Degree Name
Nursing Practice, DNP
Publication Date
2021
Upload Date
2024
First Advisor
Jessica Camp
Abstract
End-of-life (EOL) issues are far too often addressed reactively in Emergency Departments when patients can no longer express their wishes. This scenario can result in unwanted futile care, increased healthcare costs, and emotional hardships for family and healthcare workers. The purpose of this quality improvement project was to implement a protocol that would shift advanced directive conversations proactively back into primary health care settings. This action would allow patients to make and document informed decisions with their Primary Care Providers (PCPs). A pilot study conducted in November 2020 at a rural clinic provided feedback from PCPs on perceived barriers to initiating EOL discussions during Medicare Annual Wellness Visits (AWV). Providers then received results-based educational sessions. A record review for patients 65 years of age or older who had an AWV during the observed period found twenty-four annual wellness visits. The four weeks preceding the pilot had a listed EOL discussion percentage of only 38%. Following the educational intervention, twenty-two (91.66 %) of records had documented EOL discussions. Addressing provider concerns and tailoring education increased EOL AWV discussion documentation by PCP's.
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Recommended Citation
Hawley, James L., "Developing an End-of-Life Discussion Protocol in Primary Care Clinics" (2021). Doctor of Nursing Practice Projects. 42.
https://arch.astate.edu/dnp-projects/42
