Authors (including presenting author) :
Lam ACW(1)(2)(3), Chan GWC(1)(2)(3), Lam LPL (1)(2)(3), Lam JCY(1)(2)(3), Wong TWY(1)(2)
Affiliation :
(1) Caritas Medical Centre, (2) Medical and Geriatric Department, (3)Palliative Care Unit
Introduction :
In Hospital Authority, standardized AD, DNACPR and ACP forms are designed to document the decisions about end-of-life care. Nurses have the duty to make sure they are properly signed and educate patient/relatives in handling the documents. Despite of guidance for use of AD and DNACPR was established, it was frequently found the documents were not properly signed that affected the documents validity. Some of the patients or relatives were also found handling the documents improperly. Therefore, a structured educational program was developed and implemented to enhance nursing knowledge about the issue.
Objectives :
To develop and evaluate the effectiveness of an educational program in nursing knowledge of making AD, DNACPR & ACP and handling of the related documents
Methodology :
A pilot educational program was conducted in July 2021 and remedies were made accordingly to improve the educational content and pre & posttest questionnaires. A formal enhancement program was implemented in November 2021 for all the Medical and Geriatric (MG) nurses in Caritas Medical Centre. The contents of the program included (1) introduction of AD, DNACPR and ACP (2) how to apply and ensure validity of the related documents (3) nursing responsibility in clients’ education and handling of the forms. Data analysis was conducted to compared the pre & posttest questionnaires.
Result & Outcome :
Before the intervention, a pre-test questionnaire was conducted in October 2021 to explore the MG nurses’ knowledge of AD, DNACPR and ACP. Total 281 pre-test questionnaires were received. The average score was 62.6 +/- 8.66 (full mark:100). During the period from 1st November to 1st December 2021, the nurses needed either to complete a video educational program or to attend the education talk held on 1st December 2021, before doing the post-test questionnaire. Total 272 nurses (> 90% of all MG nursing staff) from 10 MG wards participated in the enhancement program and completed the post-test questionnaires. The average score of posttest questionnaires was 79.95 +/-8.91 (full mark:100). The pre & posttest questionnaires overall improvement was found statistically significant (t = 5.81, P < 0.01). Among the 20 questions of the pre & posttest, 17 questions were found significantly improved (range of χ2: 7.35 - 98.1, P < 0.01).
Conclusions:
The in-service educational program is effective and recommended to improve MG nurses’ knowledge of AD, DNACPR and ACP including handling of the related documents.
