Article Text
Abstract
Note to assessors This data has been produced by further investigation of the introduction of ReSPECT forms in our Trust. It looks at the perspective of patients‘ and links with the already accepted poster entitled ‘ReSPECT, find out what it means to me- an audit of advanced care planning’ (ID: 34336) which investigated staff’s perspective.
Introduction ReSPECT is a national initiative to embrace shared decision-making around treatment and advanced care planning. Patients are encouraged to discuss their wishes regarding treatment escalation with their care providers and families. All adults admitted to the hospital are now expected to have a ReSPECT form filled on admission. The aim of this project was to evaluate patients‘ familiarity with the process and their response to discussions regarding DNAR status and treatment escalation.
Methods A questionnaire was devised that could be filled-out by patients or by their next-of-kin (NoK) if the patient was unable to respond. It evaluated the respondent’s awareness of the ReSPECT process and if they had been involved in discussion regarding treatment escalation. They were also asked if they felt the patient discussed on the form had had their wishes respected. This questionnaire was distributed to patients across 10 acute medical and surgical adult wards from 2019–20.
Results There were 68 respondents in total, including 57 patients and 11 next-of-kin. The mean age of respondents was 87. 19% of respondents were aware of the ReSPECT process by name. 25% recalled a discussion regarding DNAR status and treatment escalation. 88% of those that had this conversation felt their wishes had been respected. 55% of those that had not had the conversation stated they would have preferred to have a discussion regarding treatment escalation and DNAR wishes.
Conclusions Based on the evidence presented, it would seem that patients aware of the ReSPECT process are a minority. It would also appear that clinicians are not succeeding in having discussions regarding advanced care planning with all patients on admission as is our target. However, it seems as though when these discussions are had, they are appreciated by a majority of the recipients. It also shows that there are patients who would have liked to express their views had they been given the opportunity.