Decisions about cardiopulmonary resuscitation

Florin, Dominique

doi:10.1136/bmj.308.6945.1653

Cited by 17 publications

(10 citation statements)

References 9 publications

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“…Our experience was similar to that described by Morgan and colleagues,3 with most patients welcoming being involved and wishing to express an opinion. However, on one occasion a relative took exception to the practice and contacted her MP and the local press and television.…”

supporting

confidence: 82%

Resuscitation and patients' views Questioning may be misunderstood by patients

Heller¹,

Potter²,

Sturgess³

et al. 1994

BMJ

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supporting

confidence: 82%

Resuscitation and patients' views Questioning may be misunderstood by patients

Heller¹,

Potter²,

Sturgess³

et al. 1994

BMJ

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“…This may account for some of the reported discrepancy between patients and doctors regarding CPR preference: when patients are given accurate information they are significantly less likely to request a preference for it. 13 21 22 Making advance directives does not seem to increase patient preference for CPR. 18 Finally, although it is a contentious issue as to whether resuscitation should be discussed with patients, what is evident from this audit is the proportion of patients who are actually unable to discuss resuscitation when the decision was made (66% in this sample, 51% in other studies 23 ).…”

Section: Discussionmentioning

confidence: 99%

An audit of “do not attempt resuscitation” decisions in two district general hospitals: do current guidelines need changing?

Harris

Davies

2007

Postgraduate Medical Journal

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Introduction: Doctors in all specialties are involved in making ''do not attempt resuscitation'' (DNAR) decisions; this can be a difficult and challenging process. Guidelines exist to provide an ethical and legal framework for the process and documentation of these decisions. Objective: To audit the documentation of resuscitation decisions in a sample of medical inpatients from two district general hospitals. Method: A retrospective case note audit of 50 medical inpatients, in which a DNAR decision had been made (28 from hospital 1, 22 from hospital 2). Results: Average age was 78.9 years (48% male:52% female). In both hospitals DNAR decisions were usually discussed with relatives (84%), documented in nursing notes (100%) and made by senior team members (90%). Although the decision was usually dated and clearly documented (98%), abbreviations were commonly used in hospital 2 (45.5% vs 0% in hospital 1, p,0.05). Decisions regarding other treatment were not consistently documented (78.6% and 72.7%, respectively) and there was little evidence that decisions were reviewed (14.3% and 31.8%). The decision was rarely discussed with the patient (6% of all patients), although 66% of patients were not in a position to have a discussion. Conclusions: Specific forms for recording DNAR decisions improve the clarity of documentation. Current recommendations to discuss resuscitation with patients are controversial and not followed. However, many patients are not in a position to hold a discussion when the need arises and the guidelines should advocate early discussion during a hospital admission in patients where this is appropriate, prior discussion with family and/or wider use of advanced directives.

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“…Previous research on communication about end-of-life care emphasised communication between the practitioner and the patient (eg Florin, 1994;Doyal et al, 1994). However, results reveal that older people would also like to talk to their family members and have them involved in the decision-making process.…”

Section: Implication For Healthcare Practice and Policymentioning

confidence: 98%

Breaking the death taboo — Older people's perspectives on end‐of‐life decisions

Vandrevala

Hampson

Chrysanthaki

2002

Quality in Ageing and Older Adults

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If you would like to write for this, or any other Emerald publication, then please use our Emerald for Authors service information about how to choose which publication to write for and submission guidelines are available for all. Please visit www.emeraldinsight.com/authors for more information. About Emerald www.emeraldinsight.comEmerald is a global publisher linking research and practice to the benefit of society. The company manages a portfolio of more than 290 journals and over 2,350 books and book series volumes, as well as providing an extensive range of online products and additional customer resources and services.Emerald is both COUNTER 4 and TRANSFER compliant. The organization is a partner of the Committee on Publication Ethics (COPE) and also works with Portico and the LOCKSS initiative for digital archive preservation. ABSTRACTThe greater availability of life-sustaining technology, such as cardiopulmonary resuscitation, and the medical, legal and moral pressures to use them, often enable the prolongation of lives of older people. The dying process can be extended regardless of quality of life. Further, there is much public debate on the increasing emphasis on individual rights and personal autonomy in the dying process. This qualitative study examined older people's perspectives on end-of-life decision-making and advance care planning. A sample of 12 older people living in the community was recruited and studied in-depth. A semi-structured interview explored patients' conceptualisations of decision-making in the later stages of life and the significant others they would like involved in the process. The data were analysed using 'content analysis'. The resulting broad categories, themes and sub-themes formed the foundation of an emerging model of older people talking about end-of-life care. Finally, results were discussed with regard to practice and policy development. KEYWORDS older people advance care planning end-of-life care communication living wills decision-making

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Decisions about cardiopulmonary resuscitation

Cited by 17 publications

References 9 publications

Resuscitation and patients' views Questioning may be misunderstood by patients

Resuscitation and patients' views Questioning may be misunderstood by patients

An audit of “do not attempt resuscitation” decisions in two district general hospitals: do current guidelines need changing?

Breaking the death taboo — Older people's perspectives on end‐of‐life decisions

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