Table 3.

Identified Barriers to Completing Advance Directives with Patients

	2013 (N= 740)		2017 (N=924)
	Inpatient (N=532)	Outpatient (N=208)	Inpatient (N=553)	Outpatient N=371)
Barriers	(%)	%	(%)	(%)
I don’t have enough time to ask or complete   AD	21	24	28	22
Patient is non-verbal or has altered mental   status	25	10	22	6
Logistic-related barriers	26	41	11	16
I do not understand the AD choices available   to patients	11	9	11	8
The forms/processes are too complicated	9	8	10	8
I feel uncomfortable asking OR AD forms do   not apply to certain patients	3	1	4	8
I don’t remember to ask	5	8	4	5
Other reasons	10	10	7	13

Note: Total does not equal 100% as respondents may have chosen one or more barrier.

Logistic-related barriers:

I do not know where the AD forms are located on the unit.

I do not know where the AD section is located in the Electronic Health Record.

I do not know how to have the AD scanned into the Electronic Health Record.

Examples of other reasons:

Patients are reluctant to discuss or complete.

Not appropriate to discuss in my work setting.

I am a surgical nurse and this is not part of my role.

I don’t do this in the Emergency Department.

This is not part of my workflow.

I work in Ambulatory Care and feel it is not relevant to our care.