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P19 The use of advance care plans in patients admitted to a public hospital
  1. J Goodwin,
  2. D Speelberg and
  3. K Grundy
  1. Canterbury Initiative, Christchurch, New Zealand


Background This study followed the clinical history of a cohort of patients with a published Advance Care Plan (ACPlan) and examined the influence of the patient’s clinical and demographic characteristics on the content of the ACPlan. The concordance between the instructions in the ACPlan and the care received during admissions and/or end of life care in a public hospital was also investigated.

Methods 149 patients with a published ACPlans between 10/09/2014 and 31/09/2017, and an admission to Christchurch Hospital within that timeframe, were randomly selected from the ACP database (n=1939). The electronic and written clinical records of each hospital admission of the patients(n=411) were reviewed to record demographic characteristic and assess competence. For those who lacked capacity, further review was undertaken to determine treatment given and concordance with the ACPlan.

Results Median age was 78 years. 57% were female, 43% male. The study showed a 98.3% concordance rate regarding the Goal of Care, and 85.7% concordance rate regarding the specific treatment preferences. A Do-not-attempt-CPR form was in place in 60.2% of the records of patients who did not want to receive CPR. Of the patients who died during the study period (n=55) 37.5% died in their preferred location, while 18.8% did not state a place of death preference.

Conclusion(s) Although the study population was limited, the results add to the evidence that ACPlans encourage the wishes of hospitalised patients to be recognised and used to guide care.

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