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You are here > Home > Reading Lists > Nursing Management > Evidence-Based Advance Directives: A Study Guide for Nurses

Evidence-Based Advance Directives: A Study Guide for Nurses
Dinah Brothers, RN, JD

Softbound book + nursing contact hours
Size: 8.5" x 11"
ISBN 1578396859
978-1578396856
HCPro / Opus
January 2005
3 contact hours!
(click button below for the very best currently available price for this important resource)

It's the nurse's job to effectively communicate options to patients and to ensure they fully understand the consequences of their decisions. Then, most importantly, it is the nurse's responsibility to make sure patients' wishes are carried out as the patients have authorized.

Special Note to Executive Nurses: This book has been written for all nurses. You may wish to purchase several copies and provide these to your nurses and managers for in-service training. They will appreciate the extra nursing contact hours it provides, and, you will know that you are complying with JCAHO and CMS rules and standards. This book is effective for both classroom instruction and self-study.

A practical and necessary training tool, Evidence-Based Advance Directives provides a concise overview of the legal, ethical, and cultural aspects of advance directives that affect nursing.

In light of recent high-profile events, end-of-life healthcare issues are more complex than ever. Your patients are more aware of their options and abilities to exercise their rights. At the same time, new advance directives legislation is being tied to your Medicare reimbursement. Of course, there will also be increased scrutiny from regulators like the JCAHO. Accountability will continue to be placed squarely on nursing shoulders. Nurses are held responsible for:

  • Balancing the many sensitive issues surrounding end-of-life care, always mindful of cultural beliefs

  • Communicating your patients' wishes to physicians, and even family members

  • Complying with legal and regulatory requirements, including the Patient Self-Determination Act

When it comes to advance directives, a patient's wish must be your command. It is such a serious responsibility. To put patients at ease, nurses must be extremely comfortable discussing advance directives with their patients. 

The nurse is held accountable for being the patient's advocate. Using case studies and role play activities, Evidence-Based Advance Directives will help nurses become more comfortable discussing advance directives with patients. It examines the cultural elements that influence advance directives to help nurses learn how to broach the difficult subjects, mindful of the cultural influences and without personal bias. It provides prepares nurses to advocate for patients in the event their advance directives are not being followed by hospital personnel or the patients' families.

With this versatile guide, instructors have the option to lead informative educational sessions in a classroom setting - or to distribute it to individual staff nurses for use as a self-study tool. Either way, the comprehensive exam at the end of the study guide will allow the nurses to assess the effectiveness of the training and the knowledge gained. Topics fully covered include:

  • Advance directives and the law

    • State law mandates advance directives

    • The Advance Directives Improvement and Education Act of 2005

  • Nurses' roles in promoting advance directives

    • Nurses' knowledge of advance directives

    • Patients' lack of knowledge about end-of-life options

  • What is an advance directive?

    • Advance directive documents

    • What should patients address in their advance directive?

  • Special considerations for patients and healthcare providers

    • Limitations on liability

    • Advance directive implications with the elderly and pediatrics

  • Legal foundation for end-of-life decisions

    • The state's interest in protecting patients

    • Making the decision to withhold or withdraw treatment

  • The ethical and moral implications of end-of-life decisions

    • Nurse as patient advocate

    • Conflict in the care of the terminally ill patient

  • Ethnic and cultural beliefs that influence advance directives

    • Cultural views regarding death

    • Treatment preferences and advance directives

  • Education and training

    • Advance directives curriculum

    • Respect nurses' individual beliefs concerning end-of-life decisions

  • Hospital compliance with advance directive mandates and standards

    • JCAHO regulations

    • Written policies and procedures

Upon completion of this activity, participants will be able to:

  • Define the hospitals' legal requirements under the Patient Self-Determination Act

  • Discuss the Advance Directives Improvement and Education Act of 2005

  • Define nurses' knowledge of advance directives

  • Discuss the nurses' patient advocacy role regarding advance directives

  • Distinguish between the living will and the durable power of attorney for healthcare

  • Define the "clear and convincing" language requirement

  • Identify when a do-not-resuscitate order may be medically and ethically appropriate

  • Identify when a patient may revoke an advance directive

  • Define special considerations regarding advance directives that must be addressed with some elderly patients

  • Verbalize the legal basis upon which advance directives are founded

  • List the state's interest in protecting patients

  • Enumerate the three-part test of the Conroy Court to determine if life-sustaining treatment may be withheld or withdrawn

  • Identify factors that may encourage healthcare providers to deviate from an advance directive when making healthcare decisions for a medically incapacitated patient

  • Understand the nurses' role in ensuring the patient's wishes outlined in an advance directive are respected

  • Define sources of conflict concerning end-of-life decisions between the patient's family and the clinician

  • Analyze the role of advance directives in reducing healthcare expenditures

  • Discuss the European American values regarding healthcare

  • Define the role of Hispanic American families in making healthcare decisions for the medically incapacitated patient

  • Analyze why African Americans may distrust the U.S. health system

  • Identify the elements of a well developed advance directive curriculum

  • Question cultural leaders to promote nurses' cultural competency regarding end-of-life decisions

  • Discuss the standards of the Joint Commission on Accreditation of Healthcare Organizations regarding advance directives

  • Identify the necessary contents of hospital policies and procedures to meet legal mandates and accreditation standards for advance directives

This educational activity for three nursing contact hours is provided by HCPro as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

Dinah Brothers, RN, JD, is a staff attorney for the Texas State Board of Medical Examiners in Austin. In this position, Ms. Brothers litigates cases against physicians for failure to practice medicine within the appropriate standard of care, for sexually inappropriate behavior with patients, and for intemperate drug and alcohol use. Prior to becoming an attorney, she worked as a nurse for ten years.

Softbound book + nursing contact hours
Size: 8.5" x 11"
ISBN 1578396859
978-1578396856
HCPro / Opus
January 2005
3 contact hours!
(click button below for the very best currently available price for this important resource)

 

It's the nurse's job to effectively communicate options to patients and to ensure they fully understand the consequences of their decisions. Then, most importantly, it is the nurse's responsibility to make sure patients' wishes are carried out as the patients have authorized.

With more than 17 years of experience, HCPro, Inc. is a leading provider of integrated information, education, training, and consulting products and services in the vital areas of healthcare regulation and compliance. The company's mission is to meet the specialized informational, advisory, and educational needs of the healthcare industry. As an acknowledged industry authority in healthcare regulation and compliance, HCPro focuses on providing its expertise in the areas of accreditation, medical staff affairs, credentialing, privileging, medical record management, regulatory compliance, nursing, quality/patient safety, infection control, and workplace safety.

(information from the publisher)

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