Prospective multicentre cross-sectional audit among older Australians accessing health and residential aged care services: protocol for a national advance care directive prevalence study.

摘要: Introduction Advance care planning (ACP), an ongoing communication and process, aims to clarify a person’s values preferences, so these guide decision-making if the person becomes unable make his or her own decisions. Ideally, ACP results in completion of advance directives (ACD), documents completed by competent people outlining their values, treatment preferences and/or appointment substitute decision-maker (SDM). ACDs are most effective at point care, where they can be used inform Australian governments fund initiatives have developed policy increase ACD rates. However, little is known about prevalence health services, making evaluation efforts difficult. This study determine records older hospitals, aged facilities general practices. Methods analysis national multicentre cross-sectional selected facilities, hospitals Following 2017 feasibility study, new protocol incorporating key learnings was developed. Sites will recruited via expression interest process. Health ≥65 years, admitted attending services on day(s) audited trained staff from sites. Site-level data collected during interest. The primary outcome presence least one record. Secondary outcomes include other documented (by practitioner(s)/family/SDM), assessment quality content concordance between any medical orders. Individuals sites characteristics present explored. Ethics dissemination Protocol approval Austin Human Research Committee, Melbourne, Australia (reference: HREC/18/Austin/109). Results disseminated peer-reviewed journals conferences. Participating jurisdictions receive individualised reports findings.