Aim To deliver a training programme to enable senior practitioners from the wider community team to complete DNACPR (‘Do Not Attempt Cardio-Pulmonary Resuscitation’) forms.
Background It is well documented that practitioners find initiating DNACPR discussions with patients difficult due to fear of causing distress, time constraints, as well as fear of complaints (Perkins, Griffiths, Slowther. NIHR Journals Library. 2016). The Institute of Medicine recommends that improved education around end-of-life care planning will help communication between the patient, family and care provider allowing for a more dignified death and limiting unnecessary suffering (Dobbins. Nurse Pract. 2016; 41(9):26–34). A systematic review of advance care plan training facilitation showed that role play is an effective pedagogy to help enhance practitioner confidence when initiating these conversations (Chan, Ng, Chan, et al. BMC Health Serv Res. 2019; 19(1):362).
Method A half-day training programme was developed by the palliative care team which incorporated advanced communication skills, legal and professional accountability, mental capacity assessment, discussion and role play to explore the complexities and importance of advance care planning conversations. A total of 16 senior practitioners including community nurses, physiotherapists and paramedics attended. The sessions were interactive and used a range of materials including recordings, presentations and simulation training. The practitioners were given the opportunity to practice complex scenarios in a safe environment to help develop their confidence within this area. Following the course, a competency document was completed, and an Observed Structured Clinical Examination performed to determine safety and expertise. Once successfully completed, this then allowed for the senior practitioners to complete DNACPR forms in the community.
Results This training session gained excellent feedback and was highly recommended by all the participants.
Conclusion By sharing expertise with community-based colleagues, trusting relationships between teams were built, enhancing patient care to be delivered within the wider community.
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