Abstract

Providing competent care at the end of life (EOL) has been recognized as an essential skill for nursing students transitioning to practice (NSTP). EOL has been defined as the phase in which patients enter the terminal stage of a chronic illness or experience an unexpected health decline that ultimately results in death (Hughes et al., 2024). Due to limited EOL education provided in nursing schools, many NSTP have experienced significant anxiety, which has contributed to decreased self-efficacy and reduced competency when caring for patients at EOL (Jablonski et al., 2020). EOL discussions are often not had or minimally discussed due to the nature of the conversation and or the discomfort of the caregiver/provider with the conversation. They were often known to be “taboo” type conversations and therefore not explored or learned about in both the academic and clinical setting. This led to the limited preparation for the NSTP when faced with caring for someone at EOL. The emotional burden from the limited experiences contributed to early attrition from the nursing profession, as some new graduate nurses reported feeling unprepared to provide safe, effective care or manage complex EOL situations (Edwards et al., 2020).

In response to these challenges, the American Association of Colleges of Nursing (AACN, 2025) emphasized the importance of strengthening EOL education within nursing curricula. The identified gap in structured EOL training underscored the need for targeted educational interventions for both pre-licensure education and transition-to-practice programs. This need informed the development of a Doctor of Nursing Practice (DNP) quality improvement (QI) project aimed at enhancing EOL competency through an educational intervention. If NSTP are better prepared to provide safe competent care for patients and families at EOL, it can be anticipated that retention in nursing will improve.

Author Details

Linda J Perez, DNP, RN - 35 years experience as a nurse. Recent DNP, M Admin and MSN

Sigma Membership

Non-member

Type

DNP Capstone Project

Format Type

Text-based Document

Study Design/Type

Clinical Practice Guideline(s)

Research Approach

Mixed/Multi Method Research

Keywords:

End of Life Care, Hospice Care, Terminal Care, Improving Competency of Care, Evaluation of Medical Care, Clinical Competence, Educational Intervention, Simulation, Simulation Methods & Models, Experiential Learning

Advisor

Pamela Stetina

Degree

DNP

Degree Grantor

Northern Arizona University

Degree Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Self-submission

Date of Issue

2026-05-22

Full Text of Presentation

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