Date of Award

Spring 5-12-2023

Document Type

Scholarly Project

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Dr. Gena Coomes

Second Advisor

Dr. Greg Belcher

Third Advisor

Dr. Janice Schiefelbein

Abstract

An Abstract of the Scholarly Project by

Teresa Gayle Hagedorn

Advance care planning (ACP) is a continuous communication process linking patients, family members, caregivers, and healthcare providers. Personal values, life goals, and preferences regarding future medical care are significant to every person as we will inevitably reach the end of life. Advance directives (ADs) promote patient autonomy and provide legal documentation of a patient’s wishes for future care. According to the National Institute of Health (2018), only 1 in 3 adults in the United States have a documented AD in their electronic medical records (EMR). This quality improvement project aimed to determine if ACP discussions initiated in a primary care clinic in the Midwest would increase the percentage of documented ADs in the EMR. The patients of one provider in a rural clinic were randomly chosen to receive an intervention discussing ADs, and patients were given time to ask questions. The intervention period was over six months. The data from 200 random charts were examined to determine if the intervention increased the percentage of patients’ charts with ADs. The intervention results did not show a significant increase in the rate of charted ADs. However, the opportunity for the provider to initiate the topic and provide evidence-based AD education cannot be discounted entirely.

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