Authors (including presenting author) :
HWANG LM (1), CHAN CH (1), NG YS (2) MOK WY (2), CHUI CY (2), WONG YY (2)
Affiliation :
(1) Palliative Home Care Team, Nursing Services Division, Tuen Mun Hospital, New Territories West Cluster (2) Department of Medicine and Geriatrics, Tuen Mun Hospital, New Territories West Cluster
Introduction :
With the upcoming legislation of the Advance Decision on Life-Sustaining Treatment Bill and related amendments, patients are empowered to make informed end-of-life care decisions. Nurses play a crucial role in facilitating these decisions, but many feel unprepared, presenting significant challenges in nursing practice.
Objectives :
This pre-legislation training program aims to bridge the gap by equipping nurses with essential knowledge and skills to understand, discuss, and implement Advance Care Planning (ACP), Advance Medical Directives (AMD), and Do-Not-Attempt Cardiopulmonary Resuscitation (DNACPR). It also enhances nurses’ confidence and competence in conducting these critical conversations, ultimately improving patient care.
Methodology :
From September 2023 to June 2024, a Palliative Care nurse conducted seven identical 1-hour training sessions for nurses from the Department of Medicine and Geriatrics, Tuen Mun Hospital. Each participant earned 1 Continuing Nursing Education point upon completing the evaluation. Key training topics included: 1. Advance Care Planning: Discussed the timing, purpose, and desired outcomes of ACP conversations. 2. Advance Medical Directive: Introduced the proposed legislative context. Preparation for patients and health care professionals, application on the relevant documents. 3. Do-Not-Attempt Cardiopulmonary Resuscitation: Covered the circumstances for consideration and procedural aspects. 4. Interactive Case Scenarios: Enhanced understanding of ACP, AMD, and DNACPR in clinical settings through case-based learning.
Result & Outcome :
A total of 116 nurses participated in the training sessions, achieving a 100% return rate for evaluations. Feedback was overwhelmingly positive, with all participants agreed the session duration was appropriate. Nurses found the training practical, relevant, and highly informative. The case-based learning approach was particularly appreciated for facilitating a better understanding of applying these concepts in real-life situations. Conclusions The pre-legislation training proved crucial in preparing nurses for the upcoming legislative changes. It ensured they are knowledgeable and confident in implementing Advance Care Planning, Advance Medical Directives, and Do-Not-Attempt Cardiopulmonary Resuscitation principles in their practice. Continued education will be essential to keep nurses updated on best practices and legal requirements, ultimately enhancing patient-centered care at the end of life.
