Poster outlining the collection and analysis of case studies about DNACPR experiences at the end of life in the community

1. Aim:
•The aims of this work are as follows:
•To highlight the practical issues re Do Not Attempt
Cardiopulmonary Resuscitation (DNCAPR) orders in
the community
•To identify gaps in policy and procedures in place
regarding DNACPR
•To identify potential new ways of working to address
any gaps
For further details contact: Deirdre.shanagher@hospicefoundation.ie Feb 2019
Introduction:
Aims:
Background:
The pending commencement of the Assisted Decision Making (Capacity) Act 2015 that will provide a legal
framework to fully support the use of advance healthcare directives in Ireland has highlighted practical
issues in relation to Cardiopulmonary Resuscitation (CPR). Though HSE policy is in place that provides some
guidance to staff across settings and specialisms the delivery of CPR is an area that health and social care
professionals working in the community are expressing experiencing conflicting practices and distressing
situations.
Conclusion:
Inconsistencies in practice and lack of clear policy and guidelines are of significant relevance and are a gap
identified by this work.
There is an opportunity for community based health and social care professionals to engage in advance care
planning.
Efforts should be made to increase and seek collaboration across specialities and settings
Method:
For the purpose of this work a small collective
case study was carried out. Rather than sharing
individual stories, six cases were analysed for
common themes that outline the issues of
relevance in relation to CPR and DNACPR orders
in the community. Crowe et al (2011) identify four
stages of conducting case studies: definition,
selecting, collecting and analysing and reporting.
Results:
The Cases: Themes:
DNACPR in the Community:
A Case Study Analysis
Authors: Deirdre Shanagher, Dr Paul Gregan, Dr Brendan O’Shea, Dr Tony Foley, Dr Emmet Walls,
Karen Charnley, Mary Ferns, Marie Lynch, Noreen Holland, Helen MacMahon, Mary Marsden
The following themes were identified via case study
analysis:
1. Advance care planning
Needs to happen earlier
2. Policy, guidelines, procedures
Clarity is needed and new ways of working need to be
established
3. Collaboration & Communication
Collaboration & Communication are needed across
settings and professions
4. Training and education
Interpersonal and communication skills