Aggressive implementation of advance directives.

Economic, social, and technical factors are an impetus for expressing end-of-life decisions as advance directives. Despite opportunities, nurses do not appear to be widely involved in practice and research regarding advance directives. Through an extensive literature review, this article will discuss a historical background, definitions of advance directives, positive outcomes, and several barriers to completion. Critical care nurses and advance practice nurses play a key role in educating nurses, their patients, and physicians about advance directives. The use of advance directives will likely increase if nurses can aggressively implement a plan on their unit. Specific methods of implementation are explored.