We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
"DO YOU HAVE AN ADVANCE DIRECTIVE?": A COLLABORATION BETWEEN NURSES AND SOCIAL WORK TO INCREASE ADVANCE DIRECTIVE DOCUMENTATION.
- Authors
Mea, Rachel; LeGrand, Ellen; Simon, Brianna; Lightheart, Erin; Marturano, Erin; Maloney, Kristen; Landsburg, Daniel
- Abstract
An advance directive (AD) is a legal document that allows patients to identify a durable power of attorney to direct care when they are unable to express wishes or are incapacitated. Nurses at an academic medical center have screened for ADs on admission to the hospital for over 30 years, yet many patients have not completed an AD or have one on file in the electronic medical record (EMR). Nurses and social workers are an underutilized resource in completing ADs. From July through November of 2020, 23.6% of discharged oncology patients had some form of an AD. The purpose of this project is to increase the documentation of an ADs, with an indirect goal of reducing the percentage of patients who spend less than 3 days on hospice. Nurse and Social Work champions were educated to assist patients in completing Our Care Wishes (OCW), an online platform that can be used to document ADs. OCW can be linked to the patient's EMR, allowing both inpatient and outpatient providers to see the document. From January 2021 through September 2021, 145 OCW consults were referred to the champions. Of those, 114 patients received the information or had a discussion with the champions. The 31 patients who were not counted in the number did not meet criteria for discussion (e.g., altered mental status, code status changed, or ICU transfer). 34 patients completed new ADs, leading to an average of 1.03 new AD per week. During the time of this project, hospice length of stay less than 3 days has decreased from 19.6% to 13.4%. Advance care planning notes among discharged patients increased from 20% to 45%. Nurse and social work champions facilitate advance care planning and documentation of ADs. Advanced care planning and ADs are associated with goal-concordant care and earlier utilization of hospice. While the decrease in hospice length of stay cannot be directly correlated to this intervention, over time we hope increased documentation will allow further investigation of this relationship and sustain the gains made. Promoting partnership between nurses and social workers to ensure completion of ADs can assist providers in delivering goal-concordant care potentially leading to decreased unplanned admissions, reduced hospital cost, and improve quality of life.
- Subjects
CALIFORNIA; CONFERENCES &; conventions; ADVANCE directives (Medical care); DOCUMENTATION; NURSES; MEDICAL practice; SOCIAL case work
- Publication
Oncology Nursing Forum, 2022, Vol 49, Issue 2, pE127
- ISSN
0190-535X
- Publication type
Article
- DOI
10.1188/22.ONF.E2