Date of Graduation

Spring 5-19-2017

Document Type

Project

Degree Name

Doctor of Nursing Practice (DNP)

College/School

School of Nursing and Health Professions

Department/Program

Nursing

Program

Family Nurse Practitioner

First Advisor

Jo Loomis

Second Advisor

Timothy Godfrey

Abstract

Vulnerable populations in the United States experience disparities in access to advance care planning and may have significant unmet healthcare needs at the end of life, including unrelieved suffering. People who are homeless have increased morbidity and mortality risks, yet lack opportunities to discuss end-of-life preferences. A Doctor of Nursing Practice project consisted of designing, implementing, and evaluating an educational intervention in two settings for nurse practitioners and other clinicians on advance care planning with individuals experiencing homelessness. The intervention was associated with increased knowledge and confidence in advance care planning ability. Participants expressed positive intention to change individual practice based on learnings. Lack of time and patient discomfort with end-of-life topics were identified as barriers to changing practice regarding advance care planning. Educational interventions on advance care planning for clinicians were effective and may help to increase patient access to this important component of care. Advance care planning is a crucial antecedent to receiving patient-centered care at the end of life, particularly for vulnerable populations.

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