113 An audit into advanced care planning for infants, children and young people with life limiting conditions

Abstract

<h3>Aims</h3> Children with life limiting conditions are expected to result in an early death. Advanced care planning is a formal care plan designed to communicate the health care wishes of children who have life limiting conditions. This plan is a core element of their palliative care. Considering this, NICE states that 100% of children with life limiting conditions should have a personalised emergency care and resuscitation plan (PECRP) in place. This audit was preformed to establish if children with life limiting conditions are being correctly identified as having a life limiting condition and to determine if these children had a completed PECRP in place or not. <h3>Methods</h3> This audit look at all 114 palliative care referral forms received by the KITE (Kids in Their Environment) Team in the Royal Derby Hospital were reviewed during the month of October 2021. Each referral was examined against the dictionary of life limiting conditions, to identify if the child being referred to the palliative care team was correctly identified as having a life limiting condition. A database of children with life limiting conditions was analysed to determine which children had a PECRP in place and which children did not. Each PECRP was assessed to determine if the wishes and choices section had been completed. <h3>Results</h3> 99% of children were correctly identified as having a life limiting condition. 31% of patients had a PECRP in place. 11% of PECRP’s had the wishes and choices section completed. <h3>Conclusion</h3> Considering this, the national standard for delivering end of life care for children with life limiting conditions are not being met. The results were presented at a local paediatric audit meeting which led to a debate and a discussion about how we can improve compliance to complete PECRP’s for children with life limiting conditions. A poster highlighting these findings was created and circulated to help educate clinicians of the importance of implementation of PECRP’s. <h3>References</h3> Nice.org.uk. 2021. Recommendations | End of life care for infants, children and young people with life-limiting conditions: planning and management | Guidance | NICE. [online] Available at: &lt;https://www.nice.org.uk/guidance/ng61/chapter/Recommendations&gt; [Accessed 12 November 2021]. [Internet]. Icpcn.org. 2021 [cited 12 November 2021]. Available from: http://www.icpcn.org/wp-content/uploads/2014/04/Directory_of_LLC_v1.3.pdf