Objectives This quality improvement project looked at enhancing do not attempt cardiopulmonary resuscitation (DNACPR) documentation in a Welsh National Health Service trust.
Methods A full clinical review cycle was carried out, evaluating 50 DNACPR forms in each data collection, totalling 100 forms. The all Wales DNACPR audit template was used to ensure standardised audit criteria. After completion of the first data collection, several changes were introduced: a new version national form was adopted by the trust; a series of education events was launched to improve understanding of the all Wales DNACPR policy. Electronic learning resources, such as the TalkCPR videos and electronic staff record modules, were widely disseminated.
Results The evaluation of data demonstrated consistency in completion of forms. The introduction of the new national form in phase 2 of the audit resulted in clearer documentation of discussions held with patients and their significant others and documented reasons why and when conversations had not taken place.
Conclusion Documentation of DNACPR discussions in the trust demonstrably improved in several domains. A central electronic record for advance and future care plans, accessible by all relevant healthcare providers, patients and carers, may be an effective way of improving further on the current paper-based model.
- Clinical decisions
- Education and training
- End of life care
- Hospital care
Data availability statement
All data relevant to the study are included in the article or uploaded as online supplemental information.
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Contributors MT had the idea for the project. Data collection was undertaken by EH, JB, EB and MT. EH wrote the initial manuscript and all authors, including CB, reviewed and edited the manuscript. MT reviewed and edited the final version.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.