Knowledge of, and participation in, advance care planning: A cross-sectional study of acute and critical care nurses’ perceptions
Nurses have a core role in facilitating discussions and enacting decisions about end-of-life issues for patients in hospitals. Nurses’ own knowledge and attitudes may influence whether they engage in meaningful end-of-life conversations with patients. To determine in a sample of nurses working in ac...
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| Veröffentlicht in: | International journal of nursing studies 2018-10, Vol.86, p.74-81 |
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| container_title | International journal of nursing studies |
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| creator | Shepherd, Jan Waller, Amy Sanson-Fisher, Rob Clark, Katherine Ball, Jean |
| description | Nurses have a core role in facilitating discussions and enacting decisions about end-of-life issues for patients in hospitals. Nurses’ own knowledge and attitudes may influence whether they engage in meaningful end-of-life conversations with patients.
To determine in a sample of nurses working in acute and critical care hospital wards:
1) their knowledge of advance care planning, including the authority of substitute decision-makers and legal validity of advance directives;
2) their own participation in advance care planning decision-making practices; and
3) associations between nurses’ socio-demographic characteristics; clinical expertise; and knowledge and behaviour in relation to advance care planning practices.
Questionnaire-based, cross-sectional study.
The study was conducted with 181 registered and enrolled nurses employed in acute and critical care wards of three metropolitan hospitals in Australia.
Nurses were least knowledgeable about items relating to the authority of medical (56%) and financial (42%) substitute decision-makers. Few nurses had prepared advance directives (10%) or appointed medical (23%) or financial (27%) decision-makers, when compared to discussing end-of-life wishes (53%) or organ donation (75%). Overall, 15% of nurses had not engaged in any advance care planning practices. Nurses who had cared for 11–30 dying patients in the last six months were more likely to have an increased knowledge score. Older nurses were more likely to participate in a greater number of advance care planning practices and an increase in shifts worked per week led to a significant decrease in nurses’ participation.
Nurses have a key role in providing advice and engaging dying patients and their families in advance care planning practices. Nurses’ own knowledge and rates of participation are low. Further education and support is needed to ensure that nurses have an accurate knowledge of advance care planning practices, including how, when and with whom wishes should be discussed and can be enacted. |
| doi_str_mv | 10.1016/j.ijnurstu.2018.06.005 |
| format | Article |
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To determine in a sample of nurses working in acute and critical care hospital wards:
1) their knowledge of advance care planning, including the authority of substitute decision-makers and legal validity of advance directives;
2) their own participation in advance care planning decision-making practices; and
3) associations between nurses’ socio-demographic characteristics; clinical expertise; and knowledge and behaviour in relation to advance care planning practices.
Questionnaire-based, cross-sectional study.
The study was conducted with 181 registered and enrolled nurses employed in acute and critical care wards of three metropolitan hospitals in Australia.
Nurses were least knowledgeable about items relating to the authority of medical (56%) and financial (42%) substitute decision-makers. Few nurses had prepared advance directives (10%) or appointed medical (23%) or financial (27%) decision-makers, when compared to discussing end-of-life wishes (53%) or organ donation (75%). Overall, 15% of nurses had not engaged in any advance care planning practices. Nurses who had cared for 11–30 dying patients in the last six months were more likely to have an increased knowledge score. Older nurses were more likely to participate in a greater number of advance care planning practices and an increase in shifts worked per week led to a significant decrease in nurses’ participation.
Nurses have a key role in providing advice and engaging dying patients and their families in advance care planning practices. Nurses’ own knowledge and rates of participation are low. Further education and support is needed to ensure that nurses have an accurate knowledge of advance care planning practices, including how, when and with whom wishes should be discussed and can be enacted.</description><identifier>ISSN: 0020-7489</identifier><identifier>EISSN: 1873-491X</identifier><identifier>DOI: 10.1016/j.ijnurstu.2018.06.005</identifier><identifier>PMID: 29966827</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; Advance Care Planning ; Advance directives ; Attitude of Health Personnel ; Authority ; Biological organs ; Care plans ; Clinical decision making ; Clinical nursing ; Critical care ; Critical Care Nursing ; Cross-Sectional Studies ; Death & dying ; Decision makers ; Decision making ; Donors ; End of life decisions ; Enrollments ; Female ; Focus Groups ; Health Knowledge, Attitudes, Practice ; Hospitals ; Humans ; Knowledge ; Legal guardians ; Male ; Middle Aged ; New South Wales ; Nurse patient relationships ; Nurses ; Nursing ; Nursing staff ; Nursing Staff, Hospital - psychology ; Palliative care ; Participation ; Pilot Projects ; Terminal care</subject><ispartof>International journal of nursing studies, 2018-10, Vol.86, p.74-81</ispartof><rights>2018 Elsevier Ltd</rights><rights>Copyright © 2018 Elsevier Ltd. All rights reserved.</rights><rights>Copyright Elsevier Science Ltd. Oct 2018</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c396t-b9f0fe06208049c2005a1cf8d09b4f84f20631a85651771b908f16ac233c90203</citedby><cites>FETCH-LOGICAL-c396t-b9f0fe06208049c2005a1cf8d09b4f84f20631a85651771b908f16ac233c90203</cites><orcidid>0000-0001-6747-0013</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ijnurstu.2018.06.005$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,30980,45976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29966827$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shepherd, Jan</creatorcontrib><creatorcontrib>Waller, Amy</creatorcontrib><creatorcontrib>Sanson-Fisher, Rob</creatorcontrib><creatorcontrib>Clark, Katherine</creatorcontrib><creatorcontrib>Ball, Jean</creatorcontrib><title>Knowledge of, and participation in, advance care planning: A cross-sectional study of acute and critical care nurses’ perceptions</title><title>International journal of nursing studies</title><addtitle>Int J Nurs Stud</addtitle><description>Nurses have a core role in facilitating discussions and enacting decisions about end-of-life issues for patients in hospitals. Nurses’ own knowledge and attitudes may influence whether they engage in meaningful end-of-life conversations with patients.
