Date of Award

Spring 5-20-2024

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice



First Advisor

Isis Cunningham, DNP, APRN, NP-C, CPNP-PC



Background: Pediatric oncology patients should be referred to palliative care early but despite research indicating the clear benefits, there is still a delay in referring patients. One of the reasons include lack of understanding amongst providers on what palliative care is. Palliative care provides symptom management, emotional support and helps the patient and family with difficult decision making.

Objectives: This project aimed to increase the number of early referrals to palliative care. The Pediatric Palliative Care Screening Tool (PaPas) was utilized to help identify the triggers which should prompt the referral.

Methods: A chart review of patients diagnosed with a malignancy or with relapsed disease, was conducted over a four-month period. The number of referrals to palliative care over that time frame was recorded. Then, the PaPas checklist tool was implemented for another four months, and the number of referrals were recorded.

Results: The referral rate increased from 8.5% pre-intervention to 94.9% post-intervention. The implementation of the PaPas checklist tool was successful in increasing the number of referrals to palliative for pediatric oncology patients.

Conclusion: This project demonstrated that the implementation of a palliative care screening tool can increase the number of early referrals to this highly important support service.

Keywords: palliative care, pediatric oncology, screening tool

Included in

Nursing Commons