Advance Care Planning: Advanced Practice Provider–Initiated Discussions and Their Effects on Patient-Centered End-of-Life Care

advance care planning, advance directives, end of life, code status, advanced cancer
CJON 2020, 24(1), 81-87. DOI: 10.1188/20.CJON.81-87

Background: Advance care planning (ACP) is an ongoing process of communication involving patients, family members, and caregivers on one side and healthcare providers on the other to establish values, goals, and preferences for future care, along with discussions concerning end-of-life care options. Advance directives promote patient autonomy and provide written documentation of a patient’s wishes for future care.

Objectives: This quality improvement project aimed to determine if ACP discussions initiated by an advanced practice provider (APP) would enhance patient-centered end-of-life care.

Methods: This study involved retrospective data collection of 20 inpatients and 20 outpatients without a scanned advance directive in the electronic health record at the time of admission or clinic visit, as well as an ACP intervention by an APP.

Findings: APPs can initiate ACP discussions with patients with cancer, which may assist in their understanding of ACP, resulting in completion of the advance directive documents and a change in their code (resuscitation) status.

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