Introduction The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) process encourages collaboration between clinicians, patients, and relatives on emergency care wishes and resuscitation decisions. While the COVID-19 pandemic disrupted aspects of the ReSPECT process, the impact on clinicians’ views of ReSPECT was unknown.
Objectives The aim of this project was to examine whether there were changes in clinicians’ knowledge, skills, and attitudes regarding the ReSPECT process during the pandemic.
Methods We conducted a cross sectional survey of senior clinicians at one acute hospital in the UK. We developed a questionnaire with a defined 5-point Likert scale and asked clinicians to recall their views on ReSPECT before the COVID-19 pandemic as well as report their current views at the time of survey distribution (last two weeks of May 2020, end of the first COVID-19 wave in the UK). We compared their retrospective self-rating of their pre-pandemic views and current views during the pandemic.
Results We analysed 171 questionnaire responses. During the pandemic clinicians’ self-reported knowledge in conducting ReSPECT discussions increased (pre-pandemic median 4, IQR 2; during pandemic median 4, IQR 1; p <0.001). Their skills (pre-pandemic median 3, IQR 1; during pandemic median 3, IQR 1; p <0.001) and confidence (pre-pandemic median 3, IQR 1; during pandemic median 3, IQR 1; p <0.001) in conducting ReSPECT discussions with relatives over the phone increased. Negative emotions whilst conducting these discussions with relatives increased during the pandemic (pre-pandemic median 3, IQR 1.5; during pandemic median 3, IQR 2; p < 0.001).
Conclusions There were differences in clinicians’ knowledge, skills, and attitudes scores on ReSPECT before and during the pandemic. Our findings highlighted that clinicians could benefit from training in remote ReSPECT conversations with relatives.
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