Palliative Nursing Commons^™

Joyful Nursing By Leading With Heart In Perinatal Loss Care And Staff Wellness, Kelli Griffiths, Holly Puckett, Bruce Slagle

Montview Journal of Research & Scholarship

This quasi-experimental study evaluates if providing individualized follow-up care through self-care bags, follow-up phone calls, open communication for debriefing, and tailored mental health resources enhances support for obstetric staff and improves their ability to care for patients experiencing perinatal loss. Interventions were implemented from February 2024 to August 2024. A total of 103 self-care bags were distributed throughout the designated hospital systems’ two labor and delivery departments. A five question post-intervention survey was conducted and found the following question to be statistically significant, “I feel the joy in nursing would be restored, to a degree, if obstetric staff were more …

Nurses' Comfort Toward Caring For The Dying: A Cross-Sectional Descriptive Study, Candies Warren

ATU Theses and Dissertations 2021 - Present

The purpose of this quantitative cross-sectional descriptive research study was to explore nurses’ comfort levels toward caring for dying patients and what factors influence the bedside nurses’ comfort levels in providing end-of-life care in an acute care hospital setting. A convenience sample (N=63) of RNs voluntarily participated in an online survey from January 2025 to March 2025 that provided direct patient care. Data was collected through Question Pro. Data collected included sociodemographic questions, questions about current comfort level, factors that influence nurses’ comfort level, and selected items from the Frommelt Attitude Toward Care of the Dying Patient (FATCOD) scale. Institutional …

Standardizing Care: Strengthening Dka Protocol Implementation Among Emergency Department Nurses, Toni Joy Angelique Biliran Miculob

Master's Projects and Capstones

Objective: The objective of this project was to address the inconsistent understanding and utilization of the Diabetic Ketoacidosis (DKA) protocol in a high-acuity emergency department within a large hospital system, where baseline survey results showed that 84% of nurses found the DKA order set confusing and only 15% felt “very comfortable” applying it.

Aim: The aim was to improve nurse clarity, confidence, and consistency in using the DKA protocol to support timely, evidence-based management of this high-risk, time-sensitive condition.

Methods: The intervention consisted of brief, targeted education delivered during pre-shift huddles across day and night shifts, focusing …

Planning For Prevention: Implementing Pressure Injury Bundles In Hospice Settings, Ellie M. Martin, Mckenzie Pool

Scholars Week

There is an increased prevalence of pressure-related injuries in the hospice setting. This can be due to age, diagnosis, comorbidities, inadequate nutrition or hydration, lack of mobility, or inadequate care due to lack of education. Prevention bundles and policies are at every facility, but are not as effective as needed. This looks at the theoretical framework and ways to prevent pressure injuries as effectively as possible. Pulling information from multiple other research studies to put the best care bundle together to decrease the amount of pressure injuries.

Palliative Care Conditions Managed At Home And Self-Reported Challenges Experienced By Informal Home-Based Caregivers In Rwanda: A Qualitative Study, Jean Claude Twahirwa, Madeleine Mukeshimana, Margaret Fitch, Godfrey Katende

School of Nursing & Midwifery, East Africa

Introduction: A greater dependency on informal home-based caregivers to assist patients in their homes stems from Rwanda’s rising palliative care needs and the burden of terminal illnesses. These caregivers play a critical role in addressing patients’ physical and emotional needs and assisting with daily activities. However, in low-resource settings like Rwanda, limited attention has been given to understanding their lived experiences and the challenges they face. This study primarily aimed to explore the lived experiences and caregiving challenges of informal home-based caregivers providing palliative care. A secondary aim was to describe the range of life-threatening conditions being managed at home …

Implementing Pain Reassessment Workflow To Improve Timely Pain Management In Hospice Patients: A Quality Improvement Project, Oluremi Omodara

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Timely pain reassessment is a vital component of hospice care, directly influencing the quality of life for patients. Despite the high prevalence of pain, which affects 55% of hospice patients due to disease progression or adverse drug reactions, only 51% of those reporting moderate to severe pain at admission receive a documented reassessment. The gap highlights an organizational issue in pain management stemming from the absence of a clearly defined period and workflow for reassessment.

