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Advance care planning in the intensive care unit: a quality improvement project

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TitleInfo
Title
Advance care planning in the intensive care unit: a quality improvement project
Name (type = personal)
NamePart (type = family)
Casas Crescenti
NamePart (type = given)
Katherine P.
NamePart (type = date)
1989-
DisplayForm
Katherine P. Casas Crescenti
Role
RoleTerm (authority = RULIB)
author
Name (type = personal)
NamePart (type = family)
Reyes
NamePart (type = given)
Darcel M.
DisplayForm
Darcel M. Reyes
Affiliation
Advisory Committee
Role
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chair
Name (type = personal)
NamePart (type = family)
Avadhani
NamePart (type = given)
Amita
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Amita Avadhani
Affiliation
Advisory Committee
Role
RoleTerm (authority = RULIB)
internal member
Name (type = corporate)
NamePart
Rutgers University
Role
RoleTerm (authority = RULIB)
degree grantor
Name (type = corporate)
NamePart
School of Nursing - RBHS
Role
RoleTerm (authority = RULIB)
school
TypeOfResource
Text
Genre (authority = marcgt)
theses
OriginInfo
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2020
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2020-05
Language
LanguageTerm (authority = ISO 639-3:2007); (type = text)
English
Abstract (type = abstract)
Purpose of the Project: Advance Care Planning (ACP) is an essential component in the delivery of high-quality nursing care. Due to current gaps between knowledge and practice, nurses’ involvement in ACP is low. The purpose of this project was to improve nurses’ knowledge about ACP processes while increasing the number of Pastoral Care referrals.

Methodology: This project consisted of a one-group pretest-posttest interventional design using a convenience sample of nurses. One intervention was an educational program that involved a lecture presentation and a case study. The outcome for this intervention was to improve nurses’ knowledge regarding ACP. A second intervention was to implement the ACP bedside assessment checklist for two months. Effectiveness of the checklist was measured with retrospective and prospective data collection of Pastoral Care referrals.

Results: A total of 26 nurses participated in this project, which represented 87% of the total population of nurses at the site. The results demonstrated a significant improvement in knowledge as indicated by the 24% increase in the posttest scores after the educational program (p < 0.05). There was also a significant increase in the number of Pastoral Care referrals from seven to 18, with a mean improvement of 1.57 (p = 0.03).

Implications for Practice: Participants’ knowledge improved, as determined by a comparison of their average pre and posttest scores. Nurses can benefit from a standardized educational program and periodic education about ACP practices. The bedside assessment checklist was a useful intervention because it empowered nurses to ask about ACP and make referrals early. The number of Pastoral Care referrals increased after the conclusion of the project, which reflected active ACP participation. This project reinforced the need for a change in current practice because ACP should be initiated at any time and revisited periodically as patients’ health status changes.
Subject (authority = local)
Topic
Advance care planning
Subject (authority = RUETD)
Topic
Adult-Gerontology Acute Care Nurse Practitioner
RelatedItem (type = host)
TitleInfo
Title
Rutgers University Electronic Theses and Dissertations
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ETD
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ETD_10856
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application/pdf
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text/xml
Extent
1 online resource (79 pages) : illustrations
Note (type = degree)
DNP
Note (type = bibliography)
Includes bibliographical references
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TitleInfo
Title
School of Nursing (RBHS) DNP Projects
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rucore10004500001
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Identifier (type = doi)
doi:10.7282/t3-7kq8-gm88
Genre (authority = ExL-Esploro)
ETD doctoral
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Rights

RightsDeclaration (ID = rulibRdec0006)
The author owns the copyright to this work.
RightsHolder (type = personal)
Name
FamilyName
CASAS CRESCENTI
GivenName
KATHERINE
Role
Copyright Holder
RightsEvent
Type
Permission or license
DateTime (encoding = w3cdtf); (qualifier = exact); (point = start)
2020-04-28 00:30:32
AssociatedEntity
Name
KATHERINE CASAS CRESCENTI
Role
Copyright holder
Affiliation
Rutgers University. School of Nursing - RBHS
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License
Name
Author Agreement License
Detail
I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
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Type
Embargo
DateTime (encoding = w3cdtf); (qualifier = exact); (point = start)
2020-05-31
DateTime (encoding = w3cdtf); (qualifier = exact); (point = end)
2022-05-31
Detail
Access to this PDF has been restricted at the author's request. It will be publicly available after May 31st, 2022.
Copyright
Status
Copyright protected
Availability
Status
Open
Reason
Permission or license
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Technical

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