Respect the ReSPECT: An audit on use of ReSPECT forms across ageing and health wards

Introduction

Advanced care planning (ACP)  conversations are very important in the geriatric department due to the frailty and co-morbidities of patients managed.

The purpose of this audit was to establish if staff on the ageing and health wards were having these discussions and any barriers and facilitators to this.  

Method

1.A snap shot audit of DNACPR and ReSPECT forms in the ageing and health wards in Forth Valley Royal Hospital.

2. A Questionnaire regarding familiarity, use, facilitators and barriers in completion of ReSPECT forms sent to medical staff on ageing and health wards.

The data was collated and presented at the medical division meeting and opened up to interactive discussion

Results

The audit showed a very poor incidence of filling the forms, out of 99  patients across ageing and health wards, 69 patients had a DNACPR in place and only 14 patients had a completed ReSPECT document.

From the Medical staff questionnaire, the  main barrier to ReSPECT completion was time and lack of confidence. The audit results were similar to a ReSPECT audit completed in 2018.

Conclusion(s).

1. DNACPR forms are completed in a majority of patients , unlike ReSPECT forms
2. Lack of time was said to be the main reason for not completing ReSPECT forms .
3. Some senior staff also felt that doctors in the community would be better suited to having ReSPECT conversations while acknowledging that this would unlikely be achievable.