Aim of the Project: The aim of the quality improvement (QI) project was to improve compliance with pain reassessment documentation within 48 hours …

Psychometric Properties Of The Turkish Version Of The Palliative Care Attitude Scale (T-Pcas-9) In Cancer Patients, Sevgi Demir Çam, Neşe İşcan Ayyildiz, Hasan Evcimen, Timüçin Çil, Berna Bozkurt Duman

Makara Journal of Health Research

Background: A reliable, validated Turkish measurement tool will allow researchers to measure the impact of attitudes towards palliative care on other health outcomes in individuals with chronic and critical illness. This study aimed to examine the Turkish psychometric properties of the Palliative Care Attitude Scale (PCAS-9) for individuals with cancer.

Methods: The Turkish adaptation of the PCAS-9 (T-PCAS-9) included 505 cancer patients, who were aged >18 years, had a diagnosis of cancer, and no mental problems. The factor structure of the T-PCAS-9 was examined using exploratory factor analysis, confirmatory factor analysis, convergent-divergent validity, and measurement invariance analysis.

Results: The three-factor …

Evaluation Of Palliative Care Awareness Among Hospitalized Patients And Their Relatives In Türkiye, Füsun Uzgör, Ayşe Özkaraman, Hülya Özen

Makara Journal of Health Research

Background: Today, with the advances in medical knowledge and technology, chronic diseases have increased worldwide in parallel with the prolonging life expectancy and the aging of the population. This has increased the need for palliative care in the delivery of medical services. This study aimed to evaluate the palliative care awareness and level of knowledge of inpatients receiving health services in a university hospital and their relatives in Türkiye.

Methods: This cross-sectional study was carried out with 360 patients and their relatives who volunteered to participate in the research. The study data were collected in face-to-face interviews using …

Living With Disability After Spinal Cord Injury: A Grounded Theory Methodology, Diaa K. Abd Ali

Al-Ameed Journal for Medical Research and Health Sciences

Study Design: A Grounded Theory Methodology is employed to investigate the study phenomenon. the entire study started from Jan. 15^th. 2021 to March, 1^st. 2022.

Aim: The study is conducted to explore the concepts that shape the experience of living with disability among patients with spinal cord injury, and to formulating a grounded theory regarding nursing care for patients with spinal cord injuries.

Setting: The study is conducted in Ibn Alkuf Hospital for Spinal Cord Injuries, Baghdad, Iraq.

Methods: A non-probability purposive sampling technique was used to select (12) patients with chronic (more than 5 years) …

Factors Informing Referral Of Adult Patients To Palliative Care Services In A Tertiary Facility In Kenya: Physicians' Perspective, Donnah A. Opiyo

Master of Medicine in Family Medicine

Background The growing burden of chronic diseases underscores the urgent need for palliative care integration into healthcare systems worldwide. Despite its benefits, palliative care remains underutilized due to various barriers, including health system limitations, institutional challenges, infrastructure gaps, and individual provider factors. However, limited research has explored the specific factors influencing physicians' decisions to refer patients to palliative care. This study sought to fill that gap by examining the key determinants shaping referral practices in a tertiary facility in Kenya.

Design and Methods This exploratory qualitative study examined 22 physician specialists from five departments at Aga Khan University Hospital, Nairobi. …

Palliative Care Beyond Cancer: The Use Of The P-Cares Tool, Breslin E. Meyer

Dissertations

Emergency Departments (EDs) often lack the necessary resources and protocols to provide comprehensive palliative care, resulting in inadequate pain and symptom management (Stoltenberg et al., 2022). This study investigates the potential transformative impact of a palliative care consultation on patients with advanced disease who screen positive using the validated P-CaRES tool. The PICOT questions: Will patients with end-stage COPD, CHF, and or other chronic conditions benefit from P-CaRES screening in the emergency department over nine weeks and receive more palliative care consultations from their primary care providers?

This project was conducted over 9 weeks, utilizing convenience sampling to select 20 …

Unsuitable Underlying Cause-Of-Death Statements: Implementation And Evaluation Of A Structured Process For Healthcare Providers Certifying Natural Causes Of Death In An Outpatient Setting, Naida Rutherford

Doctor of Nursing Practice Projects

Background: Accuracy in death certification is crucial for effective public health initiatives. Inaccuracies in unsuitable Underlying Cause-of-Death (UCOD) statements can distort mortality statistics, influence health policy, and impact resource allocation. In South Carolina, changes in the death registration process and the introduction of an unsuitable cause-of-death list highlighted an urgent need for structured training among certifiers to enhance accuracy in death documentation.

