Background In 2014, The Leadership Alliance for the Care of Dying People developed the five priorities of care for people in the last hours or days of their life. To facilitate the implementation of these priorities in Queen Alexandra Hospital, Portsmouth, a regionally created document came into use in 2015; the achieving Priorities of Care (aPoC) document. This audit focused upon the standard of the completion of this document.

Methods Documentation was audited, to review standard of completion, for patients in whom the aPoC document was used between 1/7/15 and 30/9/15. During this time there were seven deaths where the aPoC document was used. Staff ?questionnaires regarding the priorities of care and the aPoC document were also carried out.

Results The desired standard of 100% completion was used. 43% of documents were signed by the Consultant deciding to use the aPoC with 29% of cases having clear documentation that aPoC was to be used in the medical notes. On average, the standard of completion of the front page was 60%, the recognition of dying section was 61%, previous wishes of the patient 49%, individualised care plan 86%, ongoing medical review 84% and psychological review 42%. Staff questionnaires showed that 40% of staff were not aware of the five priorities of care and 28% were not aware of the aPoC document.

Conclusions Overall, the standard of completion of the document was variable. Some sections were carried out well but others showed significant areas for improvement. Staff questionnaire data suggests that across different staff groups, there is limited knowledge and awareness of the priorities of care. Staff education will therefore be the main implementation strategy prior to a re-audit of the standard of completion of the apoc document.