Date of Conferral

2022

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Barbara A. Niedz

Abstract

A staff education project was created in a tribal health system of primary care clinics to improve advance care planning (ACP) conversations between care providers and Native American tribal patients. ACP conversations and advance directive documentation occurrences were found to be low or negligible in the project site despite primary care clinics being an ideal place to start these conversations. The purpose of the staff education project was to improve the knowledge and attitudes of providers toward initiating ACP conversations in a rural underserved community of Native Americans. The knowledge-to-action model was used to frame the project. Pretests and posttests were used to gather data, and nonparametric tests were used to check the difference between scores, before and after education, related to attitudes and comfort, knowledge, and cultural competency of providers. Pretest and posttest survey data were analyzed using SPSS software. The staff education led to improved attitudes among healthcare providers (z = 3.918, p < 0.001) and knowledge (z = –4.406, p < 0.001) about ACP that were consistent with previous research evidence. Although statistical significance was not achieved on the cultural competence questions, this was likely due to preexisting knowledge and small sample size. The study’s findings confirm previous findings that staff education leads to improvement in knowledge and attitudes to start ACP conversations and documentation. The project can lead to positive social change in the lives of Native American patients by improving their end-of-life care and ensuring care aligns with their cultural beliefs, values, and preferences. Further study can be conducted to see if actual change occurs in ACP conversations between providers and patients.

Download

Included in

Nursing Commons

Share

 
COinS