Abstract 2.021: Improving do not attempt CPR documentation - quality improvement project

Taubert, Mark ORCID: https://orcid.org/0000-0003-0454-5609 2024. Abstract 2.021: Improving do not attempt CPR documentation - quality improvement project. Presented at: The 13th World Research Congress of the European Association for Palliative Care, Barcelona, Spain, 16 – 18 May 2024. EAPC Abstracts. , vol.38 (S1) Palliative Medicine: SAGE, pp. 94-95. 10.1177/02692163241242338

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Abstract

Background/aims: This quality improvement programme looked at enhancing do not attempt cardiopulmonary resuscitation (DNACPR) documentation in a Welsh National Health Service trust. DNACPR forms are documents issued and signed by doctors, nurses or allied healthcare practitioners, in order to communicate important decisions/discussions widely. Methods: A full clinical review series of ‘Plan Do Study Act’ cycles was carried out, evaluating 50 records in each cohort data collection, totalling 100. After completion of the first data collection, a new version national form was adopted; a series of education/workshop events was launched to improve understanding of the all Wales DNACPR policy. Electronic learning resources, such as TalkCPR.com videos & electronic modules, were widely disseminated. Results: The introduction of a new version national form in phase 2 of the PDSA cycle resulted in clearer documentation of discussions with patients/those close to them, including when & why conversations had not taken place. During the second data collection cycle, 100% (N=50) included attempted patient discussion. Of these, 84% (N=42) included an actual documented patient discussion, and 16%(N=8) as unable to hold discussion at the time. Overall, 100% (N=50) of forms recorded attempted discussion with significant others. Where this was not possible (n=17 forms that is, 34%), reasons found included: N=2, no significant others (&patient had capacity to be included in conversation) N=12 to be discussed later with significant others-subsequently recorded in all contemporaneous notes as having occurred later, but not always updated on initial DNACPR form N=3 patients wanted to talk about it without significant other/proxy. Conclusions: Documentation of DNACPR discussions in the trust demonstrably improved in several domains. A central electronic record, accessible by all relevant healthcare providers, patients and carers, may be an effective way of improving further on the current paper-based model, including for future data collection.

Item Type:	Conference or Workshop Item (Poster)
Date Type:	Published Online
Status:	Published
Schools:	Medicine
Publisher:	SAGE
Date of First Compliant Deposit:	14 June 2024
Date of Acceptance:	February 2024
Last Modified:	14 Jun 2024 15:23
URI:	https://orca.cardiff.ac.uk/id/eprint/169032

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