First Advisor

Dr. Lora Claywell


Rueckert-Hartman College for Health Professions

Degree Name

Doctor of Nursing Practice


Regis University


Rueckert-Hartman College for Health Professions

Document Type

Thesis - Open Access

Number of Pages

58 pages



Advance care planning (ACP) is a process that allows for an individual to document ahead of time the medical treatment they want if they are unable to communicate after an unexpected life-threatening situation. The legal forms used to document these wishes are called advance directives (ADs). Since African Americans (AAs) develop chronic disease at younger ages and often experience shorter lifespans than other racial groups, it is imperative that they have a clear understanding of the pros and cons of ACP. Regrettably, because AAs seldom complete ADs, more aggressive, and often, ineffective medical care is provided at the end of life. The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to promote patient autonomy by equipping and empowering these individuals with the knowledge needed to make informed decisions regarding end-of-life care (EOLC). The intervention utilized educational resources to engage patients in meaningful discussion and dialogue on the advantages and disadvantages of ACP during regularly scheduled clinic visits over a one-week time frame. The average number of patients aged 50 years and older who were seen in the clinic during a one-week timeframe was calculated and multiplied by 0.80 two weeks prior to the project being initiated. These calculations determined the number of chart audits that were required for pre- and post-study implementation. Sixty-five patients met the study criteria and received AD education. Fifty-six of the 65 patients agreed to be counted for the study. Fifteen ADs were executed during the intervention. This represents 27% of those who agreed to be counted.

Keywords: advance directive, advance care planning, end-of-life care, African Americans

Date of Award

Spring 2023

Location (Creation)

Colorado (state); Denver (county); Denver (inhabited place)

Rights Statement

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