Dequidt, Daisy

Devos, Ria

Hoste, Veronique

Pype, Peter

English

Ghent University Academic Bibliography

THE IMPACT OF ADVANCE CARE PLANNING ON END OF LIFE CARE IN NURSING HOMES Pype P1,2, Dequidt D1, Devos R1, Hoste V1 1Palliative Home Care Roeselare, Belgium, 2University of Antwerp, Belgium     nnnnnnNNTS  RESULTS                                                                      AIM To investigate the impact of advance care planning (ACP) on end of life care in elderly patients and their families in nursing homes and to investigate the obstacles and promoting factors for the implementation of a care model of ACP. METHODS A one year pilot study with a pre-post design Setting: Three nursing homes in Flanders, Belgium  Participants: Nurses, GP’s, patients and their families Intervention: A blueprint of the care model, a one-year follow up with monthly contacts and support.  Outcome measures: Primary outcome consists of a set of quality indicators (identification of a surrogate decision maker, ACP discussion with patient, medical chart notice, decision communication when admission to hospital). Secondary outcomes were a focus group discussion with bereaved relatives, interviews with the coordinating nurse from the nursing homes and measurement of the attitude towards death and dying amongst all nurses and GP’s using the multidimensional fear of death scale.    After 1 year Multidimensional fear of death scale       lower fear after intervention (education in palliative care amplifies effect)   Nurses    adopted structured communication as new style     ad Hospital   communication installed for future collaboration     CONCLUSIONS 1. Overall significant improvement of quality indicators 2. Appreciation for creating time and opportunities to have ACP discussions   Notice of discussion in patiënt file: + 19,5%       + uniform location in file (+ 17 %)  DNR respected   not applicable   no Family                          initial fear changed to   gratitude  ACP discussion with patiënt: + 14,5%           communication – style independent DNR discussion with patiënt: + 26%                            1 nursing home no change (already high level)  Surrogate decision maker                       no clarity/no uniformity in definition    PRACTICE IMPLICATIONS / FUTURE RESEACH 1. Clear communication needed about terminology / consequences of the discussions 2. Optimalisation of blueprint and re-implementation in new selection of nursing homes (PDCA)  3. next step: creation of uniform transfer document to communicate with home care and hospital care  

The impact of advance care planning on end of life care in nursing homes

https://biblio.ugent.be/publication/1944629/file/1968034.pdf

The impact of advance care planning on end of life care in nursing homes

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Ghent University Academic Bibliography