Welcome to the Spring 2012 Edition!
The End-of-Life Nursing Education Consortium (ELNEC) is pleased to bring you the Spring 2012 issue of ELNEC Connections, a quarterly newsletter to showcase efforts in end-of-life nursing education and practice.  This newsletter spotlights project developments and provides resources that may be useful to you as an ELNEC trainer.  ELNEC is a national education program to improve end-of-life care by nurses.  Today, over 13,800 nurses and other healthcare providers have attended a national train-the-trainer course.  ELNEC has been presented in 73 international countries and translated into 6 languages.  The project, which began in February 2000, was funded by a major grant from The Robert Wood Johnson Foundation. Additional funding has been received from the National Cancer and Open Society Institutes, and Aetna, Archstone, Oncology Nursing, Bristol-Myers Squibb, and California Healthcare Foundations, and the US Department of Veterans Affairs.  ELNEC is administered through a partnership between the American Association of Colleges of Nursing (AACN) and the City of Hope (COH).
In this Edition, read about:
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Four National ELNEC Courses Remaining for 2012
There are several ELNEC courses remaining for 2012 across the US.  Note that there are still courses available for Core, Pediatric Palliative Care, Geriatric, Critical Care, ELNEC-For Veterans, and the brand new ELNEC-For Veterans/Critical Care.  Courses are listed below in the order they will be presented. 
  • ELNEC-For Veterans and ELNEC-For Veterans/Critical Care*: July 17-18 in Glendale, CA
  • ELNEC-Summit**: August 23-24 in Washington, DC
  • ELNEC-Summit**: October 11-12 in Portland, OR
  • TBA - ELNEC-Core: November; Pittsburgh, PA (Further information will be posted on the ELNEC Web site by June 1.  This course will be in collaboration with HPNA)
*These 2 courses will be held simultaneously.
**ELNEC Summit—ELNEC-Core, Pediatric Palliative Care, Geriatric, and Critical Care train-the-trainer courses are held simultaneously. 
For more information and/or to register, go to www.aacn.nche.edu/ELNEC
ELNEC-Core Has Undergone a Change
Debuted at AACN Master’s Pre-Conference in February
At the American Association of Colleges of Nursing’s (AACN) Master’s Education pre-conference in San Antonio, TX, February 28-March 1, 2012, three of the national ELNEC Project team faculty presented the new ELNEC-Core curriculum. The curriculum was highly praised for being succinct without a loss of important content. Many ELNEC trainers have reported to the national ELNEC Project Office that it is becoming more difficult to provide a 1 ½ - 2 day ELNEC training course at their facility. Many struggle to hold even a one-day course, due to poor staffing and lack of educational funds. Moreover, to hold a one-day course means rushing through each of the eight modules in the 8 hours delegated.  With this in mind, the 2012 edition of ELNEC-Core has two modules—Cultural Considerations and Ethical Issues—embedded into the remaining six modules (Introduction to Palliative Nursing Care, Pain Management, Symptom Management, Communication, Loss/Grief/Bereavement, and Final Hours). This will allow more time for each of the six modules and still allow for review of concepts within the Cultural Considerations and Ethical Issues modules. Please note that these two modules will be made available in hard copy and on the ELNEC-Core CD-Rom, for those who want to review eight modules. If you are an ELNEC trainer and would like to order this new version, contact Pam Malloy at pmalloy@aacn.nche.edu.
Important Note: You should not be providing ELNEC courses with a CD older than 4 years old (2008 or older).
ELNEC-For Public Hospitals Trainers Making A Difference in Palliative Care Education and Practice   
In the spring of 2011, the ELNEC project was invited to participate in a two-year grant from the California HealthCare Foundation to promote palliative care throughout 16 public hospitals in California. This partnership provided the development of the ELNEC-For Public Hospitals curriculum and a 2.5 day train-the-trainer course that was held in November 2011.  In addition, the Archstone Foundation funded access to video streaming of each of the ELNEC-For Public Hospitals modules through the Hospice Education Network (HEN).  Each month, conference calls are held to update each facility as well as the national ELNEC Project Team about the progress in promoting excellent palliative care for many of the poorest, sickest, and most marginalized citizens throughout California.  With so little state/federal resources, it is amazing to hear about the great work that has taken place over the past six months.  For example, some trainers are using the ELNEC curriculum in new employee orientation; teaching the symptoms module to nurses on medical/surgical and oncology units; collaborating with local schools of nursing to incorporate palliative care into critical care rotations;  and supporting nurses through programs they have developed to prevent compassion fatigue, etc. 
