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DOCUMENTATION OF RESUSCITATION DECISIONS IN AN SPECIALIST PALLIATIVE CARE IN-PATIENT UNIT
  1. Patricia Strubbe1,
  2. Jane Millar1,
  3. Claire Haddock2 and
  4. Lottie Redmond2
  1. 1 Sue Ryder Nettlebed Hospice, Henley-on-Thames, UK
  2. 2 Reading and Newbury GP training programme

    Abstract

    Background We are based in what was the South Central Health Authority which introduced a Unified DNACPR (Do Not Attempt Cardio Pulmonary Resuscitation) policy and document (lilac form). This enabled the transfer of DNACPR decisions across different settings. This document is still recognised since the introduction of the clinical commissioning groups. When patients are admitted to an in-patient Palliative Care unit we make a decision about the patient's resuscitation and transfer (to an acute hospital in case of sudden acute deterioration) status. We document whether the patient/ carer has been informed and review the decision weekly. We also document whether a patient brought in a lilac form on admission. On discharge we offer the patients who were DNACPR during, but not prior to admission, the opportunity to ‘own’ the DNACPR decision by offering them to take the lilac form home. All the above is communicated to the clinicians in the discharge letter.

    Aims of the audit We did 2 retrospective audits of 40 consecutive set of notes to assess the completion of the resuscitation documentation and whether this information is documented on the discharge letter sent to GP and other clinicians involved in the patient's care.

    Results We will present the results of the first audit which showed a fairly good compliance both in filling in the resuscitation and transfer documentation in the notes and the documentation in the discharge letters. Specific recommendations were made about the documentation, timing of review of the decisions and on when to offer patients, who did not have a lilac form prior to admission but were DNACPR during admission, the option of taking a lilac form home on discharge. The results of the re-audit will be presented and whether the recommendations improved decision making and communication with patients, carers and professionals.

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