Other Titles
Clinical Practice Initiatives
Abstract
In today's society, people are living longer. Despite aging and health issues, many American adults do not have Advance Directives (ADs). Statistics show that only 18%-36% of the U.S. population has completed an AD (Pecanac, Repenshek, Tennenbaum, & Hammes, 2014). Although a growing need for advance care planning (ACP) is noted, it is found that healthcare teams lack the education needed to provide teaching on ACP and ADs (Kroning, 2014). It is imperative that healthcare teams stress the value of ACP in order to clarify patients' wishes for future care, ideally before hospitalization (Ke, Huang, O'Connor, & Lee, 2015). Kroning (2014) states that research indicates a critical need for education related to ACP. Education and training assists with instilling confidence to effectively educate and advocate for patients' end of life wishes (Kroning, 2014). Providing healthcare teams education about ACP has potential to increase the number of individuals with completed ADs. While the research is based in the U.S., the lack of ACP training has a global impact related to providing patients healthcare according to their wishes. Providing staff training can potentially impact other important aspects in regards to patient outcomes and healthcare costs.
A pilot study was done in a community hospital. IRB approval was deemed not required by the facilities IRB council. An instructor with training in ACP and ADs provided training sessions. The sessions were open to all healthcare team members to voluntarily attend. Classes were capped out at 15-20 attendees to allow for dialogue and questions. A performed power analysis showed that an N of at least 60 was needed to reach statistical significance.
Three different tools were used for evaluation of the program. The tools were a pretest, posttest, and an evaluation form. All instruments used also provided space for optional feedback and comments from attendees. The pretest and posttest went through an approval process from a panel of experts. The experts conducted a content validity index (CVI) and provided feedback for improvement. The panel included an ACP expert, research expert, and an adult education expert.
The pretest had a total of 6 questions. Two of the questions included Likert scale ratings on self perceived knowledge and comfort regarding ACP and ADs. The pretest also had three yes and no questions asking about previous training, if they had an AD, and if they could describe the difference between ACP and AD. The last question asked how often the individual encountered someone needing assistance with an AD. The answer choices for this question were daily, weekly, monthly, yearly, and rarely.
The posttest had a total of 4 questions. The attendee completed the posttest immediately after the training session. Questions on the posttest included: two different questions using Likert scale ratings of self perceived knowledge and comfort regarding ACP and ADs post training, a yes or no question regarding if they did not have a completed AD before the training session, did they plan on getting one, and the final question was yes or no if they could describe the difference between ACP and AD.
The evaluation tool was completed to provide feedback regarding the effectiveness of the teaching session. Questions asked on the evaluation tool were about effectiveness of the presenter, the tools, and meeting the objectives. Answers were given using a Likert scale. The final two questions on the evaluation asked yes or no if the attendee planned on making changes to their practice and a narrative format of how they planned on using the information to impact their practice. Each healthcare team member provided their pre test and posttest by putting the last 4 digits of their phone numbers in order to remain anonymous. Once completed, the instructor submitted the tools to the project manager for analysis. Answers from attendees were compared per participant to measure the change in knowledge and comfort level regarding ACP. Data is currently in the analysis process with a statistician. Data will be reported during the presentation.
This session will provide an overview of the process used to develop the ACP Training Program. Participants will be able to discuss strategies that leaders should use to ensure the healthcare team has the training needed to confidently perform ACP with patients and families. This session will offer ideas for the participants to engage with other leaders in their own settings regarding the importance of ACP training. Recommendations for assessing the environment will be provided. The presenters will provide suggestions to be used to develop a program in other settings.
Sigma Membership
Non-member
Type
Presentation
Format Type
Text-based Document
Study Design/Type
N/A
Research Approach
N/A
Keywords:
Advance Care Planning, Leadership, Training
Recommended Citation
Tully, Jessica and Boswell, Carol, "Advance care planning (ACP) training: Your role as a nursing leader" (2017). INRC (Congress). 208.
https://www.sigmarepository.org/inrc/2017/presentations_2017/208
Conference Name
28th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Dublin, Ireland
Conference Year
2017
Rights Holder
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Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Advance care planning (ACP) training: Your role as a nursing leader
Dublin, Ireland
In today's society, people are living longer. Despite aging and health issues, many American adults do not have Advance Directives (ADs). Statistics show that only 18%-36% of the U.S. population has completed an AD (Pecanac, Repenshek, Tennenbaum, & Hammes, 2014). Although a growing need for advance care planning (ACP) is noted, it is found that healthcare teams lack the education needed to provide teaching on ACP and ADs (Kroning, 2014). It is imperative that healthcare teams stress the value of ACP in order to clarify patients' wishes for future care, ideally before hospitalization (Ke, Huang, O'Connor, & Lee, 2015). Kroning (2014) states that research indicates a critical need for education related to ACP. Education and training assists with instilling confidence to effectively educate and advocate for patients' end of life wishes (Kroning, 2014). Providing healthcare teams education about ACP has potential to increase the number of individuals with completed ADs. While the research is based in the U.S., the lack of ACP training has a global impact related to providing patients healthcare according to their wishes. Providing staff training can potentially impact other important aspects in regards to patient outcomes and healthcare costs.
A pilot study was done in a community hospital. IRB approval was deemed not required by the facilities IRB council. An instructor with training in ACP and ADs provided training sessions. The sessions were open to all healthcare team members to voluntarily attend. Classes were capped out at 15-20 attendees to allow for dialogue and questions. A performed power analysis showed that an N of at least 60 was needed to reach statistical significance.
Three different tools were used for evaluation of the program. The tools were a pretest, posttest, and an evaluation form. All instruments used also provided space for optional feedback and comments from attendees. The pretest and posttest went through an approval process from a panel of experts. The experts conducted a content validity index (CVI) and provided feedback for improvement. The panel included an ACP expert, research expert, and an adult education expert.
The pretest had a total of 6 questions. Two of the questions included Likert scale ratings on self perceived knowledge and comfort regarding ACP and ADs. The pretest also had three yes and no questions asking about previous training, if they had an AD, and if they could describe the difference between ACP and AD. The last question asked how often the individual encountered someone needing assistance with an AD. The answer choices for this question were daily, weekly, monthly, yearly, and rarely.
The posttest had a total of 4 questions. The attendee completed the posttest immediately after the training session. Questions on the posttest included: two different questions using Likert scale ratings of self perceived knowledge and comfort regarding ACP and ADs post training, a yes or no question regarding if they did not have a completed AD before the training session, did they plan on getting one, and the final question was yes or no if they could describe the difference between ACP and AD.
The evaluation tool was completed to provide feedback regarding the effectiveness of the teaching session. Questions asked on the evaluation tool were about effectiveness of the presenter, the tools, and meeting the objectives. Answers were given using a Likert scale. The final two questions on the evaluation asked yes or no if the attendee planned on making changes to their practice and a narrative format of how they planned on using the information to impact their practice. Each healthcare team member provided their pre test and posttest by putting the last 4 digits of their phone numbers in order to remain anonymous. Once completed, the instructor submitted the tools to the project manager for analysis. Answers from attendees were compared per participant to measure the change in knowledge and comfort level regarding ACP. Data is currently in the analysis process with a statistician. Data will be reported during the presentation.
This session will provide an overview of the process used to develop the ACP Training Program. Participants will be able to discuss strategies that leaders should use to ensure the healthcare team has the training needed to confidently perform ACP with patients and families. This session will offer ideas for the participants to engage with other leaders in their own settings regarding the importance of ACP training. Recommendations for assessing the environment will be provided. The presenters will provide suggestions to be used to develop a program in other settings.