The effect of advance directives on ventilator-dependent patients in long-term care facilities

Healthcare administrators in long-term care facilities face insurmountable challenges in ensuring that patients receive high quality of care. Direction of care for chronic ventilator-dependent patients demands attention whether it is followed in their advance directives. The purpose of this quantitative study was to determine and compare the outcomes of care received by ventilator-dependent patients with and without advance directives (ADs) in long-term care facilities in Los Angeles. The study examined whether patients with ADs chose to prolong life or withdraw life-prolonging interventions. Twenty participants were surveyed for this research from a sampling population of 70 patients. Quality of care patient received was analyzed with four measurable constructs; decline in the patient’s activities of daily living, development of pressure ulcers, weight loss, and development of ventilator-acquired pneumonia within 30 days of patient’s hospitalization. Study findings revealed that no relationship exists between quality of care received by ventilator-dependent patients whether they have ADs or not. The demographic variables have no influence in the quality of care received by patients. Similar to results in many reviewed literatures, a significant finding in the study found that only 45% of patients in these healthcare facilities have ADs. This research was one of the first studies to explore influence of ADs on quality of care received in LTAC facilities.