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Assessment of advance care planning documentation for residents of residential aged care facilities presenting to the emergency department.
Aust Health Rev. 2020 Dec; 44(6):847-852.AH

Abstract

Objective This study assessed the availability and quality of advance care planning (ACP) documentation among older residential aged care facility (RACF) residents who presented to the emergency department (ED). Methods A prospective review of the medical records of RACF residents aged ≥75 years who presented to the ED from May to June 2018 was conducted. Availability of ACP was determined based on the presence of an ACP document inclusive of an advance care directive (ACD) in the medical record. The quality of ACP documentation was determined based on the presence of nine key components. Results In all, 48.8% of patients presented to the ED with either ACP or an ACD. However, only a mean total of 3.8 (out of 9) ACP components were documented in these documents. Conclusions Just under half (48.8%) of RACF residents presented to the ED with ACP documentation. There was limited coverage of core ACP components needed to guide clinical decision making. What is known about the topic? RACF residents are in the last years of their life and commonly lack capacity to make decisions regarding health care. Residents are at high risk of dying when acutely unwell in hospital. ACP documentation, when readily available, helps provide appropriate end-of-life care and improves both patient and family satisfaction. What does this paper add? Less than half the residents reporting to the ED from an RACF had ACP documentation available for clinicians. For those who presented to the ED with ACP documentation, most lacked sufficient information needed to provide care in full accordance with the patient's preferences. What are the implications for practitioners? There is a need to encourage, initiate, actively engage and develop systems for ACP conversations, documentation and availability when acutely unwell for people living in RACFs to provide sufficient information to guide clinical decision making. Without quality ACP, the provision of patient-centred health care may be compromised.

Authors+Show Affiliations

School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia. Email: tzyharn.chua@uon.edu.au; jessica.foong@uon.edu.au; ryanrenxin.tan@uon.edu.au; princess.rukasha@uon.edu.au.School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia. Email: tzyharn.chua@uon.edu.au; jessica.foong@uon.edu.au; ryanrenxin.tan@uon.edu.au; princess.rukasha@uon.edu.au.School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia. Email: tzyharn.chua@uon.edu.au; jessica.foong@uon.edu.au; ryanrenxin.tan@uon.edu.au; princess.rukasha@uon.edu.au.School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia. Email: tzyharn.chua@uon.edu.au; jessica.foong@uon.edu.au; ryanrenxin.tan@uon.edu.au; princess.rukasha@uon.edu.au.School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia. Email: tzyharn.chua@uon.edu.au; jessica.foong@uon.edu.au; ryanrenxin.tan@uon.edu.au; princess.rukasha@uon.edu.au; and Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; and Belmont Hospital, Croudace Bay Road, Belmont, NSW 2280, Australia; and Corresponding author. Email: carolyn.hullick@health.nsw.gov.au.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33213690

Citation

Chua, Tzy Harn, et al. "Assessment of Advance Care Planning Documentation for Residents of Residential Aged Care Facilities Presenting to the Emergency Department." Australian Health Review : a Publication of the Australian Hospital Association, vol. 44, no. 6, 2020, pp. 847-852.
Chua TH, Foong JR, Tan RR, et al. Assessment of advance care planning documentation for residents of residential aged care facilities presenting to the emergency department. Aust Health Rev. 2020;44(6):847-852.
Chua, T. H., Foong, J. R., Tan, R. R., Rukasha, P. N., & Hullick, C. (2020). Assessment of advance care planning documentation for residents of residential aged care facilities presenting to the emergency department. Australian Health Review : a Publication of the Australian Hospital Association, 44(6), 847-852. https://doi.org/10.1071/AH19238
Chua TH, et al. Assessment of Advance Care Planning Documentation for Residents of Residential Aged Care Facilities Presenting to the Emergency Department. Aust Health Rev. 2020;44(6):847-852. PubMed PMID: 33213690.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessment of advance care planning documentation for residents of residential aged care facilities presenting to the emergency department. AU - Chua,Tzy Harn, AU - Foong,Jessica Ru-Jia, AU - Tan,Ryan Renxin, AU - Rukasha,Princess Natsai, AU - Hullick,Carolyn, PY - 2019/10/21/received PY - 2020/02/12/accepted PY - 2020/11/21/pubmed PY - 2020/11/21/medline PY - 2020/11/20/entrez SP - 847 EP - 852 JF - Australian health review : a publication of the Australian Hospital Association JO - Aust Health Rev VL - 44 IS - 6 N2 - Objective This study assessed the availability and quality of advance care planning (ACP) documentation among older residential aged care facility (RACF) residents who presented to the emergency department (ED). Methods A prospective review of the medical records of RACF residents aged ≥75 years who presented to the ED from May to June 2018 was conducted. Availability of ACP was determined based on the presence of an ACP document inclusive of an advance care directive (ACD) in the medical record. The quality of ACP documentation was determined based on the presence of nine key components. Results In all, 48.8% of patients presented to the ED with either ACP or an ACD. However, only a mean total of 3.8 (out of 9) ACP components were documented in these documents. Conclusions Just under half (48.8%) of RACF residents presented to the ED with ACP documentation. There was limited coverage of core ACP components needed to guide clinical decision making. What is known about the topic? RACF residents are in the last years of their life and commonly lack capacity to make decisions regarding health care. Residents are at high risk of dying when acutely unwell in hospital. ACP documentation, when readily available, helps provide appropriate end-of-life care and improves both patient and family satisfaction. What does this paper add? Less than half the residents reporting to the ED from an RACF had ACP documentation available for clinicians. For those who presented to the ED with ACP documentation, most lacked sufficient information needed to provide care in full accordance with the patient's preferences. What are the implications for practitioners? There is a need to encourage, initiate, actively engage and develop systems for ACP conversations, documentation and availability when acutely unwell for people living in RACFs to provide sufficient information to guide clinical decision making. Without quality ACP, the provision of patient-centred health care may be compromised. SN - 1449-8944 UR - https://www.unboundmedicine.com/medline/citation/33213690/Assessment_of_advance_care_planning_documentation_for_residents_of_residential_aged_care_facilities_presenting_to_the_emergency_department_ DB - PRIME DP - Unbound Medicine ER -
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