ACP conversations in clinical practice: impact of an education initiative

This article reports on participants' experiences of facilitating advanced care planning (ACP) conversations in their clinical practice following an ACP study day. NHS Education for Scotland commissioned an educational package to be delivered by designated facilitators across all health boards in Scotland as part of the implementation of 'Living and Dying Well in Scotland' (2008). The reported impact of this programme on the practice of six nurses is the focus of this paper. Six nurses from both community (n=3) and acute care settings (n=3 ) were interviewed on a one-to-one basis 10-12 months after attendance at an ACP study day. Data were transcribed verbatim and analysed using a comparative approach to thematic analysis. The training was found to have increased participants' awareness of ACP, validated their knowledge and skills, and in turn had a positive impact on their clinical practice. However, some barriers to providing this approach were identified, including time, planning and resource constraints. Educational programmes can be beneficial and impact on clinical care. However, education is only one way to encourage ACP in health care. The complex and transactional nature of ACP should be recognised, alongside the need to pace conversations about ACP.