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OP77 The advance project: an australian national program to support nurses to initiate advance care planning in general practice
  1. J Clayton1,
  2. S Nagarajan1,
  3. V Lewis2,
  4. K Detering3,
  5. E Halcomb4,
  6. J Tieman5,
  7. G Mitchell6,
  8. J Phillips7,
  9. R Morton8,
  10. D Costa8,
  11. J Gavin9,
  12. J Stokes1,
  13. A Livingstone8,
  14. T Shaw8 and
  15. J Rhee1
  1. 1HammondCare, Greenwich, New South Wales, Australia
  2. 2LaTrobe University, Melbourne, Australia
  3. 3Austin Health, Melbourne, Australia
  4. 4University of Wollongong, Wollongong, Australia
  5. 5Flinders University, South Australia, Australia
  6. 6University of Queensland, Queensland, Australia
  7. 7University of Technology, Sydney, Australia
  8. 8University of Sydney, Sydney, Australia
  9. 9Queensland University of Technology, Australia


Background Primary care has been advocated as an ideal setting to initiate advance care planning (ACP). Few studies have examined the role of general practice nurses (GPNs) in promoting/initiating ACP. The Advance Project evaluated initiatives to address this gap.

Methods This Australian Government-funded program aims to increase GPNs’ confidence in initiating conversations with patients/carers about ACP during routine health assessments with older and/or chronically ill patients using a structured interview. This is part of a broader program enabling GPNs to identify patients at risk of deteriorating and dying and to assess these patients’ palliative/supportive care needs. Identified needs are then addressed in consultation with General Practitioners. The program includes a suite of resources and multi-component training (online, face-to-face and individual tele-mentoring). Pre/post/follow-up surveys and qualitative interviews collected GPNs’ perspectives about the training/resources and barriers to implementation in clinical practice.

Results As of 31 December 2017, 823 GPNs enrolled in training and 536 completed one or more training components. 27 workshops were held across Australia, including 182 regional/rural participants. 585 pre-training, 384 post-training, and 125 follow-up surveys were received. 20 GPNs were interviewed. There were significant improvements in GPNs’ confidence, comfort, knowledge and attitudes towards initiating ACP post-training that was sustained at follow-up. Participants were significantly more likely to have had ACP discussions with their patients at follow-up (81%) compared to baseline (55%, p<0.001).

Discussion/Conclusion GPNs can have an important role in initiating ACP. The evaluation informed refinement/expansion of the resources/training to support team-based initiation of ACP in general practice

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