A descriptive analysis of obstacles to fulfilling the end of life care goals among cardiac arrest patients
| Autor: | Daniel M Rolston, Timmy Li, Ghania Haddad, Danielle Turrin, Casey Owens |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Resuscitation
medicine.medical_specialty medicine.medical_treatment Specialties of internal medicine Patient autonomy Chart review medicine Short Paper Cardiopulmonary resuscitation health care economics and organizations Earth-Surface Processes DNR orders business.industry Do not resuscitate Emergency department Cardiac arrest Living will humanities MOLST RC581-951 Healthcare proxy Emergency medicine CPR DNR business End-of-life care |
| Zdroj: | Resuscitation Plus, Vol 8, Iss, Pp 100160-(2021) Resuscitation Plus |
| ISSN: | 2666-5204 |
| Popis: | Background and Objectives Performing cardiopulmonary resuscitation (CPR) on cardiac arrest patients with Do Not Resuscitate (DNR) orders does not respect patients’ autonomy. We aimed to 1) determine the frequency of patients who wished to be DNR prior to cardiac arrest; 2) determine what proportion received CPR; and 3) explain why DNR patients received CPR. Methods This was a retrospective chart review study of cardiac arrest patients at an emergency department. We reported the frequency and proportion of patients who 1) had valid DNR orders presented at the time of cardiac arrest; 2) had valid DNR orders that were unavailable at the time of arrest 3) had Advanced Directives but no DNR orders; 4) had their DNR orders rescinded; and 5) wished to be DNR but did not have any documents in place. Results Of 419 patients, 65 (15.51%) wished to be DNR. Out of these 65 patients, 38 (58.46 %) patients were resuscitated. Among the 38 patients, 23 (60.52%) received CPR accordingly and 15 (39.47%) patients were inappropriately resuscitated. Conclusion In our sample of 419 patients, 65 (15.51%) did not want CPR in the event of cardiac arrest and 38 (9.06%) received CPR against their wishes. This was due to failure to document DNR orders, lack of recognition of documented valid DNR orders, and use of non-actionable Advanced Directives to relay patients’ wishes. |
| Databáze: | OpenAIRE |
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