Rapid Communication| Volume 77, P1-5, April 2023

Enhancing Palliative Communication in the Intensive Care Unit Through Simulation: A Quality Improvement Project

Published:February 25, 2023DOI:


      • Palliative communication is an essential component of end-of-life care, affecting patient and family experience as well as nurse moral distress and job attrition.
      • Multifactorial constraints on end-of-life care content in prelicensure training programs have placed the onus on hiring organizations to provide training in palliative care competencies.
      • A simulation-based learning experience increased critical care nurse comfort with palliative communication when combined with the End-of-Life Nursing Education Consortium adult critical care course.
      • Qualitative feedback indicated that the simulation experience provided valuable hands-on experience for practice of palliative communication techniques.



      Palliative communication is a vital aspect of patient and family-centered end-of-life care in the intensive care unit. Despite this, specialty-specific training and education in palliative communication are generally limited for critical care nurses. The purpose of this quality improvement project was to assess the effect of adding a simulation-based learning experience to the existing End of Life Nursing Education Consortium adult critical care course on critical care nurse comfort with palliative communication as a component of end-of-life care.


      Using a pretest/post-test design, 11 critical care nurse participants completed a measure of comfort related to end-of-life communication prior to the course and immediately following the simulation experience.


      A paired-samples t-test showed a statistically increase in comfort with palliative communication from the pretest (M = 56.36, SE = 2.40) to post-test (M = 48.27, SE = 2.97), t (10) = 2.54, p = .30 (two-tailed), The mean decrease in scores was 8.09, 95% CI (0.98, 15.91). Qualitative survey responses indicated that the simulation provided valuable practice of palliative communication techniques.


      A simulation-based learning experience incorporated into an existing palliative care education course is feasible to implement and increased critical care nurse comfort with palliative communication at end-of-life.


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