Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Development of Nurse Practitioner Competencies for Advance Care Planning

Heale, Roberta DNP, NP-PHC; Rietze, Lori MSc, RN; Hill, Laura MScN, NP; Roles, Stacey MScN, RN

Journal of Hospice & Palliative Nursing: April 2018 - Volume 20 - Issue 2 - p 166–171
doi: 10.1097/NJH.0000000000000425
Feature Articles

This article describes the development of nurse practitioner (NP) competencies for advance care planning. Nurse practitioners are well positioned to implement advance care planning with their patients; however, very few patients have an advance care plan. A modified Delphi method was used to engage NPs in achieving consensus for advance care planning competencies. In round 1, draft competencies were developed from the findings of a survey of NP beliefs, knowledge, and level of implementation of advance care planning. In round 2, 29 NPs participated in the evaluation of the draft competencies and their components. Revisions were made, and a final round was conducted where 15 of the original NP participants confirmed their consensus with the final document. The final document includes 4 competencies, each with several elements: (1) Clinical Practice, (2) Consultation and Communication, (3) Advocacy, and (4) Therapeutic Management. Advance care planning competencies will provide NPs with a guide that can be used to ensure that they are able to clearly identify their distinct role in advance care planning. These competencies may inform the integration of advance care planning in a variety of health care settings and with other health care providers.

Roberta Heale, DNP, NP-PHC, is associate professor, Laurentian University School of Nursing, Sudbury, Ontario, Canada.

Lori Rietze, MSc, RN, is assistant professor, Laurentian University School of Nursing, Sudbury, Ontario, Canada.

Laura Hill, MScN, NP, is nurse practitioner, Short Term Assessment & Treatment, Health Sciences North, Sudbury, Ontario, Canada.

Stacey Roles, MScN, RN, is clinical nurse specialist trainer; consultant and diplomate, Academy of Cognitive Therapy; credentialed at the Canadian Association of Cognitive Behavioural Therapies; faculty, Psychiatry, Northern Ontario School of Medicine; and adjunct professor, School of Nursing, Laurentian University, Sudbury, Ontario, Canada.

Address correspondence to Roberta Heale, DNP, NP-PHC, Laurentian University School of Nursing, 935 Ramsey Lake Rd, Sudbury, Ontario, Canada P3C 2C6 (

This research was funded by the Counsel of Ontario University Programs in Nursing–Nurse Practitioner Program.

The authors have no conflicts of interest to disclose.

© 2018 by The Hospice and Palliative Nurses Association.