Advance Directives Do I need one Abigail Bohn

Advance Directives: Do I need one? Abigail Bohn, Cristan Sabio NORTHERN ILLINOIS UNIVERSITY Introduction Methods Do you have an advance directive? Only 25% of Americans do A systemic literature was done with twelve studies using the The results of these studies explain the importance of making Advance directives give patients autonomy regarding their (Anderson, Aldous, & Lupu, 2018). CINAHL (Cumulative Index to Nursing and Allied Health) advance care plans, as well as the need for greatly expanding health care decisions and are essential for people of all ages An advance directive is composed of: Complete database. the usage of advance care planning. Approaches found to and conditions to have. • A living will stating one’s health care preferences Key words were searched including “advance directives” improve process include: Using the RE-AIM framework, Shared Care Planning, the MY • An assigned health care power of attorney (POA) (AD) and “advance care plans” (ACP), for full-text peer • RE-AIM (RE-AIM framework: “Reach: Will older adults WAY approach, and beginning advance care plan discussions Advance directives give patients a "voice when they don't have reviewed journal articles completed between 2010 -2020 participate in an advance care planning group visit? in the primary care setting can help to increase the number of a physical voice anymore” (Davidson et al. , 2013). Advance worldwide, with abstracts and references available. Effectiveness: Will older adults engage in advance care existing advance directives are used to communicate an individual’s health care These articles contained both qualitative and quantitative data. planning conversations? Adoption: Will providers refer Some studies suggest that despite the underutilization of wishes when the individual is unable to communicate these Data was summarized analyzed to determine: patients? Implementation: Will patients come to both advance directives, they’re also insufficient (Block et al. , 2018). wishes, whether it be from illness or an accident. The living will • Existing number of advance directives sessions? What aspects of advance care planning will older Unfortunately, further research needs to be done to determine helps state these wishes and the POA helps make sure these • Advance directive accessibility adults discuss in the GMV [group medical visits]? ”) (Lum et what can be done to improve the ACP process. wishes are followed. • Advance directive efficiency al. , 2016). Maintenance was not evaluated in this study). Advance directives are for people of all ages including: • Improvement strategies for accessibility • The young and healthy • Improvement strategies for efficiency Results • Shared Care Planning: approach focuses on EOL care discussions rather than just filling out paperwork. Requires • Those with acute and chronic illnesses education for community members and training courses for • The elderly health care workers (Saralegui et al. , 2018). • Those nearing end-of-life (EOL) • MY WAY (Make Your Wishes About You approach includes an interview process which helps motivate clients to fill out an advance directive and is based on the Stages of Change . Theory: “Pre-contemplation: Patient is not ready to change, Contemplation: Patient is thinking about changing behavior, Preparation: Patient is planning to make changes in the future, Action: Patient is actively making, Changes, Maintenance: Change has happened, and patient is making efforts to maintain behavior” (Prochaska & Velicer, 1997, as cited in Anderson et al. , 2018). • Beginning ACP discussions in primary care setting Conclusion Bibliography Anderson, E. , Aldous, A. , & Lupu, D. (2018). Make Your Wishes About You (MY WAY): Using Motivational Interviewing to Foster Advance Care Planning for Patients with Chronic Kidney Disease. Nephrology Nursing Journal, 45(5), 411– 421. Retrieved from http: //www. ulib. niu. edu: 2618/login. aspx? direct=true&db=ccm&AN=132180647&site=ehostlive&scope=site Beaty-Edwards, D. & Kinloch, M. (2017). The Advance Directive Navigator: A catalyst for change and better care. Medium. Retrieved from https: //medium. com/@CBUHP/the-advance-directive-navigator-a -catalyst-for-change-and-better-care-7 f 55 af 738 ac 0 Block, B. L. , Smith, A. K. , & Sudore, R. L. (2018). Universal Advance Directives—Necessary but Not Sufficient. Journal of Law, Medicine & Ethics, 46(4), 988– 990. Retrieved from https: //www. ulib. niu. edu: 2571/10. 1177/1073110518822000 Bowman, P. (2018). How to Have Ethical Discussions in Your Practice. ONS Voice, 33(5), 44– 45. Retrieved from http: //www. ulib. niu. edu: 2618/login. aspx? direct=true&db=ccm&AN=131514679&site=ehostlive&scope=site Davidson, R. , Banister, E. , & de Vries, K. (2013). Primary Healthcare NZ Nurses’ Experiences of Advance Directives: Understanding Their Potential Role. Nursing Praxis in New Zealand, 29(2), 26– 33. Retrieved from http: //www. ulib. niu. edu: 2618/login. aspx? direct=true&db=ccm&AN=107966516&site=ehostlive&scope=site Kestigian, A. , & London, A. J. (2016). Adversaries at the Bedside: Advance Care Plans and Future Welfare. Bioethics, 30(8), 557– 567. Retrieved from https: //www. ulib. niu. edu: 2571/10. 1111/bioe. 12263 Killackey, T. , Peter, E. , Mac. Iver, J. , & Mohammed, S. (2019). Advance care Planning in Heart Failure: A Narrative synthesis of the Perspectives of Patients, Family Members, and Healthcare Providers. Canadian Journal of Cardiovascular Nursing, 29(3), 16– 25. Retrieved from http: //www. ulib. niu. edu: 2618/login. aspx? direct=true&db=ccm&AN=140208461&site=ehostlive&scope=site Lum, H. D. , Jones, J. , Matlock, D. D. , Glasgow, R. E. , Lobo, I. , Levy, C. R. , … Kutner, J. S. (2016). Advance Care Planning Meets Group Medical Visits: The Feasibility of Promoting Conversations. Annals of Family Medicine, 14(2), 125– 132. Retrieved from https: //www. ulib. niu. edu: 2571/10. 1370/afm. 1906 Nassikas, N. J. , Baird, G. L. , & Duffy, C. M. (2020). Improving Advance Care Planning in a Resident Primary Care Clinic. American Journal of Hospice & Palliative Medicine, 37(3), 185– 190. Retrieved from https: //www. ulib. niu. edu: 2571/10. 1177/1049909119872757 Pearse, W. , Oprescu, F. , Endacott, J. , Goodman, S. , Hyde, M. , & O’Neill, M. (2019). Advance care planning in the context of clinical deterioration: a systematic review of the literature. Palliative Care: Research & Treatment, 12, N. PAG. Retrieved from https: //www. ulib. niu. edu: 2571/10. 1177/1178224218823509 Saioron, I. , Souza Ramos, F. R. , Ghizoni Schneider, D. , da Silveira, R. S. , & Ramos Silveira, L. (2017). Advance directives of will: nurses’ perceptions of benefits and new demands. Anna Nery School Journal of Nursing / Escola Anna Nery Revista de Enfermagem, 21(4), 1– 7. Retrieved from https: //www. ulib. niu. edu: 2571/10. 1590/2177 -9465 -EAN-2017 -0100 Saralegui, I. , De Ormijana, A. S. , Delgado, A. , Zabala, I. , Gabilondo, E. , & Melendez, A. (2018). Shared Care Planning: A new model to integrate Advance Care Planning into community. The Basque Country experience. International Journal of Integrated Care (IJIC), 18, 1– 2. Retrieved from https: //www. ulib. niu. edu: 2571/10. 5334/ijic. s 2016 Author Unknown. (2019). Harvard Heart Letter, 30(4), 6. Retrieved from http: //www. ulib. niu. edu: 2618/login. aspx? direct=true&db=ccm&AN=139807356&site=ehostlive&scope=site