Date of Award


Degree Name

Nursing (D.N.P.)


College of Nursing

First Advisor

Dianne Conrad, DNP, RN, FNP-BC, BC-ADM, FNAP

Second Advisor

Robert F. Johnson, MD, M. Ed., FCCM, FCCP, FACP

Third Advisor

Simin Bef, MD, MBA

Fourth Advisor

Rachel Cardosa, DNP, RN, AGNP-C


There are significant numbers of people aging and nearing end of life while being incarcerated (Richter & Hostettler, 2017). Currently the Department of Corrections (DOC) does not have a standardized process for early identification of inmates who may need increased end of life care services. A potential solution to this problem would be the use of a frailty screening tool for early identification of those inmates who may need increased resources. At this time, there is not a formalized relationship between a Midwest hospice and palliative care department and the DOC. There is a desire from leadership of the hospice and palliative care department in developing a relationship with the DOC in order to improve the quality of care provided at end of life to inmates. The clinical question addressed in this project was what is an acceptable evidence-based toolkit to promote the identification of frail inmates appropriate for hospice and palliative care referral, in order to promote a relationship between a Midwest healthcare organization and the DOC?

The project type is program development that took place at a hospice and palliative care department. Key stakeholders including the hospice and palliative care administrator, program and development manager, a palliative care nurse practitioner, and the division chief of the palliative care and hospice department are participants of the project. An evidenced based toolkit was developed that included: frailty screening tool, educational materials, and a cost analysis of use of the tool. Additionally, in order to influence change and inform policymakers of the issues, local, state, and national policy briefs were included in the toolkit. Also included was a plan for implementation and evaluation of the toolkit. Acceptance of the toolkit with policy briefs was considered a successful completion of the project. The hospice and palliative care department intend to use the toolkit to form a formal relationship with the DOC for future collaboration.

Additional Files

M. Kochajda Powerpoint.pdf (766 kB)