End of life issues action: impact of education

There is an increased momentum to improve nurses' expertise in dealing with end of life issues via a standardized education program, ELNEC. This program has not been evaluated systematically. This quasi-experimental, longitudinal study's goal was to measure ELNEC Program's impact on registered nurses' death anxiety, death attitudes, and knowledge over time. General Systems Theory provided the foundation. Nurses completed surveys prior to and 3 times after the program. Research and control groups were similar. Research group's death anxiety scores increased immediately post- program, decreased 6 months later (t = -2.65, p = .02) and returned to pre-program levels at 12 months. Death attitudes varied. Knowledge levels improved significantly. The control group had steady increases in death anxiety scores. The program was associated with decreased death anxiety. Recommendations include timing evaluations after participants have time for reflection and planning "booster programs" to sustain effects. Future studies should include larger samples, incentives, and research method triangulation.