Do not attempt cardiopulmonary resuscitation decisions (DNACPR) – Policy approaches in Wales

Taubert, Mark; Rose, Ben; Rigby, Miriam

doi:10.1016/j.intcar.2023.100149

Cited by 2 publications

(1 citation statement)

References 8 publications

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“…85 A recent development has occurred in Wales where a competency framework is being developed by health boards, trusts and partner organisations to support healthcare professionals in receiving appropriate training and preparation to discuss, complete and sign DNACPR forms. 86 In addition, a quality improvement project looking at improving DNACPR documentation in Wales showed that the introduction of a new national form resulted in clearer documentation of discussions held with patients and those close to the patient and documented reasons why and when conversations had not taken place. 87…”

Section: Discussionmentioning

confidence: 99%

Do not attempt cardiopulmonary resuscitation decision-making process: scoping review

Doody,

Davidson,

Lombard

2024

BMJ Support Palliat Care

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ObjectivesTo conduct a scoping review to explore the evidence of the process of do not attempt cardiopulmonary resuscitation (DNACPR) decision-making.MethodsWe conducted a systematic search and review of articles from 1 January 2013 to 6 April 2023 within eight databases. Through multi-disciplinary discussions and content analytical techniques, data were mapped onto a conceptual framework to report the data.ResultsSearch results (n=66 207) were screened by paired reviewers and 58 papers were included in the review. Data were mapped onto concepts/conceptual framework to identify timing of decision-making, evidence of involvement, evidence of discussion, evidence of decision documented, communication and adherence to decision and recommendations from the literature.ConclusionThe findings provide insights into the barriers and facilitators to DNACPR decision-making, processes and implementation. Barriers arising in DNACPR decision-making related to timing, patient/family input, poor communication, conflicts and ethical uncertainty. Facilitators included ongoing conversation, time to discuss, documentation, flexibility in recording, good communication and a DNACPR policy. Challenges will persist unless substantial changes are made to support and promote examples of good practice. Overall, the review underlined the complexity of DNACPR decision-making and how it is a process shaped by multiple factors including law and policy, resource investment, healthcare professionals, those close to the patient and of central importance, the patient.

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Section: Discussionmentioning

confidence: 99%