Publication Date


Document Type

Scholarly Project


Family Practice Nursing


Evidence shows the many benefits of advance care planning (ACP) discussions, including; giving patients peace of mind, decreasing healthcare costs, increasing quality of care, and decreasing distress at the end of life. Due to the many proven benefits of ACP, the United States Department of Health and Human Services as well as many leading national health organizations are promoting ACP, even tying it to reimbursement. The best setting and time to initiate ACP is in the primary care setting as early as possible, before patients have any cognitive decline. In this context, patients have an established relationship with their provider, and the discussion can be ongoing and involve family members. However, despite the national push and abundant evidence showing the importance of ACP, the rate of ACP discussions and advance directive completion in primary care remains low. This evidence-based practice pilot project is guided by the Iowa Model of Evidence-Based Practice to Promote Quality Care-Revised (Iowa Model Collaborative, 2017). Incorporating the concepts of the Transtheoretical Model of Health Behavior Change (Prochaska & Velicer, 1997), the project sought to increase ACP discussions and the rate of completion of advance directives in a primary care office through educating clinicians. The pilot project was successful in increasing ACP documentation, with a pre-intervention prevalence of ACP conversations of 0% and a post-intervention prevalence of ACP conversations of 23.33%, which is consistent with the current evidence in the literature.

Embargo Date