Date of this Version


Document Type

DNP Project


Until recently, palliative care has been synonymous with hospice care for patients with end-stage cancer and other terminal illnesses. However, distinguishing between palliative care services and hospice care for the end of life has begun to slowly increase the understanding of patients and healthcare providers on the benefits of palliative care before the end of the disease trajectory. Early palliative care referrals are beneficial to patients at the onset of an advanced cancer diagnosis and can provide more benefits when referred earlier in the disease trajectory using triggers to alert providers for a patient’s need of palliative care services. Still, there is a gap in the knowledge of the benefits of early palliative care and actual early referrals for patients. The purpose of this project was to examine how in-service education using an information guide regarding palliative care and triggers for early palliative care referral increase Registered Nurses’ (RN) and Nurse Practitioners’ (NP) knowledge of palliative care and triggers for patients with Stage II and Stage III cancers, as compared to their prior knowledge regarding palliative care and triggers?

Data was collected from a sample of 23 Oncology RNs and NPs using the Palliative Care Quiz for Nursing (PCQN) instrument modified to include questions assessing knowledge about early palliative care triggers in a pre-/post-test design.

The scores of the pre- and post-intervention surveys were analyzed in GraphPad. The results of the QI project’s pre- and post-intervention surveys showed improvement in Oncology RN’s and NP’s knowledge about palliative care and triggers for early palliative care referral, attending an education in-service.

In-service education for nurses in Oncology can assist in nurses realizing that palliative care may be needed at any point in a disease trajectory and how using a trigger protocol for symptoms related to physical, emotional, mental, and spiritual suffering will help to standardize referrals to palliative care. Future research is needed to examine the early referral rates to palliative care for Stage II and III Oncology patients before and after the implementation of trigger protocols and subsequently, the impact of the usage of palliative care services on the quality of life of patients in early and advanced stages of cancer.