Date Available

4-18-2022

Year of Publication

2022

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Misty Ellis

Clinical Mentor

Dr. Adrienne Johnston

Committee Member

Dr. Kathy Isaacs

Abstract

Background: Palliative and hospice care resources are underutilized in pediatric patients with chronic and life-limiting illnesses. One contributing factor is the lack of formalized education for medical providers regarding the differences and scope of palliative and hospice care models. Without adequate education about these services, providers are not able to effectively utilize otherwise available resources to provide holistic care.

Purpose: The purpose of this study was to assess the current perception of knowledge among providers pertaining to pediatric palliative and hospice care. The study investigated improvements in educational outcomes in ten categories after participation in a web-based training. A secondary assessment was made of perceived effectiveness of the training itself.

Methods: A prospective cohort study was completed using providers within the University of Kentucky Hospital’s Emergency Department. Surveys were distributed to seventy-seven participants which included physicians and advanced practice providers. A pre and post survey using Qualtrics, and a web based educational model were used to analyze clinician knowledge. These surveys used Likert scales, multiple choice, and short answer to evaluate providers’ perceptions both before and after the education. Survey topics assessed included prior training, perceptions of educational need, and current knowledge. Categories included in the knowledge assessment and web-based training included ethics, symptom management, grief, use of resources, developmentally appropriate discussion, care planning, and difficult conversations. A paired t-test was used to compare clinician knowledge and attitudes both before and after the web-based education. As part of the post-survey the participants completed an evaluation of the educational module and a re-assessment of their perception of knowledge.

Results: A total of ten participants completed the pre-survey between November 2021 and February 2022. Six participants completed the training and post-survey during the same period. Following the training a statistically significant increase in perception of knowledge was observed in 80% of the categories and 100% of the categories displayed a score increase from the pre-survey ratings. 100% (n=6) of the participants felt that the training was useful and would recommend it to others within their cohort.

Conclusion: Literature has confirmed there is a lack of education in pediatric palliative and hospice care in the United States. After a web-based training experience, there was a recorded improvement in perception of education of the same topic among providers in the Emergency Department at the University of Kentucky. Improved Likert scale scores were observed to have statistical significance for nine of ten training categories. Further evaluation with a larger sample size and with different demographics would be useful to determine if this finding is reproducible on a wider scale.

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