Registered nurses' involvement in advance care planning: an integrative review.
BACKGROUND
Even though registered nurses are uniquely positioned to have end-of-life conversations with their patients, there is limited engagement in such discussions between patients and health-care providers. Consequently, few patients are adequately prepared to make in-the-moment treatment decisions about goals of care.


OBJECTIVE
The guiding question for this integrative review was what factors influence registered nurses' involvement in advance care planning (ACP) conversations with their patients in acute care settings?


METHODS
Based on integrative review guidelines, databases from CINAHL, Medline, Ovid, and ProQuest were searched from 1990-2014, yielding nine articles.


RESULTS
There were four patterns found in the literature: (1) Nurses' involvement in ACP, (2) Nurses' perceptions of their roles in ACP, (3) Barriers to ACP discussions, and (4) Facilitators of ACP discussions.


CONCLUSIONS
Additional educational opportunities related to ACP are necessary to promote integration of ACP into daily nursing care. Further research should focus on exploring operant mechanisms shaping nurses' ACP practice in acute care settings.
Assistant Professor, School of Nursing, Laurentian University.
Lori
L
Rietze
Professor, Centre on Ageing, School of Nursing, University of Victoria.
Kelli
K
Stajduhar
Advance care planning; Communication; Decision-making; End-of-life care; Registered nurses; Role