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The Palliative Care Educational Resource Team
(PERT) Program:
An Educational Partnership to Improve
End-of-Life Care in Nursing Homes
R25 CA82563
PERT is a comprehensive educational program designed to improve end-of-life care in long-term care facilities. Funded by the National Cancer Institute (grant R25 CA82563), a division of the National Institutes of Health, and supported by Swedish Medical Center, the PERT Program gives participants end-of-life information, skills, resources, and real-life solutions to add to their expertise in long-term care.
This section of the PERT Website provides extensive background information on the program, the rationale behind the structure of the program, a history of program implementation, and a synopsis of the feedback and study results to date.
- For ease of navigation, this page is divided into the following sections:
Specific Aims
- The goals of the PERT Program are to:
- Test and refine an educational intervention that focuses on increasing the clinical knowledge and skills of licensed staff and certified nursing assistants in nursing homes.
- Increase the knowledge, skills, and confidence of licensed staff and certified nursing assistants in nursing homes regarding end-of-life care.
- Improve collaboration by providing opportunities for nursing home staff and palliative care team members to share knowledge, ideas, and concerns.
- Document the effectiveness of this educational intervention in improving end-of-life care in nursing homes.
A Spotlight on Nursing Homes
Currently, nearly one-third of Washington State residents who die as a result of chronic illness, do so in a nursing home. Based on this trend, provision for ensuring palliative and hospice care in nursing homes is essential.
- Palliative and hospice care encompass several goals, including:
- Identification and documentation of goals for care
- Effective prevention and/or management of end-of-life symptoms such as pain and dyspnea
- Attention to psychosocial and spiritual issues and prevention of suffering
- Completion of developmental tasks related to the dying process
- Successful negotiation of grief and bereavement
Palliative and hospice care incorporates the needs of both the dying resident and his or her caregivers.
Education is the Key
Research has shown that many clinicians in a variety of health care settings lack the knowledge and training necessary to provide high quality end-of-life care. Many groups of experts, including the Institute of Medicine, American Nurses Association, and the American Association of Colleges of Nursing, call for improved basic and continuing education to improve clinicians' abilities in caring for dying patients.
Through the course of the project, PERT staff have tested, refined, and implemented a comprehensive educational program to enhance the skills of licensed nursing staff and certified nursing assistants who provide end-of-life care in nursing homes.
Areas of Focus
- The PERT Program curriculum is designed to incorporate education and discussion on several key aspects of end-of-life care. These areas of focus include:
- Pain management
- Management of other end-of-life symptoms
- Communication
- Ethical issues
- Psychosocial and spiritual issues
- Cultural diversity
- Providing care to cognitively impaired patients
- Quality improvement
Implementation
The PERT curriculum has been delivered via three routes.
- PERT Classes
The PERT Program offered a series of four classes for both licensed nursing staff and certified nursing assistants working in nursing homes. The classes each lasted approximately eight hours, and occurred over a period of four to five months. The class content included discussion, lecture, role-play, case studies, and other interactive learning activities.
In 2002 through 2004, the PERT classes were conducted three times throughout Western Washington. The classes provided participants from  approximately 40 nursing homes with new knowledge and skills that they were encouraged to share with other staff. These classes have also created opportunities for participants to network with colleagues both at participating facilities and within the palliative care community.
Follow this link for a list of long-term care facilities that sent staff to participate in the PERT classes.
PERT participants were asked to take a pre- and post-course test, complete questionnaires, and take part in a care conference. In this way evaluations can be performed to determine the effectiveness of the program.
- Trainer Workshops
After delivering three cohorts of PERT classes, the PERT investigators changed the focus to providing content through “train-the-trainer” style workshops. In 2004, the PERT Program twice offered a free, two-day workshop on care for the dying. These workshops were educational events intended for staff development coordinators, nurse educators, and hospice program case managers working in nursing homes.
Held in Spokane and Seattle, Washington, the PERT Trainer Workshops were attended by 87 nursing education professionals from 59 different facilities from throughout Washington, Oregon, and Idaho.
Follow this link for a list of long-term care facilities and hospices that sent staff to participate in the PERT Trainer Workshops.
Participants received a wealth of educational materials, including a PERT curriculum syllabus; a CD-ROM containing the PERT curriculum, forms, activities, presentations, and other valuable teaching tools; and two full days of instruction covering a complete curriculum on providing end-of-life care, with strategies for presenting the material to staff.
Workshop atmosphere was energetic and highly collaborative and the teaching materials were well received. Participants were expected to bring the PERT curriculum back to their facilities to share with other staff.
- PERT Program Website
This website complements the PERT curriculum and provides resources to participants outside of the classroom setting.
The major goals of this website are to:
- Continue making the PERT Curriculum accessible to nursing home staff and educators
- Communicate clinical information about end-of-life care delivered in nursing homes
- Encourage networking activities
- Provide opportunities for nursing home staff to share their expertise on end-of-life care
The PERT Classes and Trainer Workshops are now complete. The PERT website continues the program's educational efforts. The PERT faculty and staff encourage nurses and nursing aides to make use of this website, take advantage of the PERT educational materials and networking opportunities, and share this information with others providing end-of-life care.
Results and Reactions
The PERT Program is a research study, and results and outcomes of the study are an important aspect. Much of the study results to date have been in the form of participant feedback and reactions. Some preliminary data analyses have also been completed.
- Currently accessible study results include:
Check back to the PERT Website to view additional data analyses, which will be posted as they become available.
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