The nurse's role in end-of-life decision-making for patients and families

Briggs, Linda; Colvin, E.D.

doi:10.1067/mgn.2002.130271

Cited by 29 publications

(20 citation statements)

References 23 publications

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“…Nursing staff are frequently present and will often have the greatest “face‐to‐face” contact with patients, and families, placing them in key positions to facilitate ACP (Newton, Clark, & Ahlquist, ). Nursing regulatory bodies consider supporting patient self‐determination and decision‐making a core proficiency of practice (American Nurses Association, ; Nursing and Midwifery Council (NMC), ), and there is consensus that nurses should be playing a pivotal role in helping patients understand, explore and communicate their preferences regarding future medical treatments and end‐of‐life care (Briggs & Colvin, ).…”

Section: Introductionmentioning

confidence: 99%

Barriers to advance care planning with patients as perceived by nurses and other healthcare professionals: A systematic review

Blackwood

Walker

Mythen

et al. 2019

Journal of Clinical Nursing

110

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Introduction Advance care planning is a means for patients to communicate their wishes, fears and desires for future health decisions should they lose the ability to consider or communicate these. Despite being supported by governments and healthcare leaders, uptake amongst the general population remains low. Nurses play a crucial role in promoting and engaging with these discussions given their close relationship with patients and families in a range of clinical settings. Aim To describe the barriers that nurses and healthcare professionals believe prevent them from exploring advance care planning with their patients. Method We carried out a systematic review of peer‐reviewed journal articles from the databases MEDLINE, Embase, CINAHL Plus, Web of Science and ProQuest Central, guided by the PRISMA checklist. Results Eleven articles were identified: all were self‐reporting surveys using a mix of open and closed questions. They originated in the USA, Canada, Australia and Ireland. The participants included various healthcare professionals, with the majority of studies focussing on nurses. The two most important barriers to advance care planning are lack of education and insufficient time. Advance care planning appears to be well supported, and nurses and healthcare professionals report themselves to be comfortable and confident to take on the responsibility. Conclusion There is a need for greater education and training for nurses and healthcare professionals. In particular, there needs to be better understanding of professional and legal responsibilities. The need for sufficient time to be made available to allow these conversations, in often busy settings, will need institutional and financial support. Relevance to clinical practice Increased training and knowledge are likely to lead to more positive attitudes and greater confidence for nurses, and other healthcare professionals, which should help support and encourage patient engagement with advance care planning.

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Section: Introductionmentioning

confidence: 99%

Barriers to advance care planning with patients as perceived by nurses and other healthcare professionals: A systematic review

Blackwood

Walker

Mythen

et al. 2019

Journal of Clinical Nursing

110

View full text Add to dashboard Cite

show abstract

“…8 Beginning the discussions that enable nurses to intervene appropriately, however, requires education and experience. 8 Beginning the discussions that enable nurses to intervene appropriately, however, requires education and experience.…”

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confidence: 99%

Preferences for Care Near the End of Life

Schirm

Sheehan²,

Zeller³

2008

Critical Care Nursing Quarterly

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This article presents descriptive data and a psychometric evaluation of the Preferences for Care Near the End of Life (PCEOL) tool developed by Gauthier and Froman. The PCEOL tool identifies dimensions related to care near end of life and asks respondents to consider personal preferences in the context of their values. Analyses were conducted on data from a convenience sample of 68 adults recruited at a workshop series on anticipatory guidance for end-of-life care. Participants included nurses, nursing students, nursing assistants, social workers, and older adults. Findings supporting a 3-factor structure (personal autonomy, healthcare provider input, and spirituality and family) are interpreted and discussed. Implications are given for using the PCEOL tool in nursing care situations.

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“…The impact of patient‐driven advance care planning cannot be overstated. There are patients receiving care they did not want because either their wishes were not honored or because their advance care plan was never formalized and their wishes were not even known (Perkins, 2007; Briggs, Colvin, 2002). While advance directives have been utilized for over 15 years, it is noteworthy that only 5%–25% of Americans have formally created an advance directive clearly stating personal choices for advance care planning and end‐of‐life care (Matzo, Hijazi, & Outwater, 2008).…”

Section: Linkages Between Spiritual Assessment and Advance Care Planningmentioning

confidence: 99%

The APN role in holistic assessment and integration of spiritual assessment for advance care planning

Chrash

Mulich

Patton

2011

Journal of the American Academy of Nurse Practitioners

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Purpose: Provide advanced practice nurses (APNs) with tools and guidance on spiritual assessment for advance care planning(ACP); to review the literature on the connectedness between spiritual assessment and ACP; and to discuss implications for the APN in application of these concepts with a case study. Data sources: Selected research and clinical articles. Conclusions: There is a disconnect between what patients have expressed as their wishes regarding end‐of‐life care (EOLC) and what occurs. Spiritual beliefs and values impact patients' and families' decisions regarding EOLC, but if not discussed in advance, most wishes, especially dying at home, do not occur. Implications for practice: Incorporating spiritual assessment in a holistic assessment, it is possible to assist patients and families prior to crisis in sorting out patients' wishes with respect to EOLC during clinic visits. With the use of a simple mnemonic to guide spiritual assessment, the APN can bridge the gap between what the patient wants and what care is received at end of life.

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The nurse's role in end-of-life decision-making for patients and families

Cited by 29 publications

References 23 publications

Barriers to advance care planning with patients as perceived by nurses and other healthcare professionals: A systematic review

Barriers to advance care planning with patients as perceived by nurses and other healthcare professionals: A systematic review

Preferences for Care Near the End of Life

The APN role in holistic assessment and integration of spiritual assessment for advance care planning

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