Purpose: The purpose of this project was to implement a standardized training program for healthcare providers certifying natural causes of death and assessing the impact of reducing the unsuitable underlying cause-of-death inaccuracies in an outpatient hospice setting.

Project …

Decreasing Burdensome Transitions In Hospice Care By Increasing Nursing Visits, Kristin S. Rivers

Doctor of Nursing Practice Projects

Background: Burdensome transitions occur when hospice patients discontinue hospice services to seek hospital treatment, often disrupting end-of-life goals and creating distress for patients and caregivers. These transitions continue to rise throughout the country, highlighting the need for strategies to support patients in remaining at home throughout the dying process.

Purpose: This quality improvement project aimed to decrease hospital transitions by increasing nursing visits for hospice patients at high-risk for burdensome transitions.

Project Design: This quality improvement project used a Plan-Do-Study-Act methodology to form and implement an intervention to reduce burdensome transitions. Patients were already identified as low or high-risk …

Bereavement Needs Of Parent-Child Dyads Following Sibling Death, Shannon V. D'Alton

MUSC Theses and Dissertations

In the United States, nearly 62,000 children and adolescents experience the death of a sibling each year and sibling bereavement is one of the most distressing life events during childhood; however, it has received less attention in research compared to other forms of childhood loss. Bereaved siblings and parents are at increased risk for negative physical and psychological outcomes, yet little is known about their support and resource needs during the early years following the death. A limitation in understanding sibling bereavement is the methodological and ethical challenges of researching this vulnerable population. Consequently, the bereavement needs of surviving siblings …

Evaluation Of An External Urinary Device Protocol And Practices In Hospitalized Female Patients: A Quality Improvement Project At A Rural Midwestern Hospital, Melissa Leibnitz, Ashley Causa, Susana Lopez

Doctor of Nursing Practice Projects: College of Nursing

Aims and Objectives- 1: Describe and measure current implementation and management practices of the PureWick™. 2: Describe and measure current outcomes in the use of the PureWick™ device including mobility scores, skin breakdown, Braden scores, moisture-associated dermatitis, CAUTIs, PAUTIs, hospital LOS, HAIs and HPIs. 3: Measure the survey results from staff regarding the current PureWick™ practices. 4: Propose recommendations for an improved EB protocol for the PureWick^TM.

Background: Currently, the PureWick^TM device has been utilized by facilities as an alternative to indwelling urinary catheters in an effort to reduce the incidence of CAUTI. Since the introduction …

Implementation Of A Standardized Pain Assessment Tool To Drive Opioid Management In End-Of-Life Patients In A Medical Intensive Care Unit, Sonia Carrizales

Doctor of Nursing Practice Final Project Abstract

Purpose

This quality improvement project implemented a standardized pain assessment tool, the Multidimensional Observational Pain Assessment Tool (MOPAT), to drive opioid administration for end-of-life (EOL) patients. This project intended to increase opioid administration to EOL patients through increased confidence levels noted in bedside staff with the use of a standardized pain assessment tool.

Background

The project was implemented in a thirty-two-bed adult medical intensive care unit in Round Rock, Texas. The patients focused on in this project were those transitioned to EOL care.

Methodology

A pre-and post-survey was sent to bedside staff to gauge confidence levels. The MOPAT was then …

Use Of Interdisciplinary Rounds For The Identification Of Hospitalized Adults In Need Of Palliative Care, Brenda A. Blunt

Evidence-Based Practice Project Reports

Palliative care (PC) is specialized care that aims to provide relief from the stress and symptoms of living with a serious illness (Center to Advance Palliative Care, 2022). PC services are often underutilized in the hospital, leaving a significant number of patients with unmet needs (Haranis et al, 2023; Kawashima & Evans, 2023; Smith et al, 2019). The purpose of this evidence-based practice project was to improve processes for identifying hospitalized patients for referral to specialty inpatient PC. The intervention involved interdisciplinary rounds (IDR) for adult inpatients on two medical-surgical (MESG) units in an 84-bed community hospital in suburban Milwaukee, …