If you currently work in a public hospital in one of the other 49 states and would like to know more about this project, contact Karen Contreras at kacontreras@coh.org
ELNEC-Pediatric Palliative Care Trainers:  Making a Difference for Children and their Families
On April 26-27, 2012, 62 nurses, physicians, social workers, chaplains, and translators attended an ELNEC-Pediatric Palliative Care (ELNEC-PPC) course at the University of Arizona Medical Center, Diamond Children’s Hospital in Tucson. At the completion of the 2-day event, 32 attendees completed the train-the-trainer course and 30 attendees participated in a shorter 4-hour course that presented two modules: Introduction to Palliative Care and Communication. Under the direction of Lori Throne, MSN, RN, BC, Director of Women’s and Children’s Health, and the leadership of Cleo Harden, MD, all in-patient pediatric service areas are currently integrating best palliative and end-of-life (EOL) care evidence into clinical practice across all disciplines. To facilitate seamless transitions of care, local hospices were invited to participate in the course and in the dialogue on how to best support children and families and their decisions to remain in the hospital for hospice care or to die at home.  Dr. Harden stated that the educational opportunities provided by the ELNEC curriculum are brilliant and that the University of Arizona Medical Center will present ELNEC-Critical Care in late 2012 or 2013 to enhance adult palliative and EOL care services. If you would like to know more about this project, contact Karen Contreras at kacontreras@coh.org
ELNEC-For Veterans:  Final National Course to be Held in July
First ELNEC-For Veterans/Critical Care Course Held in April in Durham, NC
On April 3-4, 2012, 101 nurses, physicians, social workers, and chaplains attended the 5th national ELNEC-For Veterans train-the-trainer course in Durham, NC. Over half of those attended the debut of ELNEC-For Veterans/Critical Care train-the-trainer course. The participants represented VA facilities from across 24 states and the District of Columbia. All totaled, over 600 nurses and other interdisciplinary team members have attended one of five national ELNEC-For Veterans train-the-trainer courses since the first course was held 20 months ago. One ELNEC-For Veterans and ELNEC-For Veterans/Critical Care course remains under the VA contract. The final course will take place on July 17-18, 2012 in Glendale, CA (note the venue has been changed from Anaheim, CA to Glendale –a suburb of Los Angeles, CA). Both ELNEC-For Veterans and ELNEC-For Veterans/Critical Care courses will be held simultaneously. Don’t miss this final opportunity to send staff to one of these courses. Though the VA funding will no longer be available for future training after the July 2012 course, the national ELNEC Project Team is exploring ways to continue using this curriculum in 2013 and beyond. For those who work in VA facilities, contact your palliative care program manager if you have a colleague that you would like to send. Those who work in hospices, community settings, acute care facilities, schools of nursing, etc. are also welcome to attend this course. 
The registration form and FAQ are located at http://www.aacn.nche.edu/elnec/trainings/national.
