efforts to Implement and Disseminate ELNEC
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 46 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. Some are working on translating ELNEC into other languages and adapting it to increase the relevance to other cultures.
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. ELNEC faculty were invited to present this training program again at the Salzburg Medical Seminar Series for Nurses in Palliative Care in April 2008. Thirty-nine nursing faculty and administrators attended this course, representing 17 Eastern European countries. Both courses were supported by the Open Society Institute.
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: 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.
ELNEC will celebrate the 50th national train-the-trainer course, June 28, 2008 in Chicago, IL.
ELNEC Resources
- Website: The ELNEC project is described in detail at www.aacn.nche.edu/ELNEC.
ELNEC Trainers use the complete list of Trainers found on the website by state to locate colleagues with whom to consult and partner. Those outside the ELNEC network can also use this list to contact end-of-life experts as consultants and instructors.
- Newsletter: The quarterly newsletter, ELNEC Connections is sent to ELNEC Trainers, Deans/Directors of AACN member schools, various end-of-life agencies and projects, governmental agencies, and media representatives. ELNEC Connections provides information on end-of-life care and offers a forum through which the network of ELNEC Trainers can stay in contact and share successful education strategies. The newsletter is available online at www.aacn.nche.edu/ELNEC/connections.htm.
- Publications: The American Journal of Nursing (AJN), the official journal of the American Nurses Association, launched in 2002 a bimonthly continuing education series on palliative nursing care that featured the ELNEC project. The series used actual case studies to improve the way nurses care for dying patients, both physically and psychologically. The series can be viewed online at www.aacn.nche.edu/ELNEC/ajn.htm or www.ajnonline.com.Additional publications in various other professional journals can also be found on the ELNEC website
- Awards: Excellence in ELNEC Education Awards are presented to ELNEC Trainers who have made particularly noteworthy contributions to ELNEC education.
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.
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