1 / 14

Welcome to the End of …

Welcome to the End of …. Objectives:. Define Advanced Directives Relate cultural competency to patient self-determination and nursing care Identify the implications of these concepts to the CNL role. Cultural Competency & Advanced Directives. Advanced Healthcare Directives. Instructions on:

jud
Download Presentation

Welcome to the End of …

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Welcome to the End of …

  2. Objectives: Define Advanced Directives Relate cultural competency to patient self-determination and nursing care Identify the implications of these concepts to the CNL role

  3. Cultural Competency & Advanced Directives

  4. Advanced Healthcare Directives • Instructions on: • Type of care • Decision-maker: proxy/surrogate/agent • When an individual becomes unable to communicate for himself.

  5. Advanced Healthcare Directives • Types: • Durable Power of Attorney for Health Care • Living Will • Do Not Resuscitate (DNR) order

  6. TRIAD 1: The Realistic Interpretation of Advanced Directives (Mirarchy, Hite, Cooney, Kisiel & Henry, 2006) • N=452, 62% Nurses, 64% Female, • Ave. years as nurse=13.3 • Findings: • Living Wills (LW)/ADs are misunderstood as DNR orders • DNR is misunderstood as Comfort or EOL care

  7. TRIAD 1: The Realistic Interpretation of Advanced Directives • Implications: • Effect on some MDs: Less aggressive critical care procedures, fewer interventions, less documentation. • Effect on some nurses: decreased aggressiveness in nursing care with elderly who are DNR; delays in notifying MD of change in clinical status in DNR pts.

  8. Multicultural & Multi-Ethnic Considerations & Advanced Directives: Developing Cultural Competency (Giger, Davidhizar & Fordham, 2006) • ADs are based on four interrelated values promoted by the Patient Self-Determination Act (PSDA): • Patient autonomy • Informed decision-making • Truth-telling • Control over the dying process

  9. Four cultural forces that influence End-of Life (EOL) Care: • Biomedical knowledge • Power of technological imperative to determine events • Incompatibility of lay & medical knowledge • General ambivalence about EOL goals

  10. Three traditional values practiced in U.S. healthcare system: • Life is sacred-preserve at all costs. • Maintain autonomous decision-making at all times. • No person should suffer needlessly.

  11. Cultural Patterns

  12. Nursing Implications • Revalidate knowledge according to individual pt’s beliefs • Education & training: Giger-DavidhizarTranscultural Model for Pt Assessment • Value Self-Assessment

  13. CNL Tasks • Train & educate care teams on cultural competence and ADs • Check & ensure LWs/ADs are not misinterpreted by the care team • For referral, create list of care providers who may be more comfortable with Pt’s beliefs or values • Create protocols for caring for Pt’s family

  14. The End

More Related