Effect of a multimodal intervention on advance directive completion rates
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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 was to apply translational research to ACP within the primary care setting as a way of improving quality of care related to death and health care costs. The purpose of this project was to identify a sustainable program to assist primary care offices in the advancement and promotion of ACP. The intervention program utilized a multimodal approach to enhance advanced directive (AD) completion rates, and to identify influential factors affecting AD completion to tailor patient education based on these factors. The project yielded no participants. The basis of no participants is not likely a result of lack of interest but a reflection of the inadequacy of the recruitment process. The patient-initiated recruitment process was not effective in this setting because patients are not likely to think about the need for EOL care and advanced directive decision-making without being prompted to do so.
Future research should be conducted to identify appropriate and effective methods to engage patients in the ACP process through other recruitment methods such as direct-provider contact and continuous follow-up either by phone, mail, or electronic in the primary care setting. Other research opportunities are to examine the multi-modal approach to AD completion in community settings such as within faith-based organizations and health fairs.
Type | DNP Capstone Project |
Acquisition | Self-submission |
Review Type | Faculty Approved: Degree-based Submission |
Format | Text-based Document |
Evidence Level | Other |
Research Approach | Translational Research/Evidence-based Practice |
Keywords | Advance Directive; Completion Rate |
CINAHL Subject(s) | Advance Care Planning; Advance Directives; Advance Directives--Utilization |
Grantor | Nebraska Methodist College |
Advisor | Henton, Fran |
Level | DNP |
Year | 2017 |
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