Analyzing The Effectiveness Of Providing Religious And Spiritual-Based Care For Patients Currently Receiving Palliative Care Services, Rachel Ann Bruce, Cynthia Dien, Kinnice Jordan Turner, Rebecca Kay Tisdale

Student Scholar Showcase

This literature review explores the effectiveness of providing spiritual and religious-based care to patients currently receiving palliative care settings. In the context of this research, palliative care is defined as the six month period before a person’s death. By examining peer-reviewed journal articles from 2020 to 2024, this literature review will incorporate findings from multiple studies (both qualitative and quantitative) in order to effectively compare and contrast spiritual and religious beliefs and practices for patients receiving palliative care. After thorough examination, collected research has demonstrated that individuals who receive both timely and frequent religious and spiritual-base care while on palliative …

Nursing Education On The Health Benefits Of Animal Assisted Therapy, Sara C. Barker, Allie P. Dunlap, Daniel T. Do, Charde Willis

SPARK Symposium Presentations

Background: Does nurse education for pediatric oncology families teaching daily animal-assisted therapy (AAT) health benefits reduce anxiety from 35% to 18% compared to current practice?

Methods: A literature search was conducted using CINAHL (356 articles), PubMed (412 articles), and Google Scholar (289 articles) with keywords including animal-assisted interaction, pediatric cancer, pet therapy, psychological support, caregivers, and psychosocial outcomes. Filters applied included peer-reviewed articles, English language, full text, publication within the last five years, randomized controlled or quasi-experimental study design, and relevance to nursing practice. 4 articles were chosen due to being directly relevant to education related to AAT and psychosocial …

Advancing Provider Knowledge On Precedex Use To Prevent Postoperative Delirium Through Targeted Education, Brian Gibbs

Scholars Week

Postoperative delirium (POD) is a serious and multifactorial complication commonly affecting elderly surgical patients. POD is associated with increased morbidity, longer hospital stays, and higher mortality rates. The use of benzodiazepines and opioids during the perioperative period is a significant modifiable risk factor for POD. Despite the potential of Dexmedetomidine (Precedex) to reduce POD incidence due to its sedative, and analgesic properties, it is not widely available in many operating rooms (OR). This project aimed to educate anesthesia providers on the benefits of Precedex and its role in reducing POD in patients over 65 years old. A quality improvement project …

Medical Aid In Dying Education For Hospice Nurses, Ian Woo

Nursing | Senior Theses

Background: Medical aid in dying (MAID) is an option surrounding end-of-life care for hospice patients. This process gives patients the autonomy to end their life during the time and location of their choosing. MAID is growing in legalization and practice across the US. However, many nurses feel uncomfortable or unprepared when providing care for patients contemplating it. Hospice nurses should have confidence in their ability to care for patients through the process of MAID. Objective: To evaluate the effectiveness of education in strengthening new hospice nurses’ ability to care for patients through the process of MAID. Method: The research will …

Optimizing Advance Care Planning: Leveraging An Electronic Medical Record Prompt To Impact Advance Directive Documentation, Annette L. Meares

Doctor of Nursing Practice Scholarly Projects

Abstract

Background: Advance Directives (ADs) support patient-centered care by documenting preferences for future medical treatment. While the Centers for Medicare & Medicaid Services (CMS) incentivizes AD documentation through billing codes, national adoption remains low.

Local Problem: A rural Northern Illinois primary care practice had electronic referral capabilities for ACP; however, referrals remained low and inconsistent during Medicare Annual Wellness Visits (AWVs), limiting opportunities for AD completion.

