Date of Award
Evidence-Based Project Report
Doctor of Nursing Practice (DNP)
Julie M. Brandy
Advance care planning (ACP) is a topic that can be difficult for patients and providers to discuss due to lack of time, knowledge, communication skills, and discomfort surrounding the subject (Barkley et al., 2019; Hafid et al., 2021; Halpert et al., 2022; Marin, 2022). Delayed or absent ACP discussions may lead to nonbeneficial care, increased healthcare costs, end of life suffering and increased post-death family distress (Halpert et al., 2022; O’Hanlon et al., 2018). The purpose of this evidence-based practice (EBP) project was to increase the discussions and documentation regarding ACP in a family practice setting. The PICOT question guiding this project was: in patients 65 years of age or older in a family medicine office (P), does using a multi-modal intervention with provider education and PREPARE resources (I) compared to not having a standardized approach to advance care planning (C) result in a higher completion rate of advance directives (O) in a 12-week time period (T)? PREPARE (www.prepareforyourcare.org) is an interactive and evidence-based online resource to help with educating patients about end-of-life wishes and filling out an advance directive (Lum et al., 2018; Sudore et al., 2017; Sudore et al., 2018). PREPARE also utilizes behavior-change techniques to assist patients on becoming ready to start planning for their future care (Lum et al., 2018; Sudore et al., 2018). Eight participants were recruited from a healthcare organization in northcentral Indiana due to their age, existing chronic diagnoses and lack of advance care plan status. Participants were provided education using the PREPARE pamphlet to increase readiness for completing an advance directive. The primary outcome was whether or not participants completed and provided documentation of the advance directive after the intervention. This information was gathered from the participant’s electronic health record (EHR). A chi-square was conducted to analyze advance directive status after the intervention. Statistically significant findings were not found between utilizing PREPARE education and advance directive status (p =.157). The intervention was not effective at increasing advance directive completion and future research and EBP projects are needed on this topic.
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Harvey, Gabrielle Alanna, "Advance Care Planning: An Evidence-Based Practice Project" (2023). Evidence-Based Practice Project Reports. 196.