Date of Conferral

2-9-2026

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Barabara Barrett

Abstract

This Doctor of Nursing Practice (DNP) project focused on the development and expert appraisal of a clinical practice guideline (CPG) to improve home-based comfort care in hospice settings. Terminally ill patients frequently experience distressing symptoms such as pain, dyspnea, and nausea, yet inconsistent symptom management and documentation practices persist across hospice care (Henson et al., 2020). A CPG was developed to evaluate a comfort care kit for patients. The CPG was independently reviewed by a three-member expert panel using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument, which consists of 23 items that are organized into six domains and rated on a 7-point Likert scale (1 = strongly disagree to 7 = strongly agree). For each AGREE II item, individual reviewer scores were summarized using measures of central tendency (mean and median) and dispersion (range) to describe agreement and variability. Using the AGREE II standardized scoring formula for the standardized domain score. Unanimous ratings of 7 (strongly agree) from all three expert panelists resulted in a standardized domain score of 100%. This finding reflects maximal expert consensus across all evaluated items and domains, indicating strong methodological quality, clinical relevance, and readiness of the CPG for organizational endorsement. The CPG may support consistent, high-quality nursing practice for individuals at the end of life. Beyond the local setting, the draft guideline has the potential to promote equitable and compassionate care; reduce practice variability; and support positive social change by advancing quality in home-based hospice care.

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