Date of Conferral
7-30-2026
Date of Award
July 2026
Degree
Doctor of Nursing Practice (DNP)
School
Nursing
Advisor
Cara Krulewitch
Abstract
Hospice patients experiencing uncontrolled pain, dyspnea, agitation, anxiety, delirium, or other severe symptoms may require General Inpatient (GIP) hospice care for intensive symptom management. However, inconsistent recognition of symptom crises can delay escalation to the appropriate level of care, contributing to unnecessary patient suffering, caregiver distress, and avoidable emergency department or hospital utilization. This Doctor of Nursing Practice executive leadership project evaluated the implementation of an educational framework designed to improve clinician recognition and timely escalation of patients who may be appropriate for GIP hospice care. Education emphasized early identification of uncontrolled symptoms, interdisciplinary communication, documentation, and escalation for clinical review rather than independently determining that a patient did not qualify for GIP. Project outcomes were evaluated through pre- and post-education assessments, participant feedback, and review of clinical practice indicators. The project supported improved clinician knowledge, greater consistency in recognizing potential GIP eligibility, and increased confidence in escalating symptom crises. Findings demonstrate that structured education and standardized escalation guidance can strengthen clinical decision-making, promote timely access to higher levels of hospice care, and support patient-centered symptom management.
Recommended Citation
Roth, Oliver Charles, "Recognizing Appropriate General Inpatient Hospice Patients Time to Stop Normalizing Suffering" (2026). Walden Dissertations and Doctoral Studies. 20480.
https://scholarworks.waldenu.edu/dissertations/20480
