Impact of writing "comfort measures only" orders in a community teaching hospital.
Title
Impact of writing "comfort measures only" orders in a community teaching hospital.
Creator
Walker KA; Peltier H; Mayo RL; Kearney CD
Identifier
Publisher
Journal Of Palliative Medicine
Date
2010
Subject
Female; Humans; Male; Terminal Care; Adult; Medical Audit; Aged; Middle Aged; Teaching; Community; 80 and over; retrospective studies; DNAR; Resuscitation Orders; Palliative Care/og [Organization & Administration]; Hospitals; Baltimore
Description
OBJECTIVES: We compared end-of-life care for patients with and without orders for "comfort measures only" (CMO) and evaluated whether standards for palliative medicine were met., DESIGN: We retrospectively reviewed the charts of 40 patients, 20 with and 20 without a CMO order, who died in our community teaching hospital from October 2003 through September 2004. Appropriate use of medications and interventions and documentation of symptoms and family consultation were examined., RESULTS: There were no significant demographic differences between the groups. Family meeting (18/20 versus 7/20, p < 0.001) and do-not-resuscitate/do-not-intubate (DNR/DNI) code status (20/20 versus 8/20; p < 0.001) occurred significantly more frequently in the CMO group. There were no other significant differences in prescribing medications or treatments. Notation of symptoms common at the end of life did not differ between the groups except for nausea/vomiting, which was more common in the non-CMO group. In the CMO group, opioids were significantly more available and antibiotics and routine laboratory work were significantly less common after the CMO order, but no other differences were observed., CONCLUSION: CMO orders alone were insufficient for redirecting changes in care at the end-of-life.
2010
Rights
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Type
Journal Article
Citation List Month
Backlog
URL Address
Citation
Walker KA; Peltier H; Mayo RL; Kearney CD, “Impact of writing "comfort measures only" orders in a community teaching hospital.,” Pediatric Palliative Care Library, accessed March 28, 2024, https://pedpalascnetlibrary.omeka.net/items/show/14242.