Emergency Medicine Registrar originally from Scotland who enjoys the breadth of presentation that comes to rural New Zealand hospitals. Enjoys tramping, surfing and skiing.
Completion Of Ceiling Of Care Intervention Forms Within 24 Hours of Admission To A Rural New Zealand Hospital
Aims: To determine the completion rate of ceiling of care intervention forms within 24 hours of admission to Whakatane hospital.
Methods: Retrospective review of ceiling of care intervention forms found in patient’s electronic health record was done. All patients over 16 years of age admitted to any inpatient service between 1st September – 31st December 2020 were included in this study. Data analysis was conducted using SPSS.
Results: 554 patients were assessed with only 118 (21.3%) having a completed ceiling of care intervention form within 24 hours of admission. There was significant difference in the rate of completion for these forms between different specialties with general medicine (30.7%), general surgery (10.9%), orthopaedic (5.6%) and gynaecology (0%) completion rates respectively. Moreover, there was a difference in completion comparing ethnicities with New Zealand European (23.5%), Other European (33.3%) and New Zealand Maori (17.9%) completed respectively. Of the 118 completed forms, 94 (81.7%) provided written documentation as to which members of the team or patient’s family this was discussed with.
Conclusions and/or Clinical Practise Point: Fewer than one in four ceiling of care intervention forms are being completed within 24 hours of admission to Whakatane Hospital – despite the patient having been seen by both the emergency department and admitting specialty at this time. With the implementation of a new ceiling of care form due for New Zealand in 2022, this represents an important time to improve usage of these important documents for optimal patient care and to ensure patient’s choices with regard to their healthcare are being respected.