Date of Conferral

2019

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Deborah Lewis

Abstract

In the United States, more than 75% of people will spend their last months of life in a health care facility. A key role for clinicians is to discuss care goals with the patients as part of a process called advanced care planning (ACP). As part of the oncology care team, advanced practice nurses (APNs) could help to increase the frequency of ACP discussions. The purpose of this project was to assess the knowledge and practice experiences of APNs regarding ACP at a National Cancer Institute designated cancer care hospital. Carper's patterns of knowing was the theoretical framework of this project. Data from an institutional survey of APN conducted in 2017 was analyzed for this project. The survey used a standardized, validated tool designed to assess knowledge and experiences related to advanced directives and ACP among the APN staff. Survey participants included 131 APNs. Demographics and descriptive analysis of the frequency of responses was performed. Key findings were positive regarding the importance of the APN in promoting a structured communication process to discuss the patient's wishes (92%), and that an effective ACP discussion could help patients identify a trusted individual as their health care proxy (88.6%). Additionally, the data indicated that the staff APNs had a perceived lack of knowledge regarding how to conduct ACP discussions. The implications of these findings support social change by informing advanced nursing practice of the importance of ACP for patients with cancer.

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