Date of Award


Document Type


Degree Name

Doctor of Nursing (ND)

First Advisor

Dr. Alena Groves


By addressing the diseases symptoms directly, palliative care improves patients feel and can participate in their life by providing indispensable holistic health management and support for patients and families. Hospice is the focused service of palliative care, provided by specially trained healthcare professionals. Evidence suggests that patients are poorly educated on chronic illnesses, providers are failing to have end of life discussions with patients, and providers are poorly educated as to services available to patients at end of life. This quality improvement project was designed to assess provider knowledge of hospice and palliative care utilization. Convenience sampling was used to obtain participants. A pre-recorded educational session was conducted online, during which hospice admission criteria, hospice services, and benefits were reviewed. A pre-test and post-test were administered digitally at the time of the session. One month following the completion of session, another digital questionnaire was administered to reassess the same information along with self-reported practice change. A total of twelve participants completed the pre-test, six completed the post-test, and four completed the follow-up surveys. Although the three questionnaires were evaluated as independent samples and responses were not matched, all providers who completed Questionnaire 2 were participants who had attended sessions and previously completed Questionnaire 1. The nurse practitioners that participated cited lack of knowledge and their own desire to treat patients and preserve life as barriers to referring to hospice. Overall, the statistics indicated that increasing provider education only increased hospice referrals in 25% of respondents. Likewise, only 50% of respondents admitted to having made a practice change, despite 100% reporting that they felt more knowledgeable and believed they would refer more to hospice. It is likely that the limitations of the study had a large impact on the outcome of practice change.