P194 The effect of a training session on health care professionals’ confidence in withdrawal of mechanical ventilation in motor neurone disease

Introduction and objectives Mechanical Ventilation (MV) in Motor Neurone Disease (MND) improves survival and quality of life. 1 With advanced MND, the patient may decide that MV is no longer appropriate and request withdrawal. The Association of Palliative Medicine published guidelines to support clinical teams with MV withdrawal at the request of MND patients. 2 Health Care Professionals (HCPs) providing MV withdrawal find the experience challenging. Additionally, feedback from families suggests that the care falls short of what they and the patient required at the time of MV withdrawal. 2 Furthermore, patients approaching the end of their lives value close contact with carers and loved ones. 3 Therefore, it is imperative that HCPs undertaking MV withdrawal be confident with the ethical, legal and practical issues involved. Our objective was to deliver a training session to HCPs which would cover the issues involved in MV withdrawal in MND and to measure the impact of this intervention. Method A training session was developed covering ethical, legal and practical aspects of MV withdrawal at the request of MND patients. The delegates were nurses, physiotherapists and doctors from a palliative care background. Delegates rated their confidence on a scale of 0–10 in the management of MV withdrawal in MND from an ethical, legal and practical perspective before and after the training session. Data were analysed using the Wilcoxon Signed Rank Test. Results The data were collected from 64 participants. There was a significant increase in the confidence of the delegates in the management of MV withdrawal in MND after the training session (table 1). Conclusions These data demonstrate that the training session resulted in significant improvements in confidence of those delivering palliative care to patients with MND undergoing MV withdrawal. It is therefore a critical training session that all HCPs working in this area should be offered. References Bourke SC, Tomlinson M, Williams TL, Bullock RE, Shaw PJ, Gibson GJ. Effects of non-invasive ventilation on survival and quality of life in patients with amyotrophic lateral sclerosis: A randomised controlled trial. Lancet Neurol2006;5:140–47. http://apmonline.org/wp-content/uploads/2016/03/Guidance-with-logos-updated-210316.pdf [Accessed on 14/07/2018] Dening KH, Jones L, Sampson EL. Preferences for end-of-life care: A nominal group study of people with dementia and their family carers. Palliative Medicine2012;27(5):409–17.