Date of Conferral
8-20-2026
Date of Award
August 2026
Degree
Doctor of Nursing Practice (DNP)
School
Nursing
Advisor
Joseph Galan
Abstract
A quality improvement project addressed variability in after-hours hospice telephone triage through implementation of structured communication and symptom-based decision-support tools. The practice-focused question examined hospice triage nurses’ perceived confidence following implementation of these tools. A descriptive quality improvement design was used. Five hospice triage nurses received education on the CALMER communication technique and symptom-specific decision-support guides for anxiety and dyspnea. Outcomes were evaluated through a postimplementation survey assessing confidence, tool utilization, intervention perceptions, and practice recommendations. Quantitative responses were summarized using descriptive statistics, and qualitative responses were reviewed for themes. All participants reported high baseline confidence in hospice telephone triage. Following implementation, confidence remained high, with four participants reporting no change and one reporting increased confidence. Participants identified the communication framework and decision-support guides as resources supporting communication, symptom assessment, and clinical decision-making. Barriers included limited tool utilization, staffing challenges, small sample size, and variation in intervention exposure. Structured communication and decision-support tools may support standardized hospice telephone triage, consistent clinical decision-making, and staff education. Further evaluation with larger samples and longer implementation periods is recommended.
Recommended Citation
Hurst, Kelly, "Staff Education to Improve Confidence of Triage Decision-Making in Hospice After-Hours Care" (2026). Walden Dissertations and Doctoral Studies. 20543.
https://scholarworks.waldenu.edu/dissertations/20543
