Introduction This- study was undertaken at a hospice which admits patients from both community and hospital. Majority of patients have advanced disease +/–actively dying. It faces a number of challenges; No in house Doctors out of hours Arrest may not be imminent, but expected in many cases. 2010 Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) Policy. “prevent inappropriate, futile and/or unwanted attempts at CPR which may cause significant distress to patients and families as a death with an inappropriate CPR attempt may be undignified and traumatic.” Anticipatory care planning is an important aspect- of palliative care.

Aim Investigate if Hospice in line with best practice policy-2010. Highlight importance of DNACPR as a communication tool.

Method Snap Audit, in-patient notes reviewed in one day looking at following criteria. Documentation in medical notes of likelihood of cardiac arrest. DNACPR form completed fully and correctly where required Documentation of who decision had been discussed with e.g., patient, relative. 3 cycles 2010, 2014, 2016.

Discussion Following each audit suggestion for improvement was made. Audit 1 forms should be discussed on ward round. Audit 2 -consider DNACPR is included in new junior doctor/registrar induction. Following audit 3 an admission ‘check list’ was created including DNACPR consideration.

Conclusion Clear improvement through audit series. Created awareness among staff; DNACPR forms are important communication tools, thorough documentation is key. Clinical judgement imperative Lack of forms do not determine if a patient should be resuscitated.