Medical Residents’ Practices and Perceptions toward Do-Not-Resuscitate (DNR) Order

Abstract

The knowledge and implementation skills of the DNR order amongst physicians in training appear to be quite variable. Few studies had assessed residents' views on this complex topic. Our objective was to describe the medical residents' practices and perceptions toward DNR order. A 26 question survey was distributed to medical residents during the academic day activity. Only 56 residents completed the questionnaire (75% response rate). 61.40% of the residents understood the definition of DNR order. 85.96% thought physicians shouldn't order diagnostic tests for DNR patients and 92.98% thought physicians shouldn't give blood products and antibiotics to DNR patients. 45.61% thought DNR order would lead to poor care. 36.84% thought physician alone should decide about the DNR decision. 45.61% answered that DNR order never discussed with patients. 64.91% answered that consultant discussed DNR order with patients. 42.11% of residents were involved in the discussion of DNR order. 66.67% answered that time to decide about the DNR order on day of admission. 42.11% answered there was variation between consultants regarding the care of DNR patient. 43.86% answered there was variation in the clinical care before and after DNR order was placed. 87.72% thought here was a need for formal training in DNR discussion. 68.42% didn't know if KFSH and RC had clinical guidelines for DNR patients care. Conclusion:(1) Majority of the residents had misunderstanding regarding DNR patient care and comfortable care. There is a need for developing a structured residency program curriculum to address resident skills in end-oflife care. (2) Encouraged discussions DNR issues in the outpatient setting could prevent unwanted resuscitation in the acute setting. (3) Efforts are needed to increase patients and their families' awareness about the meaning of DNR order. (4) There is a need to unify and improve quality of care provided to DNR patients by developing specific strategies within a framework of goals of care.

Knowledge and attitude of ER and intensive care unit physicians toward Do-Not-Resuscitate in a Tertiary Care Center in Saudi Arabia: A survey study

“…One interesting finding is that almost half of the participants were never involved in discussing DNR with patients or family and this is probably due to the fact that 83% of the responders in our study were registrars and residents and fellows in training. Our results were similar to other studies from Saudi Arabia and Portugal,[ 10 11 12 13 14 ] which indicate that there is a need for developing a structured residency program curriculum to address resident skills in end-of-life care, and the DNR concept should be part of any training programs.…”

Do-not-resuscitate (DNR) Orders’ Awareness and Perception Among Physicians: a National Survey

“…Our findings were consistent with those of other studies from Saudi Arabia and Portugal, indicating that a structured residency program curriculum is needed to train resident with skills in end-of-life care, and that the DNR concept should be included in any training program ( 8 - 10 , 16 , 17 ).…”

Knowledge and Attitude of ER and ICU Physicians towards DNR in a Tertiary Care Center in Saudi Arabia: A Survey Study

“…One interesting finding is that almost half of the participants were never involved in discussing DNR with patients or family and this is probably due to the fact that 83% of the responders in our study were registrars and residents and fellows in training. Our results were similar to other studies from Saudi Arabia and Portugal [10][11][12][13][14] which indicate that there is a need for developing a structured residency program curriculum to address resident skills in end-of life care, and the DNR concept should be part of any training programs.…”