University of Texas MD Anderson Cancer Center.
Texas Woman's University.
Clin J Oncol Nurs. 2020 Feb 1;24(1):81-87. doi: 10.1188/20.CJON.81-87.
Advance care planning (ACP) is an ongoing process of communication involving patients, family members, and caregivers on one side and healthcare providers on the other to establish values, goals, and preferences for future care, along with discussions concerning end-of-life care options. Advance directives promote patient autonomy and provide written documentation of a patient's wishes for future care.
This quality improvement project aimed to determine if ACP discussions initiated by an advanced practice provider (APP) would enhance patient-centered end-of-life care.
This study involved retrospective data collection of 20 inpatients and 20 outpatients without a scanned advance directive in the electronic health record at the time of admission or clinic visit, as well as an ACP intervention by an APP.
APPs can initiate ACP discussions with patients with cancer, which may assist in their understanding of ACP, resulting in completion of the advance directive documents and a change in their code (resuscitation) status.
预先医疗指示（ACP）是一个持续的医患沟通过程，患者、家属和护理人员一方与医疗保健提供者另一方就未来的医疗、临终关怀方案等进行价值观、目标和偏好的讨论，并记录在案。预先医疗指示可以促进患者的自主权，并为患者未来医疗的意愿提供书面文件。
本质量改进项目旨在确定由高级实践提供者（APP）发起的 ACP 讨论是否能增强以患者为中心的临终关怀。
本研究通过回顾性数据收集，对入院或就诊时电子病历中没有扫描的预先医疗指示的 20 名住院患者和 20 名门诊患者进行分析，并由 APP 进行 ACP 干预。
APP 可以与癌症患者启动 ACP 讨论，这可能有助于他们理解 ACP，从而完成预先医疗指示文件，并改变他们的复苏状态。
