Abstract
Though the Agency for Healthcare Research and Quality (AHRQ, 2003) considers
advance care planning as “preferences for care at the end of life”, review of the
literature shows that advance care planning is more complex than this. As
preferences for care at the end of life include treatment choices and decision-
making which require thorough patient understanding, vital components entail
patient advocacy, advance directives, alternative treatment, collaboration of care,
coordination of care, cultural sensitivity, do not resuscitate orders (DNRs),
decision-making, effective communication, ethics, holistic practice, “illness
awareness” (Corli et al., 2009), living wills, patient rights, power of attorney, illness
prognostic discussions, and truth-telling. Since the AHRQ (2008) has healthcare
practice guidelines that state that physicians should conduct advance care
planning yearly with their patients, implications for the nurse practitioner are
perfecting role preparedness as increasing autonomy and responsibilities of the
profession are projected on provisions for healthcare coverage (i.e. primary care,
cancer care, and geriatrics). The primary goal for advance care planning in
terminal illness is to improve patient/family outcomes, and the nurse practitioner is
holistically prepared to conduct early and regular discussions of advance care
planning with patients and families when prognoses are poor, treatment fails, or
disease recurs.
Method. In a pilot study of 30 nurse practitioner participants in the Atlanta and
surrounding area, greater insight into communication strategies, tools, and role
preparedness of the nurse practitioner on advance care planning in terminal illness
is sought. For thorough sampling, three random practices types are selected:
internal medicine, oncology, and pulmonary care.
Keywords: communication, end-of-life, prognosis, advance care planning,
terminal illness
Files
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Metadata
- Event location
Special Collections
- Event date
4 April 2013
- Date submitted
18 July 2022
- Additional information
Acknowledgements:
Toni O. Barnett, PhD, APRN, FNP-BC, CNE