Nurses Preparation for Advanced Directives: An Integrative Review

Although nurses have a legal and ethical responsibility to educate and help patients complete advance directives, few nurses have a clear understanding of their role. This review integrates 19 studies published between 1990 and 2018 of the knowledge or confidence of nurses and nursing students regarding advance directives or of education on advance directives in nursing curricula. Fewer than half of working nurses demonstrated knowledge, confidence, or both regarding advance directives, and nursing programs which cover advance directives at all typically devote only 1.5 h or less to this legal document which potentially has impact on patient care and outcomes. Nurses with greater confidence regarding advance directives did not always have accurate knowledge about them. Nursing programs need more education specifically about advance directives, and more research is needed to determine what education methods can successfully address nurses' knowledge and confidence deficits.