Symptom management protocol and hospice nurse educational intervention improves management of exacerbated symptoms
MetadataShow full item record
Type of Work97 pages
ProgramDoctor of Nursing Practice
End of life
Symptom management protocol
Problem Statement: Hospice nurses are responsible for managing patient exacerbated symptoms, although research has shown that symptom management at end of life is deficient. The symptom management protocol (SMP) utilized by a rural hospice organization is not sufficient, causing nurses to struggle with the management and documentation of exacerbated symptoms. Purpose: The purpose of this DNP project was to determine if a revised SMP and related educational intervention will increase hospice nurse self-efficacy, and subsequent improvement in documentation, and follow-up care. Methods: Self-efficacy of the nurses related to the SMP was measured using a Palliative Care Self-Efficacy Scale and retrospective medical record chart audits comparing three months pre- and post-implementation documentation of patient symptom management provided by hospice nurses. Results: SMP implementation did demonstrate an increase in nurse self-efficacy related to symptom management over the three-month timeframe. Run Charts revealed an initial increase in nurse documentation of symptom management and follow-up; however, there was decline during the last month of the post-SMP implementation phase, indicating the necessity of ongoing protocol education. Significance: Adequate symptom management by hospice nurses leads to improved patient outcomes and quality of life, and adequate documentation of exacerbated symptoms will ensure the hospice organization will meet regulatory standards.