To determine in a sample of nurses working in acute and critical care hospital wards:
1) their knowledge of advance care planning, including the authority of substitute decision-makers and legal validity of advance directives;
2) their own participation in advance care planning decision-making practices; and
3) associations between nurses’ socio-demographic characteristics; clinical expertise; and knowledge and behaviour in relation to advance care planning practices.
Questionnaire-based, cross-sectional study.
The study was conducted with 181 registered and enrolled nurses employed in acute and critical care wards of three metropolitan hospitals in Australia.
Nurses were least knowledgeable about items relating to the authority of medical (56%) and financial (42%) substitute decision-makers. Few nurses had prepared advance directives (10%) or appointed medical (23%) or financial (27%) decision-makers, when compared to discussing end-of-life wishes (53%) or organ donation (75%). Overall, 15% of nurses had not engaged in any advance care planning practices. Nurses who had cared for 11–30 dying patients in the last six months were more likely to have an increased knowledge score. Older nurses were more likely to participate in a greater number of advance care planning practices and an increase in shifts worked per week led to a significant decrease in nurses’ participation.
Nurses have a key role in providing advice and engaging dying patients and their families in advance care planning practices. Nurses’ own knowledge and rates of participation are low. Further education and support is needed to ensure that nurses have an accurate knowledge of advance care planning practices, including how, when and with whom wishes should be discussed and can be enacted.</description><subject>Adult</subject><subject>Advance Care Planning</subject><subject>Advance directives</subject><subject>Attitude of Health Personnel</subject><subject>Authority</subject><subject>Biological organs</subject><subject>Care plans</subject><subject>Clinical decision making</subject><subject>Clinical nursing</subject><subject>Critical care</subject><subject>Critical Care Nursing</subject><subject>Cross-Sectional Studies</subject><subject>Death & dying</subject><subject>Decision makers</subject><subject>Decision making</subject><subject>Donors</subject><subject>End of life decisions</subject><subject>Enrollments</subject><subject>Female</subject><subject>Focus Groups</subject><subject>Health Knowledge, Attitudes, Practice</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Knowledge</subject><subject>Legal guardians</subject><subject>Male</subject><subject>Middle Aged</subject><subject>New South Wales</subject><subject>Nurse patient relationships</subject><subject>Nurses</subject><subject>Nursing</subject><subject>Nursing staff</subject><subject>Nursing Staff, Hospital - psychology</subject><subject>Palliative care</subject><subject>Participation</subject><subject>Pilot Projects</subject><subject>Terminal care</subject><issn>0020-7489</issn><issn>1873-491X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNqFkc1u1DAUhS0EokPhFSpLbFiQcJ1kHJsVVcWfqMQGJHaWx7muHGWcYCetukPiKXg9noSbmZYFG1aW7O8c33sOY2cCSgFCvurL0Mcl5XkpKxCqBFkCbB-wjVBtXTRafHvINgAVFG2j9Al7knMPQCSox-yk0lpKVbUb9vNTHG8G7K6Qj_4lt7Hjk01zcGGycxgjD5Fuu2sbHXJnE_JpsDGGePWan3OXxpyLjG5F7cBpnO6WjLh1y4wHN5cCudHbQbyOjPn3j198wuRwWnX5KXvk7ZDx2d15yr6-e_vl4kNx-fn9x4vzy8LVWs7FTnvwCLICBY12Fe1rhfOqA71rvGp8BbIWVm3lVrSt2GlQXkjrqrp2mpKoT9mLo--Uxu8L5tnsQ3Y40EI4Ltms-lboZisJff4P2o9LohWJEhJa0dZSESWP1CGHhN5MKextujUCzFqT6c19TWatyYA0NDYJz-7sl90eu7-y-14IeHMEkPK4DphMdgGpgy4kStt0Y_jfH38A3DaolA</recordid><startdate>201810</startdate><enddate>201810</enddate><creator>Shepherd, Jan</creator><creator>Waller, Amy</creator><creator>Sanson-Fisher, Rob</creator><creator>Clark, Katherine</creator><creator>Ball, Jean</creator><general>Elsevier Ltd</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6747-0013</orcidid></search><sort><creationdate>201810</creationdate><title>Knowledge of, and participation in, advance care planning: A cross-sectional study of acute and critical care nurses’ perceptions</title><author>Shepherd, Jan ; Waller, Amy ; Sanson-Fisher, Rob ; Clark, Katherine ; Ball, Jean</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c396t-b9f0fe06208049c2005a1cf8d09b4f84f20631a85651771b908f16ac233c90203</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Advance Care Planning</topic><topic>Advance directives</topic><topic>Attitude of Health Personnel</topic><topic>Authority</topic><topic>Biological organs</topic><topic>Care plans</topic><topic>Clinical decision making</topic><topic>Clinical nursing</topic><topic>Critical care</topic><topic>Critical Care Nursing</topic><topic>Cross-Sectional Studies</topic><topic>Death & dying</topic><topic>Decision makers</topic><topic>Decision making</topic><topic>Donors</topic><topic>End