DNR: “Do Not Resuscitate” or “Death Not Reversible”?

Quinn, Kieran L.; Workman, Stephen

doi:10.1089/jpm.2017.0466

Cited by 2 publications

(2 citation statements)

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“…Family palliative care consultation can allow dying patients and their families to make end-of-life care decisions together and allow providers to understand a patient’s needs before discussing DNR consent and related health care considerations. Professionals suggest that physicians discuss palliative care with patients and their families at the earliest appropriate time to convey empathy and to ease the process of signing a DNR consent [ 1 , 22 ]. In a study of health care providers’ attitudes toward DNR consent, 57% of the respondents indicated that they believed that providing enough information regarding DNR consent to patients was important.…”

Section: Discussionmentioning

confidence: 99%

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Investigating Key Factors Related to the Decision of a Do-Not-Resuscitate Consent

Lin

Liu

Huang

et al. 2021

IJERPH

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Background: The decision to sign a do-not-resuscitate (DNR) consent is critical for patients concerned about their end-of-life medical care. Taiwan’s National Health Insurance Administration (NHIA) introduced a family palliative care consultation fee to encourage family palliative care consultations; since its implementation, identifying which families require such consultations has become more important. In this study, the Taiwanese version of the Palliative Care Screening Tool (TW–PCST) was used to determine each patient’s degree of need for a family palliative care consultation. Objective: This study analyzed factors associated with signing DNR consents. The results may inform family palliative care consultations for families in need, thereby achieving a higher DNR consent rate and promoting the effective use of medical resources, including time, labor, and funding. Method: In this retrospective study, logistic regression analysis was conducted to determine which factors affected the DNR decisions of 2144 deceased patients (aged ≥ 20 years), whose records were collected from the Taipei City Hospital health information system from 1 January to 31 December 2018. Results: Among the 1730 patients with a DNR consent, 1298 (75.03%) received family palliative care consultations. The correlation between DNR consent and family palliative care consultations was statistically significant (p < 0.001). Through logistic regression analysis, we determined that participation in family palliative care consultation, TW–PCST score, type of ward, and length of stay were significant variables associated with DNR consent. Conclusions: This study determined that TW–PCST scores can be used as a measurement standard for the early identification of patients requiring family palliative care consultations. Family palliative care consultations provide opportunities for patients’ family members to participate in discussions about end-of-life care and DNR consent and provide patients and their families with accurate medical information regarding the end-of-life care decision-making process. The present results can serve as a reference to increase the proportion of patients willing to sign DNR consents and reduce the provision of ineffective life-prolonging medical treatment.

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Section: Discussionmentioning

confidence: 99%

“…The main purpose of do-not-resuscitate (DNR) is to ensure patients’ medical autonomy is respected and to prevent ineffective medical treatment [ 1 , 2 ]. DNR policies were first enacted in the United States in 1976.…”

Section: Introductionmentioning

confidence: 99%

Investigating Key Factors Related to the Decision of a Do-Not-Resuscitate Consent

Lin

Liu

Huang

et al. 2021

IJERPH

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Demystifying Limited Code

Sabolish,

Pennartz

2023

J Hosp Palliat Nurs

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Upon admission to an acute care hospital, patients and families are faced with determining their cardiopulmonary resuscitation status during conversation with providers. Medical providers are tasked with providing education and options in the context of the patient's acute and chronic conditions. Misconceptions are common in the general public, and providers may struggle with providing guidance in high-stress situations. Literature review revealed a lack of national consensus on code status definitions. Electronic health records may include multiple options for code status orders, which may lead to confusion for patients and medical staff, resulting in provision of potentially ineffective or undesired medical care. The following discussion will examine multiple cases in a large health care system and a novel way of standardizing resuscitation options using Havelock's change theory. This quality improvement project was approved by the institutional review board.

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DNR: “Do Not Resuscitate” or “Death Not Reversible”?

Cited by 2 publications

References 10 publications

Investigating Key Factors Related to the Decision of a Do-Not-Resuscitate Consent

Investigating Key Factors Related to the Decision of a Do-Not-Resuscitate Consent

Demystifying Limited Code

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