Introduction ReSPECT is a national initiative led by the Resuscitation Council(UK). It encourages doctors to work in partnership with patients to establish their wishes and thoughts on future treatments should they become unwell. Moving away from old DNAR forms requires a significant culture shift. We replaced these forms at Ashford & St Peter’s Hospital NHS Trust November 2018. In this audit we aimed to assess the success of the rollout of ReSPECT forms hospital-wide in the first 3 months, aiming for more than 98% of patients having a valid form.

Methods Retrospective notes audit. The first 10 patients discharged from each ward, including patients who died, were selected for an electronic notes review looking for a ReSPECT form or documented evidence that a ReSPECT form was filled during admission. The presence of a ReSPECT form and the extent to which it was correctly filled out were recorded in a spreadsheet.

Results 209 patient records were examined (100 Male, 109 Female) across a mix of surgical and medical wards, average age of 77 years. A total of 87 forms were reviewed, meaning 42% had a ReSPECT form present. Personal/clinical details and summary of emergency care and treatment recommendations were completed 70% of the time. Areas for improvement include mental capacity documentation and section 3 patient personal preferences.

Conclusions Although uptake initially appears poor in retrospect our standard of 98% was likely too high, a 42% uptake is a significant achievement for the first 3 months. By identifying areas for improvement we have been able to put in place initiatives to target these specifically. We recognise the need to continue to facilitate a change in culture within our trust and promote shared decision making and ‘the conversation’ as a process not a one off. We will re-audit next year.