ELNEC-Critical Care is Now Available on HEN
In April 2012, palliative care leaders in critical care video-taped ELNEC-Critical Care for the Hospice Education Network (HEN). These modules, available 24/7 online, are ideal to review during educational meetings, annual competencies, interdisciplinary team meetings, etc. You may subscribe to 1, 2, or all 8 ELNEC-Critical Care modules. Those who presented the modules were: Betty Ferrell, PhD, RN, MA, FAAN, FPCN, Principal Investigator of ELNEC & Research Scientist at City of Hope, Duarte, CA; Marian Grant, DNP, RN, CRNP, ACHPN, Assistant Professor at the University of Maryland School of Nursing, Baltimore, MD; Judith Nelson, MD, JD, Associate Director of the Medical Intensive Care Unit and Respiratory Care Unit at Mount Sinai Medical Center, New York City, NY; Dorothy Wholihan, DNP, MSN, ANP-BC, ACHPN, faculty at New York University School of Nursing and the Bronx VAMC; and Clareen Wiencek, PhD, CNP, ACHPN, Nurse Manager at the Thomas Palliative Care Unit, Virginia Commonwealth University Health System, Richmond, VA. For more information, go to www.hospiceonline.com
ELNEC Faculty Present ELNEC-International in Armenia
Armenian Nursing Leaders Are Committed to Meeting Palliative Care Issues
Pictured from left to right:
Betty Ferrell, Nessa Coyle, Patrick Coyne, Judy Paice, and
Nicoleta Mitrea
On March 19-21, 2012, the first palliative care seminar for Armenian nurses was presented in Dilijan, Armenia, with 35 nursing leaders in education and clinical practice attending. The seminar was supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria, the Ministry of Health, OSF-Armenia, and OSI International Palliative Care Initiative. Due to the tremendous success of the first ELNEC seminar in Armenia, the trained faculty expressed their willingness to introduce the course in  nursing colleges throughout Armenia. Establishment of palliative nursing care specialization in Armenia will be a huge step forward for increasing quality of life of patients with life-limiting illnesses. The need for palliative nursing care is increasing. According to a 2009 needs assessment, conducted in Armenia, over 600 nurses will be needed to care for the 3200-3600 Armenians who will be diagnosed with life-limiting illness annually. Providing palliative care educational programs and training centers are of high priority for the country. Now that ELNEC-International is translated into Armenian, this education will progress more quickly.
ELNEC Trainer Partners with Physician Colleague to Begin Hospice Without Borders                                  
Angela Lee, RN attended her first ELNEC train-the-trainer course in June 2011 in Denver, CO.  Angela attended ELNEC to receive training and materials to take to Rwanda later that year.  With her colleague, David Slack, MD, they both founded Hospice Without Borders, headquartered in University Place, WA.  Hospice Without Borders partners with domestic and international community leaders working to improve access to and quality of hospice and palliative care services to preferentially reach the underserved, marginalized, and destitute sick and dying.  In September 2011, Angela and David travelled to Rwanda, to work with those who have already begun so much of the groundwork in establishing hospice and palliative care in this country.    
Pictured above:
David Slack and Angela Lee
Though much progress in promoting and providing palliative care has been made in other African countries such as Uganda, Kenya, and Zimbabwe, Rwanda is experiencing the pain of “building capacity.” There are many positive indications that Rwanda is on the right path of providing palliative care. For example, the Rwandan Ministry of Health has approved national standards for palliative care and morphine has been placed on the nation’s essential medicine list. To learn more about the impressive work that Angela and David have started, along with wonderful local partners in Rwanda, see their report, visit http://www.aacn.nche.edu/elnec/about/Rwanda-Report.pdf.
If you are interested in learning more about Hospice Without Borders, contact Angela at angela@hospicewithoutborders.com or check out the Web site at www.hospicewithoutborders.com.
ELNEC Monograph Published
The Archstone Foundation, which funded numerous ELNEC-Critical Care and ELNEC-Geriatric training courses for nurses throughout California, has published a monograph titled, ELNEC -  History, Statewide Effort & Recommendations for the Future: Advancing Palliative Nursing Care. This resource provides the 11-year history of ELNEC, describes the statewide effort to educate nurses in palliative care, and offers recommendations on how nursing can provide this care through education, practice and research. To view this monograph, go to www.aacn.nche.edu/ELNEC
Did You Know?
