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RES29
The Effectiveness Of Advance Directives: Nurses Share Their Perspectives
By: Turcotte, J.; Florida Hospital Orlando, Orlando, FL
For further information, please contact: jean.turcotte@flhosp.org
Purpose: The purpose of this qualitative research study was to determine, through the experiences of Registered Nurses, what factors influence the ability of patients, surrogate decision-makers, and healthcare providers to carry out Advance Directives.
Background/Significance: As front-line healthcare providers, Registered Nurses have valuable insight regarding factors that prevent congruency between an individuals wishes and the actual medical care they receive. Methods: An inductive qualitative research approach was used to gain first-hand knowledge from eight front-line Assistant Nurse Managers who were selected using purposive sampling. Data was collected through an anonymous on-line survey and then through individual in-person interviews. Data analysis consisted of manually identifying and grouping themes.
Results: Factors identified included: Communication - which included locating and understanding information; Beliefs - professional, personal, cultural and religious; Legal aspects - related to documents, designation of decision-makers, and interpreting information and meaning; Education and support for healthcare personnel, family members, and decision-makers; Ownership - who does this benefit most?
Conclusions: The ability to carry out Advance Directives is dependant on the clarity in which the patients' wishes are understood by the patient and then communicated to those responsible for carrying out their wishes. It is also imperative to identify the legal decision-maker and to provide support to that person, as well as others who may be involved. In addition, a means to deal with conflicting beliefs must also be established. Finally, there is a need for additional education related to the legal, ethical, professional and especially personal aspects of Advance Directives.
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