‘Do Not Attempt Resuscitation’ – Do Standardised Order Forms make a clinical difference above hand-written note entries?

‘Do Not Attempt Resuscitation’ – Do Standardised Order Forms make a clinical difference above hand-written note entries?

Lewis KE; Edwards VM; Hall S; Temblett P; Hutchings H

Resuscitation

2009

Advance Directives; cardiopulmonary resuscitation; DNAR; DNAR Outcomes; Patient Selection; Routine data

SummaryAim To quantify any effect of Standardised Order Forms (SOFs), versus hand-written note entries for ‘Do Not Attempt Resuscitation’ – on the selection and survival of remaining cardiopulmonary resuscitation (CPR) attempts. Methods A prospective, observational study in two UK Hospitals, comparing numbers, demographics and survival rates from CPR attempts for 2 years prior to and 2 years after the introduction of SOFs (the only change in DNAR policy). Results There were 133 CPR attempts, representing 0.30% of the 44,792 admissions, pre SOFs and 147 CPR attempts representing 0.32% of the 45,340 admissions following the SOFs (p = 0.46). The median duration of a CPR attempt was 11 min prior to and 15 min following the SOFs (p = 0.02). Of the CPR attempts, there was no change in mean age (p = 0.34), proportions occurring outside working hours (p = 0.70) or proportions presenting with an initial shockable rhythm (p = 0.30). Survival to discharge following CPR was unchanged (p = 0.23). Conclusions The introduction of SOFs for DNAR orders was associated with a significantly longer duration of CPR (on average by 3–4 min) but no difference in overall number, demographics or type of arrest or survival in the remaining CPR attempts.

2009-01

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Journal Article

Backlog