of life decisions</topic><topic>Enrollments</topic><topic>Female</topic><topic>Focus Groups</topic><topic>Health Knowledge, Attitudes, Practice</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Knowledge</topic><topic>Legal guardians</topic><topic>Male</topic><topic>Middle Aged</topic><topic>New South Wales</topic><topic>Nurse patient relationships</topic><topic>Nurses</topic><topic>Nursing</topic><topic>Nursing staff</topic><topic>Nursing Staff, Hospital - psychology</topic><topic>Palliative care</topic><topic>Participation</topic><topic>Pilot Projects</topic><topic>Terminal care</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shepherd, Jan</creatorcontrib><creatorcontrib>Waller, Amy</creatorcontrib><creatorcontrib>Sanson-Fisher, Rob</creatorcontrib><creatorcontrib>Clark, Katherine</creatorcontrib><creatorcontrib>Ball, Jean</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of nursing studies</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shepherd, Jan</au><au>Waller, Amy</au><au>Sanson-Fisher, Rob</au><au>Clark, Katherine</au><au>Ball, Jean</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Knowledge of, and participation in, advance care planning: A cross-sectional study of acute and critical care nurses’ perceptions</atitle><jtitle>International journal of nursing studies</jtitle><addtitle>Int J Nurs Stud</addtitle><date>2018-10</date><risdate>2018</risdate><volume>86</volume><spage>74</spage><epage>81</epage><pages>74-81</pages><issn>0020-7489</issn><eissn>1873-491X</eissn><abstract>Nurses have a core role in facilitating discussions and enacting decisions about end-of-life issues for patients in hospitals. Nurses’ own knowledge and attitudes may influence whether they engage in meaningful end-of-life conversations with patients.
To determine in a sample of nurses working in acute and critical care hospital wards:
1) their knowledge of advance care planning, including the authority of substitute decision-makers and legal validity of advance directives;
2) their own participation in advance care planning decision-making practices; and
3) associations between nurses’ socio-demographic characteristics; clinical expertise; and knowledge and behaviour in relation to advance care planning practices.
Questionnaire-based, cross-sectional study.
The study was conducted with 181 registered and enrolled nurses employed in acute and critical care wards of three metropolitan hospitals in Australia.
Nurses were least knowledgeable about items relating to the authority of medical (56%) and financial (42%) substitute decision-makers. Few nurses had prepared advance directives (10%) or appointed medical (23%) or financial (27%) decision-makers, when compared to discussing end-of-life wishes (53%) or organ donation (75%). Overall, 15% of nurses had not engaged in any advance care planning practices. Nurses who had cared for 11–30 dying patients in the last six months were more likely to have an increased knowledge score. Older nurses were more likely to participate in a greater number of advance care planning practices and an increase in shifts worked per week led to a significant decrease in nurses’ participation.
Nurses have a key role in providing advice and engaging dying patients and their families in advance care planning practices. Nurses’ own knowledge and rates of participation are low. Further education and support is needed to ensure that nurses have an accurate knowledge of advance care planning practices, including how, when and with whom wishes should be discussed and can be enacted.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>29966827</pmid><doi>10.1016/j.ijnurstu.2018.06.005</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-6747-0013</orcidid></addata></record> |
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| identifier | ISSN: 0020-7489 |
| ispartof | International journal of nursing studies, 2018-10, Vol.86, p.74-81 |
| issn | 0020-7489 1873-491X |
| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals; Applied Social Sciences Index & Abstracts (ASSIA) |
| subjects | Adult Advance Care Planning Advance directives Attitude of Health Personnel Authority Biological organs Care plans Clinical decision making Clinical nursing Critical care Critical Care Nursing Cross-Sectional Studies Death & dying Decision makers Decision making Donors End of life decisions Enrollments Female Focus Groups Health Knowledge, Attitudes, Practice Hospitals Humans Knowledge Legal guardians Male Middle Aged New South Wales Nurse patient relationships Nurses Nursing Nursing staff Nursing Staff, Hospital - psychology Palliative care Participation Pilot Projects Terminal care |
| title | Knowledge of, and participation in, advance care planning: A cross-sectional study of acute and critical care nurses’ perceptions |
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