Date of Award


Document Type

Restricted Access Thesis

Degree Name

Doctor of Nursing Practice (DNP)




With approximately 70% of all Americans not having an advance directive (AD), it is of vital importance for healthcare providers to establish a patient-driven, end of life care plan (e.g., Advance Directive) to identify a patient’s wishes/desires with the dying process (Tepper, 2015). Not only does advance care planning (ACP) give patients autonomy and control over their healthcare needs regarding end of life issues, but it also removes the burden placed on family members, and gives healthcare providers an outlook of what the patient really wants. Therefore, the aim of this Scholarly Project was to determine the efficacy of providing an AD/ACP interactive training at the beginning of a clinic appointment in expanding AD awareness, implementation, and improved satisfaction with health care needs. The findings from this exploratory quality improvement project demonstrated mixed themes and patterns of providing early education before a primary care visit as well as stimulating conversation with the healthcare provider. Although findings were varied, there was an overwhelmingly positive response to the educational brochure, the need of AD in the primary care setting from both patients and providers, increased comfort level in addressing end of life issues with a healthcare provider, and applicability to most cultural groups. Consequently, plans for future study and project development should be encouraged to identify additional factors related to AD completion and how the healthcare visits can overcome time as a significant barrier.


SC 11.DNP.2019.Kleinhek.GM