It is estimated that the number of people who die of life-limiting illnesses in Canada will double by the year 2056. Advance care planning (ACP) is one way to improve the quality of end-of-life care. ACP is a process of ongoing discussions whereby a person communicates important values and desired outcomes at the end of life prior to healthcare crises. Nurse practitioners (NP) commonly diagnose and plan healthcare for patients who may have life-limiting conditions and thus are in a strategic position to engage patients in ACP. Currently, we have a poor understanding of the extent and nature of NP involvement in ACP. This descriptive study explored Ontario NPs' knowledge, beliefs and level of implementation of ACP. NPs employed in hospital settings were significantly more likely to engage in ACP with patients and to have a policy governing ACP initiation compared with their community-employed counterparts. There were no significant differences between the NPs in these two settings in the beliefs, attitudes or personal comfort in initiating ACP. Implications for education, practice and research are provided.

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