title: Advance directives: the clinical nurse specialist as a change agent.
abstract: The purpose of this article is to describe the impact the clinical nurse specialist (CNS) has on the advance directive process within the cardiac surgery patient population. As a change agent, the CNS needs to be able to increase the number of advance directives obtained and increase the provision of dignified, self-directed, quality patient care. With requirements from The Joint Commission and the Patient Self-determination Act, the change in process must take place to ensure that healthcare professionals are doing all they can do to carry out a patient's wishes. The 6-Source Influencer Model is applied to a case study to illustrate the role of the CNS as a change agent. Following this model, the CNS can facilitate lasting institutional change in the advance directive process. Based on the example, it is possible that a CNS can act as a change agent for other patient populations within the healthcare setting.
authors.affiliation: Marcella Niehoff School of Nursing-Master's Program, Loyola University Chicago, Illinois, USA. kmeehan@nmh.org
authors.forename: Karen Anne
authors.initials: KA
authors.lastname: Meehan
mesh_terms: D016223:Advance Directives / Q000331:legislation & jurisprudence; D006801:Humans; D007591:Joint Commission on Accreditation of Healthcare Organizations; D008962:Models, Theoretical; D009720:Nurse Clinicians; D024802:Nurse's Role; D013903:Thoracic Surgery; D014481:United States