Semester

Summer

Date of Graduation

2019

Document Type

Problem/Project Report

Degree Type

DNP

College

School of Nursing

Department

Family Medicine

Committee Chair

Lori A. Constantine

Committee Co-Chair

Katharine J. Buck

Committee Member

Katharine J. Buck

Committee Member

Constance Beckom

Abstract

The best mechanism to achieve successful advance care planning has yet to be identified. A randomized, controlled, experimental study was performed with a sample of 54 men and women who met inclusion criteria and were randomized into the intervention versus the control group in an outpatient clinical setting in rural West Virginia (WV) from December 2018 to March 2019. Participant mean age was 72.4 years. For those who chose to participate (n=42), the intervention group received the usual standard of care, which was a face to face advance care planning (ACP) discussion with the new intervention of a video decision aid in preparation to complete advance directives (AD) or have Physician Orders for Scope of Treatment (POST) forms completed by the healthcare provider. Those in the control group who agreed to participate received only the standard of care. Overall, 73.8% (n=31) of the total participants completed AD as a result of any ACP intervention. Participants who received the video intervention in addition to the standard of care completed more advance directives than those who only received the usual standard of care (88% vs 63%). The video decision aid should be an additive component to ACP interactions to enrich the standard verbal counseling. Additionally, incorporating evidenced-based guidelines connects ethical and regulatory components to ACP interactions. Health care organizational culture should support an environment that standardizes end of life (EOL) conversations in every practice setting. Further research should be done to determine the most effective approach in delivery of ACP.

Download

Share

COinS