In 2011, 187 regional ELNEC courses were registered through the ELNEC Project Office?  These courses were presented in 39 states, the District of Columbia, and 3 international countries.  In just the first 4 months of 2012, the ELNEC Project Office has received 85 notification forms regarding regional ELNEC courses that trainers are providing to their staff, students, and community partners.  These courses were/will be held in 29 states, and Mexico.  Sixty courses are registered as ELNEC-Core (70%), 16 courses for ELNEC-Pediatric Palliative Care (19%), and 7 courses for ELNEC-For Veterans (8%).  Two additional courses are registered for ELNEC-Critical Care and ELNEC-International (3%).  Most are training courses with 12 (15%) trainers offering train-the-trainer courses.  At this rate, ELNEC trainers will far surpass the number of training/train-the-trainer courses held in 2011.
Important Note: If you plan to hold an ELNEC course, be sure to complete the notification form and send it to the ELNEC Project Office. The form is located at http://www.aacn.nche.edu/elnec/planning-course
By the way...guess which state currently has the most trainings registered for 2012? Massachusetts with 9 registered courses!!!
Earn Online CE for Palliative Care Communication Curriculum Live on CECentral
Four modules, each lasting one hour, are available through CE Central at no cost. You may choose to complete as many modules as you like. The purpose of this study is to assess communication curriculum for an online continuing education format. A certificate of completion will be provided and the activity will be added to the participants’ records of CE activity. For more information, visit www.CECentral.com/COMFORT.
Quick Links
Here are some of the links we use most frequently at the ELNEC Project Office.  Hope you find these helpful.
  • Center to Advance Palliative Care (CAPC): CAPC is the leading resource for palliative care program development and growth. Access essential palliative care tools, education, resources and training for healthcare professionals. 

  • City of Hope Pain and Palliative Care Resource Center (COHPPRC):The purpose of the COHPPRC is to serve as a clearinghouse to disseminate information and resources to assist others in improving the quality of pain management and end of life care. The COHPPRC is a central source for collecting pain assessment tools, patient education materials, quality assurance materials, end of life resources, research instruments and other resources. 

  • End of Life/Palliative Education Resource Center (EPERC): Fast Facts and Concepts provide concise, practical, peer-reviewed, and evidence-based summaries on key topics important to clinicians and trainees caring for patients facing life-limiting illnesses. Fast Facts are designed to be easily accessible and clinically relevant monographs on palliative care topics. They are intended to be quick teaching tools for bedside rounds, as well as self-study material for health care professional trainees and clinicians who work with patients with life-limiting illnesses.

  • Hospice Education Network (HEN): The Hospice Education Network offers a comprehensive and innovative solution to the challenge of providing high quality education for hospice and other end-of-life care professionals. HEN offers courses for new staff orientation, annual in-services, volunteer training, and continuing education for nurses, social workers and counselors.  HEN is the next generation of web-based education, and it is developed specifically and exclusively for hospice and palliative care programs and professionals.  Most of the ELNEC curricula are now available on HEN

  • Hospice and Palliative Nurses Association (HPNA):  Established in 1986, HPNA is the nation's largest and oldest professional nursing organization dedicated to promoting excellence in hospice and palliative nursing care. Under the arm of HPNA are 2 other organizations: The National Board for Certification of Hospice and Palliative Nurses (NBCHPN®)®), which offers specialty certification for all levels of the hospice and palliative nursing care team and administrators.  Currently, NBCHPN® certifies over 17,000 health professionals. Hospice and Palliative Nurses Foundation (HPNF) depends on the generous spirit of individuals, businesses and foundations to support quality of life by enhancing nursing excellence.  Your gift embraces hospice and palliative nursing by generating opportunities for nursing education, research and leadership!

  • Joint Commission Advanced Palliative Care Certification: Launched in September 2011, the Joint Commission’s Advanced Certification Program for Palliative Care recognizes hospital inpatient programs that demonstrate exceptional patient and family-centered care and optimize the quality of life for adult and pediatric patients with serious illness.
Let Us Hear From You!
We are interested in your thoughts and suggestions about end-of-life nursing issues. What would you like to see in this newsletter? Do you have a story to share about how end-of-life nursing education has made a difference for your patients and their families?
Please forward your suggestions or comments to:

Pam Malloy
ELNEC Project Director
202-463-6930 X238
End-of-Life Nursing Education Consortium (ELNEC)