An Evaluation of the Influence of the Care (Compassion and Respect at the End-of-Life) Program on Registered Nurses' Knowledge snd Comfort About End-of-Life Care and Care Delivery for Patients with Life-Limiting Illnesse

In the United States, there is an urgent need for quality palliative and end-of-life care for patients at the end of life or living with life-limiting illnesses. Palliative and end-of-life training among nurses is inadequate and inconsistent. Little is known about nurses' knowledge and comfort when caring for the dying.;The purpose of this pilot study was to evaluate the influence of the CARE (Compassion and Respect at the End-of-life) Program and the CARES* Tool at Huntington Hospital to empower nurses to deliver compassionate, dignified, and personalized nursing care at the end of life consistent with patient and family wishes.;The study design was a one group pre-test/post-test intervention study using the End-of-Life Professional Caregiver Survey (EPCS) to measure nurses' knowledge and comfort about end-of-life care in the domains of patient- and family-centered communication, cultural and ethical values, and effective care delivery.;Fifty-one participants were recruited, and 24 participants completed the post-surveys of EPCS and the CARES Tool Evaluation 6 weeks after the CARE Program training. Participants reported an 18% increase in scores in the domain of patient- and family-centered communication; 21% increase in scores in the domain of cultural and ethical values; and 18% increase in scores in the domain of effective care delivery. Participants without prior knowledge of care for the dying improved the most in all three domains, whereas participants working in critical care showed the least improvement in scores in all three domains. Item analyses of the EPCS questionnaire items revealed that most participants feel comfortable with being present with dying patients and with encouraging patients and families to complete advance care planning. The participants felt least comfortable in addressing requests for physician-assisted death. In addition, the CARES Tool was found to be an effective educational tool to improve knowledge and comfort of nurses to provide compassionate, person-centered care for patients at the end of life or living with life-limiting illnesses.;The CARE Program and the CARES Tool have demonstrated effectiveness in increasing nurses' knowledge and comfort with end-of-life care and care delivery for patients with life-limiting illnesses. This study has provided original data and insights into the use of an evidence-based palliative care training program. Implications and suggestions for future research will include how the CARE Program and the CARES Tool impact patient and family outcomes, care satisfaction, physicians and other health care team members' end-of-life care practices, and nursing students' end-of-life care education and training.;*CARES (Comfort, Airway, Restlessness and Delirium, Emotional and Spiritual Support, and Self-Care).