Development and evaluation of an aged care specific Advance Care Plan
Identifieur interne : 000599 ( Main/Exploration ); précédent : 000598; suivant : 000600Development and evaluation of an aged care specific Advance Care Plan
Auteurs : William Silvester [Australie] ; Ruth A. Parslow [Australie] ; Virginia J. Lewis [Australie] ; Rachael S. Fullam [Australie] ; Rebekah Sjanta [Australie] ; Lynne Jackson [Australie] ; Vanessa White [Australie] ; Rosalie Hudson [Australie]Source :
- BMJ Supportive & Palliative Care [ 2045-435X ] ; 2013.
Abstract
To report on the quality of advance care planning (ACP) documents in use in residential aged care facilities (RACF) in areas of Victoria Australia prior to a systematic intervention; to report on the development and performance of an aged care specific Advance Care Plan template used during the intervention.
An audit of the quality of pre-existing documentation used to record resident treatment preferences and end-of-life wishes at participating RACFs; development and pilot of an aged care specific Advance Care Plan template; an audit of the completeness and quality of Advance Care Plans completed on the new template during a systematic ACP intervention.
19 selected RACFs (managed by 12 aged care organisations) in metropolitan and regional areas of Victoria.
Documentation in use at facilities prior to the ACP intervention most commonly recorded preferences regarding hospital transfer, life prolonging treatment and personal/cultural/religious wishes. However, 7 of 12 document sets failed to adequately and clearly specify the resident's preferences as regards life prolonging medical treatment. The newly developed aged care specific Advance Care Plan template was met with approval by participating RACFs. Of 203 Advance Care Plans completed on the template throughout the project period, 49% included the appointment of a Medical Enduring Power of Attorney. Requests concerning medical treatment were specified in almost all completed documents (97%), with 73% nominating the option of refusal of life-prolonging treatment. Over 90% of plans included information concerning residents’ values and beliefs, and future health situations that the resident would find to be unacceptable were specified in 78% of completed plans.
Standardised procedures and documentation are needed to improve the quality of processes, documents and outcomes of ACP in the residential aged care sector.
Url:
DOI: 10.1136/bmjspcare-2012-000392
PubMed: 23626906
PubMed Central: 3632978
Affiliations:
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Parslow</name><affiliation wicri:level="1"><nlm:aff id="af2"><institution>Australian Institute for Primary Care and Ageing, La Trobe University</institution>,<addr-line>Melbourne, Victoria</addr-line>,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Lewis, Virginia J" sort="Lewis, Virginia J" uniqKey="Lewis V" first="Virginia J" last="Lewis">Virginia J. Lewis</name><affiliation wicri:level="1"><nlm:aff id="af2"><institution>Australian Institute for Primary Care and Ageing, La Trobe University</institution>,<addr-line>Melbourne, Victoria</addr-line>,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Fullam, Rachael S" sort="Fullam, Rachael S" uniqKey="Fullam R" first="Rachael S" last="Fullam">Rachael S. Fullam</name><affiliation wicri:level="1"><nlm:aff id="af1"><addr-line>Respecting Patient Choices</addr-line>,<institution>Austin Health</institution>,<addr-line>Heidelberg, Victoria</addr-line>,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Sjanta, Rebekah" sort="Sjanta, Rebekah" uniqKey="Sjanta R" first="Rebekah" last="Sjanta">Rebekah Sjanta</name><affiliation wicri:level="1"><nlm:aff id="af1"><addr-line>Respecting Patient Choices</addr-line>,<institution>Austin Health</institution>,<addr-line>Heidelberg, Victoria</addr-line>,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Jackson, Lynne" sort="Jackson, Lynne" uniqKey="Jackson L" first="Lynne" last="Jackson">Lynne Jackson</name><affiliation wicri:level="1"><nlm:aff id="af1"><addr-line>Respecting Patient Choices</addr-line>,<institution>Austin Health</institution>,<addr-line>Heidelberg, Victoria</addr-line>,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="White, Vanessa" sort="White, Vanessa" uniqKey="White V" first="Vanessa" last="White">Vanessa White</name><affiliation wicri:level="1"><nlm:aff id="af2"><institution>Australian Institute for Primary Care and Ageing, La Trobe University</institution>,<addr-line>Melbourne, Victoria</addr-line>,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Hudson, Rosalie" sort="Hudson, Rosalie" uniqKey="Hudson R" first="Rosalie" last="Hudson">Rosalie Hudson</name><affiliation wicri:level="1"><nlm:aff id="af3"><institution>School of Nursing and Social Work, University of Melbourne</institution>,<addr-line>Melbourne, Victoria</addr-line>,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></analytic><series><title level="j">BMJ Supportive & Palliative Care</title><idno type="ISSN">2045-435X</idno><idno type="e-ISSN">2045-4368</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Objectives</title><p>To report on the quality of advance care planning (ACP) documents in use in residential aged care facilities (RACF) in areas of Victoria Australia prior to a systematic intervention; to report on the development and performance of an aged care specific Advance Care Plan template used during the intervention.