Digital Commons Network^™

Exploring Patients' Perceptions Of An Advance Care Planning Intervention In The Emergency Department: A Qualitative Study, Youkie Shiozawa, Saaya Morton, Nanako Shirai, Hannah Oelschlager, Lucy Kiernat, Anita N Chary, Anna C Revette, Adrian Haimovich, Smit Desai, Kai-Wei Chang, Shan W Liu, Maura Kennedy, Mara A Schonberg, Kei Ouchi

Faculty, Staff and Students Publications

Objectives: Emergency department (ED) visits offer opportunities for seriously ill patients to formulate future medical care goals, yet ED clinicians lack practical strategies for these conversations. ED GOAL, a behavioral intervention, engages seriously ill yet clinically stable older adults in the ED to address advance care planning (ACP) with their outpatient clinicians. In a randomized trial, goals-of-care documentation was significantly higher in the intervention group compared to controls after three (24.3% vs. 9.9%, p = 0.03) and 6 months (31.4% vs. 12.7%, p < 0.01). This study is a sub-analysis to learn about intervention arm participants' perceived benefits and obstacles of the intervention.

Methods: We conducted semi-structured interviews between October 2022 and August 2024 (N = 52) with intervention-arm patients …

Effect Of A Multimodal Intervention On Advance Directive Completion Rates, Maria B. Douthett

Group: Nebraska Methodist College

Advance care planning (ACP) could be working better both in the primary and hospital settings. When a patient is admitted in the hospital, there are several questions asked during admission regarding ACP but little screening on ACP is done in the primary care setting. Existing research supports ACP as a benefit to quality of death and health care costs, however, there is limited research on how to apply it in the primary care setting. Most of the research regarding ACP and end-of-life (EOL) care focuses on the process in the hospital or in nursing homes.

The goal of this project …

Advance Directive Protocol In The Primary Care Setting, Alexei Boettcher

Group: Nebraska Methodist College

Background and Review of Literature: Advance directives (AD) are documents that offer patients a way to avoid unwanted care in the event of a serious illness or incapacity. Studies demonstrate the care patients receive at the end-of-life is not often consistent with their preferences, as a result of suboptimal communication between the patient and provider as well as documentation of health care proxies and treatment preferences (Isaac & Curtis, 2016). The lack of a current formal protocol used by primary care providers regarding ADs, particularly towards the young adult patient population, resulting in insufficient discussions of patients’ wishes regarding end-of-life …

[Excerpt From] Hospice & Palliative Care Handbook: Quality, Compliance, And Reimbursement (4th Ed.), Tina M. Marrelli, Jennifer Kennedy

Sigma Publications: Book Excerpts

This item record pertains to an excerpt and additional resources from Hospice & Palliative Care Handbook: Quality, Compliance, and Reimbursement, Fourth Edition, which is provided free of charge by the publisher.

About this book: Hospice & Palliative Care Handbook, 4th Ed., offers updated coverage of all aspects of hospice and palliative care for the entire healthcare team who provide important care while meeting difficult multilevel regulations. This edition includes examples and strategies covering key topics related to standards, guidelines, goals, and effective care planning.

New to this edition are:

• Expanded pediatric and geriatric clinical care guidelines
• More robust …

Advance Care Planning In Cancer Patient - Caregiver Dyads, Natasha Michael

Theses

For many, a cancer diagnosis signals death's inevitability and elicits much existential concern. In the quest for life prolongation, many are offered or seek life-sustaining treatments, fail to appreciate a declining trajectory and lack the opportunity to seek information or plan meaningfully for their future.

Advance care planning (ACP) provides an avenue for patients and their caregivers to plan for future care. ACP is defined ‘as a process that supports adults at any age or stage of health in understanding and sharing their personal values, life goals and preferences regarding future medical care’ and is a key quality indicator in …

Enhancing Outpatient Participation In Advance Care Planning Via Nurse-Led Intervention: An Integrative Review, Daniel Patrick Arthur

Doctoral Dissertations and Projects

Advance care planning allows for medical care at the end-of-life that is congruent with a patient’s wishes, values, and beliefs. Even with well-known organizations such as the Institute of Medicine recommending advance care planning completion and legislative encouragement such as the Patient Self-Determination Act of 1990, only approximately one-third of American adults have completed any form of advance directive. Barriers to participation include lack of time, lack of knowledge, and misconceptions on the part of healthcare providers and patients. As an integral part of the care team having significant patient contact in most healthcare settings, nurses are in an ideal …

Effects Of Advance Care Planning Intervention On End-Of-Life Decision Making, Minju Kim, Jieun Lee

International Nursing Research Congress (INRC)

The purpose of this study was to systematically review reports of published randomized controlled trials to ascertain the effectiveness of an advance care planning intervention.

Challenges In Advanced Care Planning In Primary Care: A Systematic Review, Pamela Willson, Sue Ellen Gondran

International Nursing Research Congress (INRC)

The greatest obstacle to Advance Care Planning (ACP) is initiating the difficult conversation about death and planning for the end that is culturally sensitive and patient-centered. Poor end-of-life communication skills, lack of relationship building skills, and time constraints were the highest rated barriers to ACP. Improving outcomes will be discussed.

Advance Directives For Older Adults In Primary Care: An Intervention To Promote Screening And Documentation, Kathryn Bower

DNP Projects

Background: Advance care planning is the process of making decisions about the healthcare one wishes to receive should they become unable to make decisions for themselves, including the development of advance directives and designation of health care surrogates. Advance care planning is universally supported by governing bodies and professional organizations; however, less than one-third of Americans have an advance directive or designated health care surrogate.

Purpose: The purpose of this project was to assess primary care provider attitudes and knowledge of advance care planning and to increase screening for and documentation of advance directives and/or health care surrogates …

Factors Associated With The Advance Care Planning Among Community Older Adults In Taiwan, Yen-Chun Lin, Wen-Yu Hu

International Nursing Research Congress (INRC)

Because of the cultural taboo, only few older adults in Taiwan have had the opportunity to discuss advance care planning (ACP). The purpose of this study was to investigate the knowledge, attitude, and stage of change regarding ACP among community older adults and to explore the associated factors in Taiwan.

Advance Care Planning In A Dementia Specialty Practice, Valerie T. Cotter, Maryam Hasan, Jheesoo Ahn, Chakra Budhathoki, Esther Oh

International Nursing Research Congress (INRC)

Participants attending this session will learn about a project aimed to enhance the rate of advance care planning (ACP) conversations in a dementia specialty practice by increasing physician knowledge, skill and confidence in having ACP conversations and using relevant Medicare codes.