Identifying Gaps in Knowledge and Comfort in MOLST Discussions in Advanced Practice Nurses
MetadataShow full item record
A Medical Order for Life Sustaining Treatment (MOLST) form is used in health care to document patient treatment decisions for end-of-life care or medical management. In practice, MOLST forms are not being completed due to barriers experienced by providers. The capstone project question proposed was, in Advance Practice Nurses (APN) working in the adult care setting, will a survey of their knowledge and comfort regarding MOLST form discussions help identify specific gaps in knowledge or comfort for the APNs? Research has shown that providers are experiencing barriers in MOLST discussions in knowledge and comfort, but research has not identified exact barriers (Bernacki & Block, 2014; Ganguli, Chittenden, Jackson, and Kimball, 2016; Hickman, Keevern, & Hammes, 2015). The Trajectory Model of Nursing was utilized in the creation of the MOLST discussion survey due to the important of assessing the trajectory of illness of each patient in order to decide if patients are appropriate for a MOLST discussion, based off of their projected illness (Granger, Moser, Germino, Harrell, & Ekman, 2006). A survey consisting of sociodemographic questions, nominal questions assessing knowledge, and a 5-point Likert scale assessing comfort was used in the data collection. A quantitative descriptive analysis was used with a chi-square test with cross tabulation. 24 APN’s were included in the study, with results showing a deficit in knowledge in MOLST form discussions and a decreased comfort level during MOLST discussions, specifically in Nurse Practitioners who work in a non-intensive care setting. Areas have been identified where MOLST education can be beneficial with an indication for further research on APN comfort levels that will improve MOLST discussions in the future.