The Effect of an Introductory Palliative Care Education Program in Increasing Knowledge and Communication Self-Efficacy Among NICU Nurses

Neonatal palliative care is an essential component of care for the most vulnerable infants and their families, yet its provision in neonatal intensive care units (NICUs) remains inconsistent, in part due to gaps in nurse education and training. This project evaluated the effect of a brief, introductory palliative care education program on NICU nurses’ knowledge and communication self-efficacy. A one-group pretest–posttest design was used at a private hospital NICU in northern California, where 25 NICU nurses completed a 20-minute self-study video and a small-group role-play session covering the SPIKES and NURSE communication tools. A 10-item investigator-developed survey measured knowledge and self-efficacy at baseline, immediately after training, and 4 weeks later. Mean self-efficacy scores rose from 16.7 at baseline to 19.2 immediately after training and 20.1 at 4-week follow-up, with statistically significant immediate and lasting gains in self-efficacy and overall scores ( P < .001), although knowledge gains did not reach statistical significance. Prior infant death experience did not affect gains; however, nurses without prior palliative care education showed significantly greater lasting gains in knowledge and overall scores than those with prior training. Four weeks after training, all participants recalled the communication tool acronyms, and 68% reported using them in practice. This brief, low-cost program improved NICU nurses’ communication self-efficacy and can be readily incorporated into NICU orientation and continuing education.