Identification and validation of end-of-life nursing care competencies for Kenyan nurses: A modified Delphi technique

Abstract

Background: The number of patients requiring end-of-life care in acute care hospitals in Kenya continues to increase due to increases in non-communicable diseases. Despite advances in the field of palliative care (PC), its utilization is deficient in our setting, particularly at the end of life. Many patients and family members have unmet needs during the end-of-life phase. The aim of this study was to identify and validate end-of-life nursing competencies required by non-specialized nurses in Kenya. Validation of competencies for end-of-life care would help to develop relevant professional development programs in palliative care for these nurses. Methods: A two-round modified Delphi study was conducted. A 20-member panel of specialists in end-of-life care was involved in the identification and validation of the end-of-life nursing care competencies. Results: The results highlighted a total of eight core competencies namely: palliative nursing care; pain management; symptom management; ethical-legal issues; psychosocial, cultural and spiritual considerations; communication; loss, grief and bereavement; and death and dying. Additionally, 92 sub-competencies were identified that general nurses should possess within three domains of learning: knowledge (43 competencies), attitude (17 competencies), and practice/skills (32 competencies). Conclusions: The study forms a basis from which the identified end-of-life competencies can be utilized for continuous professional development programs for general nurses in acute care hospitals. Such programs could enhance the capacities of the general nurses and promote the integration of end-of-life care in acute care hospitals, thus improving the outcomes in quality of life for patients and families. Keywords: palliative care, end-of-life care, nurse competencies, Kenya