Advanced Care Planning (ACP) is a process where patients reflect on what matters most to them and determine who may make decisions for them should they be unable to speak for themselves. Components of ACP may include reflecting on personal values and beliefs; naming a substitute decision maker; sharing preferences about goals of care with family, friends, or healthcare workers; and recording personal wishes via documents such as an advanced directive. The benefits of ACP have been well-established, including decreased anxiety and depression towards end-of-life, increased satisfaction with care, and care that aligns with patients’ goals and preferences. Despite the known benefits of ACP, healthcare provider engagement in ACP is low, and ACP has not been integrated into standard nursing practice at BC Cancer.
As a nurse at BC Cancer, Heather Kilgour recognized the opportunity to improve ACP practices and create more supportive environments for oncology nurses to conduct ACP. An important first step was to gather more information related to the current ACP climate across BC Cancer, barriers and facilitators to engaging in ACP, and changes needed to better support oncology nurses to conduct ACP.
Therefore, the purpose of this study was to (1) understand oncology nurses' experiences and perspectives related to ACP and (2) inform how to better support oncology nurses in engaging in meaningful ACP discussions across BC’s cancer care system.
In this study, we invited registered nurses, licensed practical nurses, nurse practitioners, and nursing leaders across BC Cancer and Community Oncology Network sites to participate in semi-structured interviews. During the interviews we asked open-ended questions to better understand nurses’ perspectives and experiences related to ACP, including what changes nurses perceived are needed to feel supported in engaging in ACP with their patients.
We are currently developing a knowledge translation plan to mobilize findings from this nursing-led, embedded research project, to inform a provincial practice change that better supports oncology nurses in engaging in ACP with patients and their families.
Stay tuned for the manuscript, a visual infographic, and opportunities for engagement.
If you’re interested in learning more about this project please contact Heather Kilgour at heather.kilgour@bccancer.bc.ca.