Date of Award

Summer 2022

Document Type

Final DNP Paper

Degree Name

Doctor of Nursing Practice (DNP) in Family Nurse Practitioner



Faculty Chair

Dr. Lori McGrath


Background: Heart failure affects the lives of more than 6 million people in the United States and outpatient heart failure clinics offer an opportunity to educate patients while providing evidence-based care. A needs analysis revealed that many heart failure patients do not have an advance directive (AD) on file.

Purpose: The DNP project aims to implement an educational program that provides the tools and knowledge to heart failure patients to assist patients in determining their end-of-life care goals and allow them to document these goals in the Five Wishes document.

Methods: This quality improvement project consisted of a didactic educational program offered to newly enrolled heart failure patients in a rural outpatient heart failure clinic that focused on general information about the diagnosis of heart failure, the prognosis, and what an advance directive is and its benefit. All 12 patients were provided with free copies of the Five Wishes document.

Results: Key results included an increase of 25% of patients who understand this disease better and the benefits of having an AD to express their end-of-life choices. Four patients (33.3%) returned a completed AD to the clinic to file their medical records.

Conclusion: This quality improvement project was multifaceted and stressed the importance of increasing patient knowledge through an educational session about heart failure and advance directives in patients diagnosed with heart failure, which would increase the completion rates of advance directives in these patients.

Hagins Wright Defense Approval Form.pdf (104 kB)
Manuscript Defense Approval Form



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