Doctor of Nursing Practice (DNP) Projects

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education, self-efficacy, healthcare professionals, advance care planning, palliative care


Healthcare providers are not comfortable having Advance Care Planning (ACP) conversations with patients and families. This project aimed to determine if ACP education modules improve self-efficacy with ACP. The project was a pre-/post-implementation design utilizing the validated ACP Self-Efficacy (ACP-SE) survey. Participants completed the pre-test ACP-SE followed by four Center to Advance Palliative Care (CPAC) ACP education modules and a Project-Lead-developed state-specific advance directive (AD) module that were accessed on-demand electronically. Participants were Advanced Practice Providers (APPs; n=21) on the inpatient heart failure service at an urban academic medical center. Thirteen APPs had complete pre and post-test and surveys data (61.9%). The majority of participants were white (95%), female (92%), aged 20-39 (83%), and NPs (62%) with 0-5 years of experience. The Wilcoxon Signed Rank Sum Test was used for median sum ACP-SE score comparisons for paired pre/post data. There was a significant median increase in ACP-SE scores pre and post intervention (W=2.9; p=0.002). The number of ACP conversations post-education modules ranged from 0-11 with a mean of 3.2 per APP, and a total of 68 conversations for all APPs during the month after the intervention. With increasing comfort and self-efficacy for discussing ACP, the desired effect is that ACP discussions will become a routine component of patient care.

Available for download on Thursday, June 16, 2022



Date Posted: 25 February 2022