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Title: Healthcare-providers experiences with Advance Care Planning and Goals of Patient Care medical treatment orders in Residential Aged Care Facilities; an explanatory descriptive study.
Austin Authors: Martin, Ruth S;Hayes, Barbara J;Hutchinson, Anastasia;Yates, Paul A ;Lim, Wen Kwang
Affiliation: Melbourne Health, 300 Grattan Street, Melbourne, Victoria, 3052, Australia
Northern Health, 185 Cooper Street, Epping, Victoria, 3076, Australia
University of Melbourne, 1-100 Grattan Street, Melbourne, Victoria, 3010, Australia
Deakin University, 75 Pigdons Road, Waurn Ponds, Geelong, Victoria, 3216, Australia
Austin Health
Issue Date: 2022 2021-05-19
Publication information: Internal Medicine Journal 2022; 52(5): 776-784
Abstract: Advance Care Planning (ACP) is a process by which people communicate their healthcare preferences and values, planning for a time when they are unable to voice them. Within Residential Aged Care Facilities (RACF) both the completion and the clarity of ACP documents is variable and, internationally, medical treatment orders have been used to address these issues. In this study, Goals of Patient Care (GOPC) medical treatment orders were introduced alongside usual ACP in three RACF to improve healthcare decision-making for residents. This study explored the experiences of RACF healthcare-providers with ACP and GOPC medical treatment orders. The study was of Explanatory Descriptive design. Within three RACF where the GOPC medical treatment orders had been introduced, focus groups and interviews with healthcare-providers were performed. The transcribed interviews were analysed thematically. Healthcare-providers reported support for ACP and GOPC but also discussed many problematic issues. Analysis of the data identified four main themes: Enablers, Barriers, Resident autonomy and Advance documentation (ACP and GOPC). Healthcare-providers identified ACP and GOPC as positive tools for assisting with medical decision-making for residents. Although barriers exist in completion and activation of plans, healthcare-providers described them as progressing resident-centred care. Willingness to follow ACP instructions was reported to be reduced by lack of trust by clinicians. Families were also reported to change their views from those documented in family-completed ACP, attributed to poor understanding of their purpose. Participants reported that GOPC led to clearer documentation of residents' medical treatment-plans than relying on ACP documents alone. This article is protected by copyright. All rights reserved.
DOI: 10.1111/imj.15374
ORCID: 0000-0002-4965-7949
Journal: Internal Medicine Journal
PubMed URL: 34008332
Type: Journal Article
Subjects: Advance Care Planning
Goals of Care
Medical Treatment Orders
Residential Aged Care Facilities
Appears in Collections:Journal articles

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