Electronic advance care in community: Nurses' role

Advance care planning implementation occurs across the world using different legislative frameworks, different language to describe both the process and the outcome, and different models to develop these plans. Many countries are in the process of developing personally controlled electronic health records. Including advance care plans as part of this record is proposed in Australia. The eACP in Community project aims to develop a model that will engage community dwelling older adults with chronic life-limiting illnesses in the process of advance care planning that is person-centred, evidence-based and has a focus of dignity of life. A systematic review was conducted to identify models of advance care planning and to examine the nurses’ role. A realist review comprising metasynthesis of 8 qualitative studies and 9 quantitative studies informed the Dignity of Life Advance Care Planning Inventory Model. The DOLAC Model proposes a formal role for nurses in the consultation and development of the advance care plan as well as assisting with the relevant legal requirements for documentation. The medico-legal framework around advance care plan development needs to be understood by nurses around the world to better inform end-of-life care planning and practice. The DOLAC Model offers guidance to curriculum developers and policy makers to enable nurses to expand their scope of practice to include all aspects of advance care plan development.