Date of Submission

Fall 12-24-2023

Document Type


Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Dr. Ricky Norwood

Second Advisor

Dr. Juli Maxworthy


Background: Healthcare providers in primary care treat patients at various stages of life. As patients age, it becomes necessary for providers to support their older patients throughout the aging process and address patient care even into life’s end stages. Primary care providers (PCPs) are well-positioned to provide this support and can do so through incorporating end-of-life (EOL) conversations in practice. Such discussions are called advance care planning (ACP). Though PCPs can play a crucial role in their patients’ EOL care decisions, providers report their limited knowledge of ACP as a barrier to its application.Consequently, further education for providers on utilizing ACP in practice can increase provider knowledge and confidence in implementing this aspect of patient care.

Objective: This literature review will illustrate how PCPs are uniquely prepared to support their patients in EOL care discussions but could benefit from further education on ACP to address the knowledge gap.

Methods: A comprehensive literature search was conducted regarding barriers to ACP use in the clinical setting and further education for providers on ACP to increase its implementation. The search used several databases, including CINAHL Complete, PubMed, and Scopus.

Results: Ten studies met the inclusion criteria for analysis. Three major themes arose during the literature review: PCPs are well-suited to implement ACP; limited provider knowledge of ACP is a barrier to the occurrence of EOL conversations in practice; further education for providers on ACP could increase their knowledge of and confidence in implementing ACP with patients.

Conclusions: The literature review indicates that provider education on ACP is necessary and can contribute to positive patient outcomes.