The Benefits of and Barriers to Psychiatric Advance Directive Implementation

The Benefits of and Barriers to Psychiatric Advance Directive Implementation Lauren Haindfield Faculty Sponsor: Dr. Barbara Harris Background: Psychiatric advance directives can be beneficial for patients with mental disorders, but their implementation is limited in large part due to a knowledge gap. Objectives: The purpose of this integrative literature review was to identify both the benefits of and barriers to psychiatric advance directives. Methods: This integrative literature review used the databases of CINAHL, PubMEd, and PsychInfo. Search terms included pad implementation, barriers to pad implementation, psychiatric advanced directives, benefits of psychiatric advanced directives, and current pad practices. Results: PAD implementation is most successful when the process is facilitated by a healthcare provider, since most patients do not understand the documents and lack the knowledge of what key components should be included in them. A knowledge gap amongst providers in both emergency department and inpatient settings was found as a main barrier in regards to what makes up PAD documentation. Many perceived benefits to PAD use include: increased autonomy, empowerment, and active participation in treatment options by mentally ill clientele. Conclusion: In order for PAD implementation to occur, the barriers to their use must be examined and resolved. Nurses can play a pivotal role in shrinking the knowledge gap between patient and provider by serving as the patient’s advocate and providing information to both parties. Further research is needed in order to examine the effectiveness of nurses bridging this PAD knowledge gap