Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

7-10-2024

Graduate Advisor

Amanda Finley

Co-Advisor

Marina Fischer

Committee

Carla Moore-Beckerle

Abstract

Abstract Problem: Advance directives (ADs) are legal documents which outline one’s medical wishes if they are unable to make such decisions for themselves. ADs have been shown to reduce cost and improve quality-of-life (Starr et al., 2019), (Wright et al., 2008). Only 1/3 of adults in the United States have a completed advance directive (AD) or living will (Yadav et al., 2017). However, 90% of Americans feel it is important to have conversations about end of life, but only 30% have had this conversation (Institute for Healthcare Improvement, 2020). The Five Wishes document addresses decisions at end of life and has been shown to be more readable, understandable, and appealing when compared to similar documents

Methods: This quality improvement project selected patients aged 45-100 medical decision-making capacity without a completed AD. These patients participated in an advance care planning (ACP) conversation with their provider and were given the Five Wishes document. Patients were instructed to return to their next visit with the completed document. AD completion rates were compared through a retrospective chart review and compared to data pre-intervention.

Results: Following this QI project, the total number of patients included in this study was 20 (n=20). Ten patients were included in the control group and ten patients were included in the intervention group. This study did not show an increase in AD completion.

Conclusion: The Five Wishes document was not shown to increased AD completion in this population. However, this study did show that patients are receptive and interested in participating in advance care planning conversations.

Disclosures: This work was supported by a grant provided by the Aging with Dignity organization who provided the Five Wishes booklets which were utilized in this project.

Download

Share

COinS