Public demand and professional standards dictate that primary care providers must be prepared to offer guidance and advance care planning for end-of-life decision-making to their patients. The purpose of this study was to describe the relationship between nurse practitioners' (NPs) knowledge of legal guidelines for end-of-life decision-making, their knowledge of the clinical application of advance care planning (ACP), and their comfort in counseling patients on these issues and personal attitudes toward end-of-life care. This descriptive, correlational study used survey data from a convenience sample of 145 Washington State NPs. Most NPs in this study were reasonably knowledgeable about the legal guidelines for end-of-life decision-making and clinical applications for ACP. They were somewhat comfortable with counseling patients on end-of-life decisions and expressed positive attitudes toward end-of-life care. However, a significant number of NPs were ill-informed about the legal guidelines and few actually incorporated ACP into their clinical practice. The authors suggest educational programs should focus on addressing the problem of stable misinformation related to legal guidelines. In addition, education should offer NPs didactic information and role modeling to skillfully incorporate ACP into clinical practice.
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