Evaluating the Effectiveness of an Educational Intervention on End-of-Life Care Knowledge and Attitudes among Adult ICU Nurses: A Pretest-Posttest Study Open Access

Reiber, Rebecca (Fall 2025)

Permanent URL: https://etd.library.emory.edu/concern/etds/t148fj62z?locale=en
Published

Abstract

Title: Exploring Intensive Care Unit (ICU) Nurses Knowledge and Attitudes Toward End-of Life (EOL) Care

Background: EOL care is a complex task placed predominately on the nursing profession. It entails a specific knowledge base, preparation, and understanding of personal attitudes toward death and dying to be able to provide high quality EOL care. Increased nursing education about EOL in the ICU is needed to improve patient care and decrease nursing psychologic distress and burnout.  

Objective/Purpose: The purpose of this quality improvement project is to understand attitudes and improve knowledge of adult ICU nurses in providing EOL care to patients and their families. 

Study Design/Research Methods: A pretest-posttest design was used to evaluate the impact of an educational in-service on ICU nurses’ knowledge and attitude toward EOL care. The study population included adult ICU registered nurses in a cardiac ICU at a tertiary care facility. Participants completed a validated pretest-posttest survey that assessed knowledge and attitudes on EOL care before and after a 15-minute educational intervention. The posttest survey also included 3 open-ended questions to evaluate the intervention, gain information regarding previous EOL care education completed, and determine what aspects of the intervention were most helpful. The quantitative data obtained from both surveys was compared using a paired t-test and descriptive statistics summarized key features of the participants.  

Results: Using a one-tailed paired t-test, the pre-intervention knowledge versus post-intervention knowledge did not reach statistical significance (p=0.11) using an alpha value of 0.05. Mean knowledge was 10.42 (SD 1.8) on pre-test compared to post-test of 11.42 (SD 2.14). Mean attitude was 3.9 (SD 0.75) on pre-test compared to 3.8 (0.40) on post-test. 57% of participants stated they had not received formal or on-job EOL care education. Of the participants who received EOL care training, 28.6% solely received education on the job. Post-intervention, participants noted feeling more capable of handling tasks related to EOL care due to a heightened understanding of evidenced-based practice tools, hospital policies, and available educational resources.

Conclusion: There was an overall increase in post-test knowledge scores compared to pre-test knowledge, however a greater sample size is needed to reach statistical significance. These findings emphasize the importance of EOL education for nurses in the ICU. Increased knowledge can lead to improved attitudes, reduced psychologic distress and better patient-centered care. 

 

Keywords: Death and dying, education, nursing, ICU nurse, end-of-life, critical care nurse, and care 

Table of Contents

Table of Contents

Abstract…………………………………………………………………………………………....3

Introduction ……………………………………………………………………………………...6

Background ……………………………………………………………………………………… 6

Significance ……………………………………………………………………………………… 7

Clinical Question…………………………………………………………………………………8

Project Objective, Assumptions, Limitations…………..………………………………….8

Conceptual/Theoretical Framework………………………………………………………….9

Literature Review………………………………………………………………………………...10

Practical Implications…………………………………………………………………………..11

Methods…………………………………………………………………………………………...12

Results………………………………………………………………………………………..…...18

Discussion………………………………………………………………………………………...18

Implication/Recommendation………………………………………………………………..20

Conclusion………………………………………………………………………………...……..21

Appendix A: Pre-Study Survey………………………………………………………………..25 

Appendix B: Post-Study Survey……………………………………………………………….28 

About this Scholarly Project

Rights statement
  • Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.
School
Specialty
Degree
Submission
Language
  • English
Research Field
Keyword
Committee Chair / Thesis Advisor
Last modified

Primary PDF

Supplemental Files