</p></sec><sec><title>Design</title><p>An audit of the quality of pre-existing documentation used to record resident treatment preferences and end-of-life wishes at participating RACFs; development and pilot of an aged care specific Advance Care Plan template; an audit of the completeness and quality of Advance Care Plans completed on the new template during a systematic ACP intervention.</p></sec><sec><title>Participants and setting</title><p>19 selected RACFs (managed by 12 aged care organisations) in metropolitan and regional areas of Victoria.</p></sec><sec><title>Results</title><p>Documentation in use at facilities prior to the ACP intervention most commonly recorded preferences regarding hospital transfer, life prolonging treatment and personal/cultural/religious wishes. However, 7 of 12 document sets failed to adequately and clearly specify the resident's preferences as regards life prolonging medical treatment. The newly developed aged care specific Advance Care Plan template was met with approval by participating RACFs. Of 203 Advance Care Plans completed on the template throughout the project period, 49% included the appointment of a Medical Enduring Power of Attorney. Requests concerning medical treatment were specified in almost all completed documents (97%), with 73% nominating the option of refusal of life-prolonging treatment. Over 90% of plans included information concerning residents’ values and beliefs, and future health situations that the resident would find to be unacceptable were specified in 78% of completed plans.</p></sec><sec><title>Conclusions</title><p>Standardised procedures and documentation are needed to improve the quality of processes, documents and outcomes of ACP in the residential aged care sector.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Alfonso, H" uniqKey="Alfonso H">H Alfonso</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cantor, Md" uniqKey="Cantor M">MD Cantor</name></author><author><name sortKey="Pearlman, Ra" uniqKey="Pearlman R">RA Pearlman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Eues, Sk" uniqKey="Eues S">SK Eues</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fried, Tr" uniqKey="Fried T">TR 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uniqKey="Silvester W">W Silvester</name></author><author><name sortKey="Fullam, R" uniqKey="Fullam R">R Fullam</name></author><author><name sortKey="Parslow, Ra" uniqKey="Parslow R">RA Parslow</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Martin, B" uniqKey="Martin B">B Martin</name></author><author><name sortKey="King, D" uniqKey="King D">D King</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Prommer, Ee" uniqKey="Prommer E">EE Prommer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fried, Tr" uniqKey="Fried T">TR Fried</name></author><author><name sortKey="Bradley, Eh" uniqKey="Bradley E">EH Bradley</name></author><author><name sortKey="Towle, Vr" uniqKey="Towle V">VR Towle</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Australie</li></country></list><tree><country name="Australie"><noRegion><name sortKey="Silvester, William" sort="Silvester, William" uniqKey="Silvester W" first="William" last="Silvester">William Silvester</name></noRegion><name sortKey="Fullam, Rachael S" sort="Fullam, Rachael S" uniqKey="Fullam R" first="Rachael S" last="Fullam">Rachael S. Fullam</name><name sortKey="Hudson, Rosalie" sort="Hudson, Rosalie" uniqKey="Hudson R" first="Rosalie" last="Hudson">Rosalie Hudson</name><name sortKey="Jackson, Lynne" sort="Jackson, Lynne" uniqKey="Jackson L" first="Lynne" last="Jackson">Lynne Jackson</name><name sortKey="Lewis, Virginia J" sort="Lewis, Virginia J" uniqKey="Lewis V" first="Virginia J" last="Lewis">Virginia J. Lewis</name><name sortKey="Parslow, Ruth A" sort="Parslow, Ruth A" uniqKey="Parslow R" first="Ruth A" last="Parslow">Ruth A. Parslow</name><name sortKey="Sjanta, Rebekah" sort="Sjanta, Rebekah" uniqKey="Sjanta R" first="Rebekah" last="Sjanta">Rebekah Sjanta</name><name sortKey="White, Vanessa" sort="White, Vanessa" uniqKey="White V" first="Vanessa" last="White">Vanessa White</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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