Background The number of older frail nursing home residents is increasing in the UK. Advance Care Planning (ACP) for this population provides an opportunity to empower older people by discussing and documenting their wishes and preferences for their future care. The nursing home workforce is well placed to carry out ACP but lack confidence and training.
Aim To evaluate the success of a programme of ACP training for nursing home employees.
Methods Three longitudinal questionnaire surveys completed before and after the initiation of the ACP training programme by both nursing homes that had completed the training and those yet to undergo the training and the results compared to identify changes. A knowledge based questionnaire on ACP administered to staff before completing the training at baseline and repeated a number of weeks after the training. A survey of ACP practice within the nursing home completed by managers at baseline before initiation of the training programme and then again a number of weeks later.
A survey of place of death of nursing home residents in a twelve month period before the initiation of the training programme and a twelve month period after commencement of the programme.
Results 16 nursing homes were included in the study, 12 that had undergone the training programme and 4 that had not. Superior Advance Care Planning knowledge was evident in those staff that had completed the training. There was an increase of 85% in the number of Advance Care Plans completed in the training homes and an overall reduction in hospital deaths of 25% for residents from training homes.
Conclusions A programme of Advance Care Planning training for nursing homes is successful in improving nursing home staff knowledge, increasing ACP practice and reducing hospital deaths.
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