Article Text
Abstract
Background ReSPECT is a joint venture between professional bodies in the UK led by the Resuscitation Council to standardise documentation of DNAR decisions and patients’ preferences for care. ReSPECT was introduced in Chesterfield Royal Hospital (CRH), Derbyshire in June 2018.
Aims The aims of this project were: 1) Evaluate hospital clinicians’ views on ReSPECT and 2) Highlight which aspects of the form clinicians are finding difficult. This information should help to improve the ReSPECT process and guide future training.
Methods We conducted a survey of ten questions on Survey Monkey, collecting a mix of qualitative and quantitative data. This was distributed via email to all doctors at CRH in September 2018 three months after the implementation date. Results were analysed and distributed to stakeholders.
Results A total of 43 doctors completed the survey, representing a range of grades and specialties. Mean score for how user-friendly respondents found the form was 6 out of 10. The proportion of respondents who found ReSPECT useful in planning patient care was 58%. However, approximately three quarters of respondents had encountered difficulties with the form (74%).
Six broad themes around difficulties with ReSPECT were identified: 1) Time required, 2) CPR decision, 3) Complexity, 4) Scale – life sustaining vs comfort, 5) Paper format and storage issues and 6) Capacity assessment. Suggestions for improvement of the ReSPECT process included: larger boxes on the form, clearer emphasis on CPR decision, and improving systems for handover between care settings.
Conclusion The ReSPECT process has implications for the palliative care of patients admitted to hospital. The results of this survey demonstrate concerns from clinicians, and suggestions for improvement. The suggestions of CRH staff could provide a basis for guidance for other implementers and improvements to future versions of the form nationally.