Targeted Morphine Administration Training to Enhance Nurses' Knowledge and Self-Efficacy for End of Life Dyspnea

Dyspnea is a prevalent and distressing symptom at the end of life (EOL), affecting up to 90% of dying patients and causing significant suffering for patients and families. Morphine sulfate remains the standard pharmacological treatment for refractory EOL dyspnea, effectively modulating central respiratory drive and alleviating breathlessness perception, distinct from its use in chronic stable breathlessness, where recent evidence shows limited benefit and potential harms. Many nurses, however, lack adequate knowledge and confidence in administering morphine appropriately due to misconceptions about addiction, respiratory depression, and hastening death. This quasi-experimental study evaluated a brief online training module on morphine administration for EOL dyspnea among registered nurses. Of 69 enrollees, 34 provided complete pre- and post-intervention data. Paired t tests revealed significant improvements in knowledge and self-efficacy. These findings highlight the value of targeted, scalable education in addressing knowledge gaps, enhancing nurse confidence, and supporting evidence-based EOL symptom management.