Methods: This quality improvement project targeted Medicare AWV patients without ADs documented in the electronic medical record (EMR). During a 10-week pre-intervention period, baseline data were collected. In the subsequent 10-week intervention phase, an …

Implementation Of The Nurse-Driven Palliative Care Referral Protocol: A Quality Improvement Project, Khrystyna Lacombe

Doctor of Nursing Practice Scholarly Projects

Implementation of the Nurse-Driven Palliative Care Referral Protocol

Background and Purpose: Palliative care enhances quality of life, symptom management, and patient–family communication for individuals with serious illness. Despite strong evidence and national recommendations for early integration, referrals remain inconsistent and often occur late. At Advocate Sherman Hospital, only 17.9% of eligible oncology inpatients received palliative care consults. The absence of standardized referral criteria, reliance on provider discretion, and misconceptions equating palliative care with hospice contributed to delayed or missed consults. The purpose of this quality improvement (QI) project was to increase palliative care referrals by 20% within eight weeks through …

Perception Of Spirituality By Intensive Care Unit Nurses, Adejoke Felicia Ogidan

Nursing Dissertations - Archive

ICU nurses are identified as a population of nurses with a high risk of experiencing psychological stress due to the nature of their job in the ICU (Lyndon, 2015; Welp et al., 2015). Psychological stress is detrimental to nurses' mental health and the quality of patient care.

According to Watson’s Transpersonal Human Caring Theory, the spiritual perception of the nurse influences the nurse’s spiritual care practice, which in turn affects their self-care and care provided by the nurse to patients (Watson, 2021)This research explored the ICU-Ns' perception of spirituality and its relationships with spiritual care practices and self-assessed competency in …

Bibliography, Mary P. Bennett

Faculty/Staff Personal Papers

Bibliography of publications by Mary Bennett.

Reducing Anxiety And Burden: The Effect Of Caregiver Education In Hospice Care For Immigrant Families, Nicole Maria

Nursing | Senior Theses

Purpose

The purpose of this research proposal is to explore the impact of early mental health screenings, comprehensive education, and support in alleviating caregiver burden and anxiety among hospice immigrant family caregivers.

Methods

This research proposal will evaluate the effectiveness of caregiver education and mental health screenings. Baseline data will be collected using the Zarit Burden Scale and the State-Trait Anxiety Inventory (STAI). After interventions are implemented, a post survey will be conducted to evaluate the effectiveness.

Results

If the findings are statistically significant, they will support the hypothesis that caregiver education can reduce burden, improve caregivers’ mental well-being, and …

Early Palliative Care In Heart Failure, Meadow Stempek, Beverly Balfe, Jennifer Tantarelli

Articles, Abstracts, and Reports

No abstract provided.

Preparing For Loss: The Impact Of Hospital-Based Parental Death On Sibling Relationships, Elyssa Thea Cajilig

Nursing | Senior Theses

The death of a parent is a profound and life-altering experience, especially for children and adolescents, who no longer have a parental figure to guide them through the struggles of processing grief and adjusting to life. Objective: The purpose of this study is to examine the impact of hospital-based parental death preparations on sibling relationships after the loss of a parent. Methods: This quasi-experimental, mixed method longitudinal study will explore the impact of structured hospital-based bereavement support on the quality of sibling relationships after parental loss. Quantitative surveys will assess relationship dynamics at three time points: immediately post-loss, 2 years …

Nursing Students’ Attitudes And Preparedness For Maid, Kristal Candray

Nursing | Senior Theses

Medical assistance in dying (MAiD) also known as physician-assisted suicide in addition to euthanasia is on the rise with an increase in decriminalization of the practice(s) and enactment of practice-protected policies in many countries. Ethics and morals on the subject continue to be controversial in healthcare. As student nurses enter the field as clinicians, they may encounter a patient requesting MAiD. Studies from students in other countries where MAiD and/or euthanasia is practiced found that student nurses do not feel adequately prepared to navigate such situations. However, although MAiD has been legalized in a handful of states within the United …

Preparing Nurses For Medical-Assistance In Dying: The Role Of Comprehensive Education And Training, Keira O'Reilly

Nursing | Senior Theses

Medical-assistance in dying (MAID) is a process in which a consenting patient self-administers lethal medications with the intent of ending their life. This process is marked with ethical, emotional, and spiritual complexities. Nurses play a key role in MAID, through providing care as well as being a patient advocate. Specifically, intensive care unit (ICU) nurses often provide care to critical or terminally ill patients. However, according to the research, little formal training or education about MAID has been put into place for ICU nurses. To investigate, primary research articles regarding healthcare professionals’ experiences with MAID, educational gaps, and current training …