A Survey of the understanding of the Adults with Incapacity Act in an Edinburgh Teaching Hospital

Background: The Adults with Incapacity (Scotland) Act 2000 allows doctors and others to act on behalf of adult patients deemed incapable of making, communicating or understanding decisions, by reason of mental disorder or inability to communicate due to physical disability. Aims: We reviewed the knowledge and understanding of the Act in a sample of healthcare workers in a Teaching Hospital. Methods: A sample of healthcare workers working in acute Medicine of the Elderly wards in the Royal Infirmary of Edinburgh was surveyed between July and August 2009 with the aid of a questionnaire. Participants were then given a one-page information sheet about the Act, after which the questionnaire was repeated to assess learning. Results: Both questionnaires were analysed anonymously using paired t-tests. All eighteen doctors surveyed, twenty-one (87.5%) nurses and three (50%) auxiliaries were aware of the Act. The level of understanding and prior training in the Act varied amongst the groups. Specifically, knowledge regarding the role of relatives in decision making was poor in all cgroups. Perceived confidence levels in use of the Act were low.Provision of a simple information sheet significantly improved understanding of the Act in nurses (p=0.0001) and nursing auxiliaries p=0.0042, but not in doctors (p=0.1881). Conclusions: Awareness of the Adults with Incapacity (Scotland) Act 2000 varied amongst staff groups in an acute Medicine of the Elderly ward with doctors being more aware than other groups. Provision of a simple information sheet improved understanding of the Act in nurses and nursing auxiliaries but not in doctors who had a higher baseline knowledge.