IMPROVING ADVANCED CARE PLANNING COMPLETION IN A DIALYSIS UNIT THROUGH COLLABORATION WITH THE ACP TEAM

Mrs Prabhjot Kaur Deol¹

¹Monash Health, , Australia

Biography:

Prabhjot Kaur Deol is a Clinical Nurse Specialist at a dialysis unit in Monash Health, Australia. Her practice focuses on staff and patient education, promoting a holistic care approach that values patient-centred outcomes. She is passionate about continuous quality improvement within the unit, fostering collaboration, education, and innovation to enhance patient experiences and clinical outcomes across the dialysis service.

Abstract:

Advanced Care Planning (ACP) is essential in person-centred care, particularly for patients with chronic kidney disease who may face end-of-life decisions. Prior to COVID-19, the dialysis unit had champions for ACP implementation. However, following the transition to electronic records and the prioritisation of patient and staff safety during the pandemic, ACP efforts were largely inconsistent, especially in transient renal patients. This project aimed to improve the ACP completion rates, aligning with Standard 6 of the National Safety and Quality Health Service Standards (NSQHS) on Purpose-Driven Care.

A collaborative approach was established, where a dialysis staff member with ACP portfolio partnered with the ACP team to reintroduce ACP into the unit. This included in-service education by the ACP team, introducing what ACP is to patients (ACP champion read each question and explained the importance of this values directive), one-on-one training by the ACP team for the ACP champion, and direct engagement with patients. A private room (dialysis units’ isolation room) was booked for each patient for ACP discussion with ACP team or the ACP champion during dialysis, making the process more accessible and reducing the need for separate appointments.

This initiative led to a significant increase in ACP completion, rising from just three patients with ACP documents to 15 patients. Challenges included overcoming patient reluctance to discuss end-of-life preferences, managing GP witness requirement, and addressing language barriers.

This initiative successfully enhanced ACP completion, promoting proactive end-of-life care. Future efforts will focus on continued follow-ups and overcoming language barriers through translator involvement.