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Document Type

DNP - University Access Only

Award Date


Degree Name

Doctor of Nursing Practice (DNP)


Graduate Nursing

First Advisor

Mary Isaacson


palliative care, rural, PCKT, C-COPE, PPSv2, ELNEC


Palliative care (PC) is an interdisciplinary approach to improving the quality of life of patients with life-threatening illnesses. The early implementation of PC may be delayed when healthcare professionals lack knowledge or have been inadequately trained in the delivery of PC, especially in the rural area where specialized PC programs are not readily available. A convenience sample of rural nurses received PC education based on the End-of-Life Nursing Education Consortium curriculum. A pre-/post-test approach using the Palliative Care Knowledge Test to measure nurses’ PC knowledge and the Comfort with Communication in Palliative and End of Life Care to assess comfort was utilized. A statistically significant increase in nurses’ PC knowledge occurred following education provision; no change in nurses’ comfort in end-of-life (EOL) and palliative communication was recognized. The Palliative Performance Scale Version 2 (PPSv2) was implemented as a nurse-driven PC screening tool. There was a seven-fold increase in the number of patients identified as PC candidates when compared to data from one year prior. No increase in PC referrals occurred. Recommendations for future projects include offering PC education to rural providers in addition to rural nurses, screening patients in the clinic setting using the PPSv2, and considering other factors that may affect nurse comfort in palliative and EOL communication since this DNP Project found no correlation between PC education and nurses’ comfort level.

Library of Congress Subject Headings

Palliative treatment.
Rural nurses -- Attitudes.


Includes bibliographical references



Number of Pages



South Dakota State University


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