Date of Award


Degree Name

Nursing (D.N.P.)


College of Nursing

First Advisor

Karen Burritt

Second Advisor

Ruth Ann Brintnall

Third Advisor

Sandy Nelson


The United States health system strives to improve the care patients receive while reducing healthcare expenditures. A significant portion of the nation’s healthcare expenditure is spent on end of life care. Palliative care provides one solution to reducing healthcare expenditures while improving the patient experience. Reducing symptom intensity is one example of palliative care’s success. A midwest palliative care program was tasked to gather quality data on the service’s ability to manage patient symptoms.

The program selected the MD Anderson Symptom Inventory to improve symptom assessment and provide quality metrics for the organization. Additionally, research suggests rural populations have poorer access to palliative care services compared to non-rural patients. In response, a qualitative questionnaire was administered to rural and non-rural patients at consultation to gather information regarding barriers to palliative care services. Finally, the quality improvement initiative was evaluated for acceptability, feasibility, and sustainability. The scholarly project provided the organization characteristics of the population served, accurately assessed symptoms, and tracked performance of symptom management over time. The implications of this project is the MD Anderson Symptom Inventory provided a sustainable and feasible plan for a community based palliative care program to generate and gather quality data. The perceived barrier questionnaire revealed that patients experience symptoms for a long time prior to a palliative care referral and a knowledge gap exists regarding the role and existence of palliative care.

Included in

Nursing Commons