Document Type

DNP Project


School of Nursing

Date of Degree

Spring 2018


Doctor of Nursing Practice (DNP)

Primary Advisor

Ellen Kurtzman, PhD, MPH, RN, FAAN; Margaret Barton Burke, PhD, RN, FAAN


Background: Approximately 1.66 million Americans are diagnosed with cancer each year and another 589,430 die from the disease. As treatment options have expanded, many cancer patients are living longer with worsening symptoms and disabilities and an increased illness burden. These patients are ideal candidates for palliative care. Palliative care involves care delivered by a team of clinicians with specialty training and a focus on improving the quality of life for patients with serious illnesses. A number of major organizations have made formal recommendations regarding the integration of palliative care into comprehensive cancer care including the American Society of Clinical Oncology and the National Comprehensive Cancer Network. With an advanced education and scope of practice, a holistic orientation, and an evidence-base that substantiates their provision of safe and effective care, nurse practitioners (NPs) are well positioned to improve access to palliative care; yet, many NPs lack basic knowledge of palliative care and do not have competencies to provide such care.

Objectives: This project aimed to measure differences in NPs’ knowledge of basic palliative care concepts and their self-rated self-competence in the provision of its care before and after a formal education program.

Methods: This study used a one-group pre-post test design and valid and reliable instruments to measure the effects of an education intervention on NPs’ knowledge of basic palliative care and self-reported self-competence. The content for the education intervention, which was drawn from the End of Life Nursing Education Consortium’s (ELNEC) Advanced Practice Registered Nurse (APRN) curriculum, was delivered in one 8-hour program. The sample included NPs who practiced in the regional network sites of a National Cancer Institute designated comprehensive cancer center. Statistical differences were tested using paired t-tests, and a Wilcoxon Signed Ranks test.

Results: A total of 37 NPs participated in the program. Knowledge, as measured by the ELNEC KAT increased from a mean of 89.03 to a mean of 90.49. Paired samples t tests revealed a statistically significant difference between the mean pre and mean post-test scores (t =-2.165, df =36, p= .037). Self-reported self-competence as measured by the PCNSC increased from a mean of 3.21 to a mean of 4.10. Paired samples t tests revealed that the difference between the mean pre and mean post PCNSC score was statistically significant (t =-9.202, df =36, p= .001).

Conclusion: A one-day course based upon the ELNEC APRN clinical modules was effective in improving both knowledge, and self-competence of basic palliative care among oncology NPs.

Open Access




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