Exploring End-of-Life Knowledge and Attitudes Toward Certification Among Oncology and Palliative Care Nurses

Purpose:
The purpose was to evaluate end-of-life knowledge and perceived value of certification among oncology and palliative care nurses. This study was based on the concept of coaching, a key role of the advanced practice nurse. Results were used to develop a program to encourage nurse certification.

Background/Significance:
Hospital based oncology and palliative care nurses provide end-of-life care daily. The amount of formal training gained in schools of nursing specific to end-of-life care varies. Exploring what is known about end-of-life care is essential in creating staff education programs. Professional nursing certification is one means of validating theoretical knowledge. Exploring attitudes of nurses toward certification may help educators gain insight into opportunities to encourage certification.

Methods:
A descriptive design was used to explore end-of-life knowledge and attitudes toward certification among oncology and palliative care nurses in a community hospital setting. An electronic survey system was used to obtain consent and collect demographic data in addition to responses to an 18-item Perceived Value of Certification (PVCT) tool and a 50-item End-of-Life Nursing Education Consortium Knowledge Assessment Test (ELNEC-KAT). A convenience sample of RN's employed on the Oncology and Palliative Care Units of the hospital was used. Mean overall test scores on the ELNEC-KAT were compared. Cronbach's alpha, total score and intrinsic and extrinsic values for the PVCT were evaluated.

Results:
33 RN's (19 oncology / 14 palliative care) participated. Overall test scores on the ELNEC-KAT were not significantly different (p=.089) for Oncology Nurses (85%) and Palliative Care Nurses (80%). Internal consistency reliability testing yielded an alpha of .949. Intrinsic value of certification yielded an alpha of .959. Extrinsic value of certification yielded an alpha of .817. Although the overall perceived value of certification was high, intrinsic values of certification were higher among oncology nurses than palliative care nurses. Oncology nurses had significantly more years of nursing experience while palliative nurses reported spending more time per week providing end-of-life care.

Conclusions and Implications for Practice:
Findings served as a baseline measure of the perceived value of certification and were helpful in developing and providing a 10-week certification prep course. Subsequently, the percent of palliative care RN's with national certification increased from 4.17% to 30.43% which exceeds the NDNQI mean.