Development and pilot testing of a theory-driven and evidence-based advance care planning training programme for nurses in acute care settings.

Abstract

Purpose: To develop and pilot-test a novel training programme for nurses in acute care settings to improve their decision-making support skills, knowledge, attitudes, and confidence in conducting advance care planning (ACP).

Methods: A single-group repeated measures design was employed. This study was conducted in two phases. In Phase 1, a theory-driven and evidence-based ACP training programme for nurses was developed based on the results of a prior systematic review and qualitative interviews. In Phase 2, a pilot study was conducted to assess the feasibility and acceptability of the ACP training programme according to the Tickle-Degnen typology and to explore the programme's preliminary effects.

Results: Guided by the theory of planned behaviour and the experiential learning model, a multi-media experiential ACP training programme, the MEACP, was developed, comprising a 10-module mobile application and a 2-h, nurse-led skill-building workshop. The study had a high recruitment rate (91%), with 20 nurses consenting to participate in the MEACP. The nurses remained attentive and active during the workshop and were highly satisfied with the programme. The outcome evaluation results demonstrated preliminary positive effects of the MEACP in terms of improving the nurses' decision-making support skills, knowledge, attitudes, and confidence in conducting ACP.

Conclusions: The MEACP could feasibly be introduced in acute care settings and was found to be an acceptable educational intervention. This work contributes to nursing practice by providing information about the design of an innovative ACP training programme. Finding will highlight the importance of a paradigm shift regarding ACP in acute care settings.