Abstract

Ensuring patients receive care in the fashion they so choose at the end of life should be considered and addressed upon any admission process. The project site noted many unnecessary, repeated emergency room (ER) visits for residents so an evidence-based solution was sought. The purpose of this quantitative, quality improvement project was to determine if the implementation of the Carolina Caring Hospice Agency ACP (CCHAACP) toolkit would impact ACP implementation and reduce ER visits among residents in an assisted living facility (ALF) in Western North Carolina over four weeks. Orem's selfcare theory was the framework of the project. Data was obtained from the electronic health record for the number of ACPs and the quality department provided the ER visits data among the sample of 31 residents of an ALF. A Chi-square test indicated a clinical and statistically significant improvement in the implementation of ACP between the comparative (n=0, 0%) and the implementation group (n=3, 30%), X2 (1, N=31) = 6.98, p= .008. A chi-square analysis indicated there was no statistically significant reduction in ER visits (X2(1, N = 62) = .295, p = .587). However clinical significance was noted in reducing readmissions by 6.5%. Therefore, the implementation of the CCHA-ACP toolkit may improve ACP implementation but additional data analysis is needed on reducing readmission rates. Recommendation are to sustain the project and reanalyze data after six months to determine if the short project timeline impacted the statistical analysis.

Description

This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 28647431; ProQuest document ID: 2564509836. The author still retains copyright.

Author Details

JohnPaul King, DNP, CDP, RN

Sigma Membership

Theta Tau

Type

Dissertation

Format Type

Text-based Document

Study Design/Type

Quality Improvement

Research Approach

Quantitative Research

Keywords:

End-of-Life Care, Self-Determination, Living Wills, End-of-Life Planning

Advisor

Bridget Drafahl

Second Advisor

Kevin O'Neil

Degree

DNP

Degree Grantor

Grand Canyon University

Degree Year

2021

Rights Holder

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All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Proxy-submission

Date of Issue

2023-05-23

Full Text of Presentation

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