Educating Outpatient Psychiatric Nurse Practitioners on Psychiatric Advance Directives

Abstract

Psychiatric advance directives have been used as a tool to help communicate patient’s wishes during psychiatric emergencies when the patient is unable to do so themselves. While psychiatric advance directives have been used since the early 2000’s, they have been slow to be used throughout the United States, especially in Western states such as California. The purpose of this quality improvement project was to educate outpatient psychiatric nurse practitioners on psychiatric advance directives, as well as to determine advantages and barriers to their use in clinical practice. This project was conducted at an outpatient psychiatric private practice with multiple locations throughout California, and participants included adult specialty psychiatric nurse practitioners. A total of four participants completed all portions of the intervention, which included a pretest to assess for knowledge, skills, and attitudes about psychiatric advance directives, a 30-minute educational session, and a posttest. Overall, the intervention helped increase provider’s knowledge and skills regarding discussing psychiatric advance directives with their patients. However, providers reported less intent to use and learn more about psychiatric advance directives in practice. Providers also provided feedback about practical barriers and facilitators to using psychiatric advance directives in clinical practice.