UC Irvine

Background Palliative care improves symptom management and quality of life for patients with serious illness, with nurses playing a central role in care coordination, symptom management, communication, and end-of-life support. This evidence-based quality improvement project aimed to enhance step-down unit nurses’ knowledge and self-efficacy in providing palliative care at a tertiary medical center in Los Angeles, California. Methods: Guided by the Johns Hopkins Evidence-Based Practice Model, this project used a pre–post design with voluntary participation, recruiting nurses through huddles, peer invitations, and break room signage. The educational intervention consisted of two short, mobile-accessible videos that participants could view independently. Palliative care knowledge was measured using the Palliative Care Quiz for Nurses (PCQN), and self-efficacy was assessed with the Self-Efficacy in Palliative Care (SEPC) before and after the intervention. Data was analyzed using descriptive statistics. Results: Twenty-six nurses were recruited for the project. Of these, 18 completed the pre-intervention survey, 10 completed both the pre- and post-PCQN, and 8 completed both the pre- and post-SEPC. Overall, 8 nurses completed all three surveys, resulting in a 10% participation rate among unit staff. Mean knowledge scores (n=10) increased from 53% pre-intervention to 66% post-intervention. Improvements were noted across all three domains, with the greatest improvement observed in symptom and pain management. Mean self-efficacy scores (n= 8) improved from 68.9% pre-intervention to 92.7% post-intervention, representing a 23.8 percentage point increase following the educational intervention. Self-efficacy (n= 8) related to discussing a patient’s impending death with family members increased from 49.4% pre-intervention to 88.6% post-intervention, reflecting an improvement of 39.2 percentage points. Conclusion: A short video-based palliative care intervention improved knowledge and self-efficacy among step-down unit nurses. However, sustainability of the project is low due to the low participation rate. Despite this, findings support the use of targeted education to enhance palliative care competence and confidence and potentially improve patient outcomes.