Graduation Year


Degree Type

Open Access Capstone

Document Type


Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Molly Bradshaw-O’Neal

Department Affiliation


Second Advisor

Lisa G. Jones

Department Affiliation



Despite studies indicating the benefits of palliative care, many barriers remain that prevent individuals from accessing this specialty service. Palliative care needs improved utilization. The purpose of this quality improvement project was to improve the utilization of palliative services and increase general knowledge and confidence among nursing staff within one nursing home facility. In the intervention bundle, training was provided on the use of a Palliative Referral Flowchart and the Palliative Performance Scale (PPS) along with evidence-based materials made available to residents and families. Data was collected pre and post intervention. Knowledge was improved by 26 %. Confidence was improved by 50 %. The distribution of handouts was increased by 100 % with utilization of materials being increased by 20 %. Overall referral rates increased by 71 % in 2023 compared to 2022. The average PPS score of referrals increased to 44 % in 2023 as compared to 36 % in 2022. This indicates that the palliative referrals were placed earlier in the disease process. Collectively, the impact of the project was beneficial to nursing staff and indicates educational efforts should continue to evolve in future nursing practice. Literature continues to support that palliative care can positively impact quality of life.

IRB Approval Number (if applicable)


Included in

Nursing Commons