| dc.description.abstract | Advance directives (ADs) summarize goals or preferences for future care regarding life-sustaining treatment and designates a surrogate decision-maker in the event a patient is unable to make healthcare decisions. These legal documents are especially important for providing patient autonomy and allowing people to communicate their medical care preferences to family, friends, and healthcare professionals. Two thirds of Americans have not completed an advance directive and 70% of Americans (more than 1.7 million) die of chronic diseases. Benefits of ADs include: autonomy during end-of-life, honored preferences, enhanced quality of medical decisions, less emotional distress, and even a decrease in healthcare costs. Approximately 60% of patients stated that they are open to talk about advance care planning (ACP); however, only 21% percent of providers reported talking frequently about matters related to ACP or end-of-life care. Literature review findings revealed that providers lack training and education about ADs and ACP conversations, leading to discomfort in skills, confidence, and knowledge about having these essential discussions. The purpose of this practice improvement project (PIP) was to increase nurse practitioners’ knowledge of facilitating ACP conversations, and completion of AD among patients living with a chronic disease, over the age of 65, seen within the primary care setting.
A total of 14 healthcare professionals participated in a one-hour educational webinar posted on the North Dakota Nurse Practitioner Association (NDNPA) website over a three-month time period between September 30, 2021 and December 30, 2021. Pre/post Likert scale surveys were administered to each participant electronically via Qualtrics. Confidence Likert scale surveys found the education increased participants’ knowledge, confidence, and understanding of ACP and AD. PIP findings also demonstrated an increase in understanding of the Serious Illness Conversation Guide and an increase in both confidence and likeliness of increasing and initiating ACP conversations with patients. Education on ACP and AD resources should continue to be provided for healthcare providers online. Future research should look into how providing ACP and AD education directly affects AD rates in patients living with a chronic disease, over the age of 65, seen within the primary care setting. | en_US |
