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Purpose of Project: Advance care planning (ACP) entails use of living wills, designation of healthcare proxies, conversations of hopes and fears, and specific medical interventions the patient desires or wishes to forgo. Benefits of early ACP include increase in patient dignity, autonomy, satisfaction, greater utilization of palliative care services, less aggressive medical treatments during end-of-life care, and decreases in healthcare costs (Dube et al., 2015). Despite these benefits only 18 to 36% of Americans have a completed advance directive (AD) on file, which is linked to an average of $750 billion, or 30% of all healthcare costs being spent on unwanted medical interventions (Splendore & Grant, 2017). Evidence points to the lack of initiation of early ACP discussions by healthcare providers (HCPs) as a contributor to the low rates of completed ADs. For HCPs, the most cited reasons for not initiating these discussions are lack of time and most importantly, lack of knowledge and training on ADs and how to engage patients in these sensitive discussions with proper, culturally-sensitive communication skills (Howard et al., 2018).

Methodology: This quality improvement project utilized a pre- and post-quasi-experimental study design to measure healthcare providers attitudes towards initiating ACP discussions. A pre- and post-survey with identical statements using a Likert-scale was administered prior to and upon completion of the educational module.

Results: The findings of this study demonstrate an increase in healthcare provider comfort to initiate ACP conversations with patients in response to the educational module.

Implications for Practice: Therefore, an online educational module geared towards HCPs on how to engage patients in early ACP discussions using the Five Wishes AD tool and proper billing for these services will foster positive attitudes that will lead to an increase in patient-healthcare provider conversations. This article supports the need for HCP educational interventions to foster early ACP conversations that will increase AD completion rates in the United States, a national goal of the Institute of Medicine report.

ETD_10589

DNP

Includes bibliographical references

doi:10.7282/t3-0xda-6t41

ETD doctoral

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