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Quality of advance care planning policy and practice in residential aged care facilities in Australia.
BMJ Support Palliat Care. 2013 Sep; 3(3):349-57.BS

Abstract

OBJECTIVES

To assess existing advance care planning (ACP) practices in residential aged care facilities (RACFs) in Victoria, Australia before a systematic intervention; to assess RACF staff experience, understanding of and attitudes towards ACP.

DESIGN

Surveys of participating organisations concerning ACP-related policies and procedures, review of existing ACP-related documentation, and pre-intervention survey of RACF staff covering their role, experiences and attitudes towards ACP-related procedures.

SETTING

19 selected RACFs in Victoria.

PARTICIPANTS

12 aged care organisations (representing 19 RACFs) who provided existing ACP-related documentation for review, 12 RACFs who completed an organisational survey and 45 staff (from 19 RACFs) who completed a pre-intervention survey of knowledge, attitudes and behaviour.

RESULTS

Findings suggested that some ACP-related practices were already occurring in RACFs; however, these activities were inconsistent and variable in quality. Six of the 12 responding RACFs had written policies and procedures for ACP; however, none of the ACP-related documents submitted covered all information required to meet ACP best practice. Surveyed staff had limited experience of ACP, and discrepancies between self reported comfort, and levels of knowledge and confidence to undertake ACP-related activities, indicated a need for training and ongoing organisational support.

CONCLUSIONS

Surveyed organisations â policies and procedures related to ACP were limited and the quality of existing documentation was poor. RACF staff had relatively limited experience in developing advance care plans with facility residents, although attitudes were positive. A systematic approach to the implementation of ACP in residential aged care settings is required to ensure best practice is implemented and sustained.

Authors+Show Affiliations

Respecting Patient Choices, Austin Health, Heidelberg, Victoria, Australia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24644755

Citation

Silvester, William, et al. "Quality of Advance Care Planning Policy and Practice in Residential Aged Care Facilities in Australia." BMJ Supportive & Palliative Care, vol. 3, no. 3, 2013, pp. 349-57.
Silvester W, Fullam RS, Parslow RA, et al. Quality of advance care planning policy and practice in residential aged care facilities in Australia. BMJ Support Palliat Care. 2013;3(3):349-57.
Silvester, W., Fullam, R. S., Parslow, R. A., Lewis, V. J., Sjanta, R., Jackson, L., White, V., & Gilchrist, J. (2013). Quality of advance care planning policy and practice in residential aged care facilities in Australia. BMJ Supportive & Palliative Care, 3(3), 349-57. https://doi.org/10.1136/bmjspcare-2012-000262
Silvester W, et al. Quality of Advance Care Planning Policy and Practice in Residential Aged Care Facilities in Australia. BMJ Support Palliat Care. 2013;3(3):349-57. PubMed PMID: 24644755.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Quality of advance care planning policy and practice in residential aged care facilities in Australia. AU - Silvester,William, AU - Fullam,Rachael S, AU - Parslow,Ruth A, AU - Lewis,Virginia J, AU - Sjanta,Rebekah, AU - Jackson,Lynne, AU - White,Vanessa, AU - Gilchrist,Jane, Y1 - 2012/11/15/ PY - 2014/3/20/entrez PY - 2014/3/20/pubmed PY - 2015/5/30/medline KW - advance care planning KW - advance directive KW - aged care facilities KW - homes for the aged KW - palliative care SP - 349 EP - 57 JF - BMJ supportive & palliative care JO - BMJ Support Palliat Care VL - 3 IS - 3 N2 - OBJECTIVES: To assess existing advance care planning (ACP) practices in residential aged care facilities (RACFs) in Victoria, Australia before a systematic intervention; to assess RACF staff experience, understanding of and attitudes towards ACP. DESIGN: Surveys of participating organisations concerning ACP-related policies and procedures, review of existing ACP-related documentation, and pre-intervention survey of RACF staff covering their role, experiences and attitudes towards ACP-related procedures. SETTING: 19 selected RACFs in Victoria. PARTICIPANTS: 12 aged care organisations (representing 19 RACFs) who provided existing ACP-related documentation for review, 12 RACFs who completed an organisational survey and 45 staff (from 19 RACFs) who completed a pre-intervention survey of knowledge, attitudes and behaviour. RESULTS: Findings suggested that some ACP-related practices were already occurring in RACFs; however, these activities were inconsistent and variable in quality. Six of the 12 responding RACFs had written policies and procedures for ACP; however, none of the ACP-related documents submitted covered all information required to meet ACP best practice. Surveyed staff had limited experience of ACP, and discrepancies between self reported comfort, and levels of knowledge and confidence to undertake ACP-related activities, indicated a need for training and ongoing organisational support. CONCLUSIONS: Surveyed organisations â policies and procedures related to ACP were limited and the quality of existing documentation was poor. RACF staff had relatively limited experience in developing advance care plans with facility residents, although attitudes were positive. A systematic approach to the implementation of ACP in residential aged care settings is required to ensure best practice is implemented and sustained. SN - 2045-4368 UR - https://www.unboundmedicine.com/medline/citation/24644755/Quality_of_advance_care_planning_policy_and_practice_in_residential_aged_care_facilities_in_Australia_ L2 - http://spcare.bmj.com/cgi/pmidlookup?view=long&pmid=24644755 DB - PRIME DP - Unbound Medicine ER -