Abstract
Introduction-
Treatment Escalation Plans (TEPs) and Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) forms are vital in hospital care, providing clarity on patient management while considering patient wishes. Though DNACPR decisions ultimately lie with doctors, discussions with patients or relatives foster understanding. Factors such as comorbidities and the Clinical Frailty Scale (CFS) influence these decisions. Proper form completion guides patient care and helps prevent adverse outcomes, but incomplete forms often lead to challenges for medical teams.
Objective-
This quality improvement project aimed to educate doctors on completing these forms to improve patient care.
Method-
Data were collected on TEP and DNACPR form completion across hospital wards, focusing on CFS, comorbidities, consultant approval, and patient/family involvement. Teaching sessions and educational leaflets were provided to doctors to enhance understanding. Post-intervention data were collected and analysed.
Results-
Two audit cycles were completed: the first with 156 patients, the second with 129. Compliance to Consultant approved DNACPR form completion increased by 9% (from 79% to 88%). Patient and family involvement in DNACPR decisions improved by 2% (from 84% to 86%). Documentation of comorbidities increased by 6% (from 20% to 26%), and CFS documentation improved by 5% (from 13% to 18%), though overall levels remained low.
Conclusions-
The interventions improved doctors' understanding of the importance of completing TEP and DNACPR forms, rationalising patient's care.The study highlights the crucial role of these forms in managing hospitalised patients and providing timely, appropriate care.Continued education through teaching and informational leaflets is essential for better patient outcomes.