Measuring Current Knowledge to Develop an Advanced Heath Care Education Program for Nurses

The Patient Self-Determination Act requires the use of advanced health care directives (AHCDs), which are legal documents that outline the medical care that a patient wishes to receive if the patient becomes unable to communicate. Research has shown that nursing staff have deficient training and knowledge to provide patients with effective information on AHCDs, meaning patients may not be prepared to make informed decisions about end-of-life care. Guided by the theoretical framework of andragogy, the purpose of this study was to explore AHCD education levels at an acute care community hospital, with the end goal of developing an educational program aligned with the learning needs of the nurses at the local hospital. A quantitative descriptive and correlational research design was employed to assess 49 nurses working full-time in a medical/surgical unit. The guiding research question examined nurses' current AHCD knowledge according to the Knowledge-Attitudinal-Experiential Survey on Advanced Directives (KAESAD). The descriptive findings indicated 66% accuracy on general AHCD knowledge items, 53% mastery for assessing PSDA and the New York State advanced directive (AD) law, and an overall 43% AHCD knowledge deficit among study participants. Additionally, Pearson correlation analyses determined that nurse age was positively correlated with KAESAD scores, and 18% of participants noted the need for training on ADs on the open-ended survey question. The results informed an advanced health care education program for nurses at the local site. Social change implications include addressing the need for increased information for both practitioners and patients about end-of-life decision making.