Date of Award

Spring 5-27-2017

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Joseph Burkard, DNSc, CRNA

Abstract

According to expert reports and recent research, frequent clinician-patient conversations about individual end-of-life preferences are necessary to avoid unwanted treatment and to ensure that desired treatments are received. The ongoing diffusion of Physician Orders for Life-Sustaining Treatment (POLST) educational initiatives in skilled nursing facilities (SNFs) are vital to success of California’s POLST program, which is now recognized as only 1 of 3 mature POLST programs in the country. The purpose of this evidence-based practice project was to answer the question: Among staff in a skilled nursing facility, does implementing a formal POLST education program compared to current practice improve staff knowledge, comfort level and documentation of the POLST form? A pre- and post-education questionnaire was used. Results indicated a POLST education program significantly improved staff knowledge and promoted much-needed awareness of underutilized POLST educational resources (retrieved from the Coalition for Compassionate Care of California, www.caPOLST.org), available for SNF residents, families, practitioners and staff. As a result, these efforts provide higher quality end-of-life decision making which is essential with future uploading of these order forms into an electronic POLST registry (SB 19: e-POLST Registry Pilot) to be stored during nursing facility resident’s care transitions.

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