School of Nursing
Doctor of Nursing Practice (DNP)
Advance Care Planning, Nurse-led, Feasibility, Acceptability, Effectiveness
Arthur, Daniel Patrick, "Enhancing Outpatient Participation in Advance Care Planning Via Nurse-Led Intervention: An Integrative Review" (2021). Doctoral Dissertations and Projects. 2996.
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 position to intervene to improve advance care planning completion and documentation rates. This integrative review examines the ability of outpatient nurse-led interventions to overcome barriers and enhance participation in advanced care planning. Healthcare leaders looking to improve completion and documentation rates of advance care planning in the outpatient setting will find this review provides a solid evidentiary foundation supporting nurse-led advance care planning interventions are effective, feasible, and acceptable to patients and healthcare providers alike.