Promoting Excellence : ESRD Table of Contents : ENEC Learning Objectives

Education for Nephrologists in End-of-Life Care (ENEC) Learning Objectives

Module 1: Gaps in End-of-Life Care

  1. Describe the current state of dying in America
  2. Contrast this with the way people wish to die
  3. List the 3 most common causes of death in ESRD patients
  4. List the most common characteristics of ESRD patients who elect to withdraw from dialysis and factors that most influence their decisions

Module 2: Giving Bad News

  1. List 3 reasons why communication of bad news is important
  2. List the clinical events in the course of ESRD that are most often considered “bad news”
  3. Identify the 6-step protocol for delivering bad news and what to do at each step

Module 3: Advance Care Planning

  1. Define advance care planning and why it is important
  2. List the steps of advance care planning
  3. List events in the course of ESRD when advance care planning should be updated
  4. Identify pitfalls and limitations of advance care planning

Module 4: Pain Management

  1. Identify different pain types (nociceptive and neuropathic) and common clinical presentations
  2. How to assess pain to initiate intervention, using simple bedside methods
  3. Factors that alter pain therapy in ESRD patients
  4. How to adjust dosage based on re-assessment for effective management and toxicity

Module 5: Symptom Management

  1. How to identify and manage adverse direct (toxic) and indirect analgesic side-effects
  2. Identify variety of secondary symptoms that arise from pain therapy
  3. How to manage the usual complications
  4. How to identify symptoms that may be related to inadequate pain therapy

Module 6: Incorporating Palliative Care into your Dialysis Unit

  1. Identify 3 reasons why palliative care must be incorporated into dialysis units as a standard of care
  2. Discuss the ASN/RPA Guidelines for end-of-life care
  3. List the major barriers to incorporating palliative care into dialysis units
  4. List potential members of the team responsible for incorporation of palliative care and their distinctive roles

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Promoting Excellence in End-of-Life Care is a National Program Office of The Robert Wood Johnson Foundation dedicated to long-term changes in health care institutions to substantially improve care for dying persons and their families. Visit for more resources.

Promoting Excellence