Perceptions about advance directives by nurses in a community hospital

Knowledge, Attitudes, and Predictors of Advance Directive Discussions of Registered Nurses

The purpose of this study was to describe nurses’ knowledge, attitudes, and experiences regarding advance directives. A secondary purpose was to examine predictors of advance directive discussions between nurses and patients. Seven-hundred and nineteen respondents, randomly selected from a list of registered nurses in the state of Ohio, completed mailed questionnaires. Descriptive t test, chi-square, and logistic regression statistics were used in the data analyses. The respondents were knowledgeable and possessed positive attitudes about advance directives. Higher self-perceived confidence in advance directive discussion skills and the experience of caring for at least one patient with a current advance directive were found to be significant predictors of advance directive discussions. These findings suggest that experience with advance directives documents is critical for nurses’ comfort and that developing interventions to further nurses’ confidence in their discussion skills may increase advance directive discussions.

Knowledge about patients' rights among professionals in public health care in Finland

BACKGROUND

The legal rights of patients include civil rights for patients and the duties of healthcare professionals. Knowledge of legislation and the ability to put juridical norms into practice are among the main aspects of professionals.

AIM

The aim of the study was to describe the level of healthcare professionals' knowledge about patients' legal rights and to describe background variables associated with the knowledge. The legal rights are based on the Finnish Act on the Status and Rights of Patients.

METHOD

The data were collected from healthcare professionals (nurses and physicians) in public health care in Finland (recruited N = 290, responded n = 191) with a questionnaire designed for the study. The response rate was 66%. The data were analysed statistically.

RESULTS

Healthcare professionals were partially familiar with patients' legal rights. The right to good health care, treatment and access to care and right to self-determination were the best-known areas. The respondents lacked knowledge on the right to information and the right to use the services of patient ombudsman. Based on self-evaluation, half of the respondents thought that they had weak knowledge of the legislation on patients' rights. However, they perceived knowledge about patients' rights as being important. There was no correlation between respondents' self-evaluated knowledge and actual scoring on the knowledge test.

CONCLUSION

These results implicate a need for further education aimed at healthcare professionals and development of professional training about patients' legal rights.

Advance directives: evaluation of nurses' knowledge, attitude, confidence, and experience

This study assessed nurses' knowledge, attitudes, experience, and confidence in discussing advance directives with patients. Concepts were measured using a questionnaire administered to 87 acute care registered nurses. Results indicated lack of knowledge about laws regarding advance directives, moderately negative attitudes toward advance directives, moderate confidence, and moderate experience with advance directives. The study supports the need to explore ways to assist nurses to be comfortable with advance directives discussions to improve quality patient care.

Emergency nurses' knowledge, attitudes, and experiential survey on advance directives

The purpose of this study was to determine emergency nurses' knowledge of, attitudes toward, and experiences with advance directives (ADs). This was a descriptive, correlation, mailed survey study sent to a random sample of members of the Emergency Nurses Association. The results, based on the responses of 579 emergency nurses, found that the nurses were not very knowledgeable about ADs in general (68% correct) and even less knowledgeable about the Patient Self-Determination Act (PSDA) (51% correct) and their state laws (56% correct). The nurses were experienced with ADs but they were less confident in their ability to assist patients with completing ADs. Forty-seven percent of the nurses agreed that actively assisting some terminally ill patients to die should be made legal. Nurses need information pertaining to ADs in general, the PSDA, and their individual state laws. This could increase their level of confidence in being able to effectively assist patients to understand and complete ADs.

Knowledge, attitudes and practices of nursing personnel regarding advance directives

The aim of the study was to describe the knowledge, attitudes and practices of nursing personnel working in acute care settings regarding advance directives (ADs). The study was descriptive using a 40-item, newly developed tool (Update on Advance Directives questionnaire) distributed to 108 nursing personnel (mostly registered nurses) who were willing to complete the questionnaire. The findings were that nursing personnel reflected a lack of knowledge concerning federal and state laws and general information about ADs. Nursing personnel had very low rates of AD completion but most felt ADs were valuable for the patient. We concluded that nurses need more resources, e.g. knowledge, administrative and physician support, and communication tools to facilitate advance planning for end-of-life care for patients. The role of the health care provider, be it the nurse, physician or other, needs to be clarified regarding the most practical setting for AD formulation.

What is Needed to Assist Patients with Advance Directives from the Perspective of Emergency Nurses

INTRODUCTION

Nurses, by the nature of their practice, are in a unique position to help patients complete advance directives (ADs). This article focuses on an open-ended question that was part of a larger quantitative survey, "What do emergency nurses need to increase their ability to assist patients with ADs?"

METHODS

A random sample of emergency nurses in four states was surveyed. Of the 663 nurses who responded to the survey, 506 (76%) wrote responses to the open-ended question. Thematic analysis was used to establish and saturate themes.

RESULTS

The major themes discussed most often by the nurses were the need for more education and more time to discuss ADs with patients. Other themes discussed by nurses were the need for: a supportive work environment, other health care professionals' participation conducive to assisting patients, patient/public education related to ADs, communication, and particular nursing characteristics needed to successfully assist patients with ADs. Not all the nurses in the study felt that assisting patients with ADs was the role of emergency nurses.

CONCLUSIONS

Those nurses who saw assisting patients with ADs as their role were very clear about what they needed to be able to carry out the role (more time to spend with patients and more education related to ADs) and that they could not fulfill that role without the support of their institution's administration.