Date of Award

Spring 5-8-2020

Document Type

DNP Project

Project Team Faculty Member

Dr. Andrew Griffin

Project Team Faculty Member

Dr. Valerie Yancey


DNR, Code Status, COPD, Intubation, Advance Directives


When considering patients with COPD, current evidence indicates that discussions related to prognosis, illness trajectory, and goals of care between the provider and patient do not happen as they should. Consequently, without any advanced directives, the default in crisis is “do everything”. This gap in practice supported the need to implement an evidence-based assessment protocol regarding advance care planning needs in patients with COPD. The purpose of this project was to increase the number of COPD patients having advanced directives in a mid-western primary care clinic. The protocol included a chart review to assess for completed advanced directives among patients scheduled to be seen in the primary care setting. Subsequently, staff received education regarding the importance of advance directives and instruction on how to offer information to patients. Of the 105 charts reviewed during the first week of implementation, none had a completed advance directive in place. All patients met criteria for completion of advance directives and 11 completed advance directive forms were returned in the first week. Upon formal evaluation of the protocol staff identified the protocol easy to understand, feasible for daily use, and beneficial to practice. Two primary care providers have initiated this protocol in their clinics.

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