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Decisions not to resuscitate in a Swedish university hospital

Friberg, H. LU ; Adolfsson, A. and Lundberg, D. LU (1997) In Acta Anaesthesiologica Scandinavica 41(10). p.1263-1266
Abstract

Background: Cardiopulmonary resuscitation (CPR) has the potential to save many lives. Used indiscriminately though, it may be harmful and not in the best interest of the patient. An advance directive to refrain from resuscitation in selected patients is probably not uncommon in Sweden, but guidelines ruling this are still generally lacking. This study was performed to evaluate the use and documentation of do-not-resuscitate orders in a Swedish university hospital. Methods: Adult inpatients at 7 medical, 3 surgical and 2 neurological wards, a total of 220, were investigated on one specific day by interviewing the physicians and nurses responsible for their care. Results: We found a discrepancy in doctors' and nurses' perception... (More)

Background: Cardiopulmonary resuscitation (CPR) has the potential to save many lives. Used indiscriminately though, it may be harmful and not in the best interest of the patient. An advance directive to refrain from resuscitation in selected patients is probably not uncommon in Sweden, but guidelines ruling this are still generally lacking. This study was performed to evaluate the use and documentation of do-not-resuscitate orders in a Swedish university hospital. Methods: Adult inpatients at 7 medical, 3 surgical and 2 neurological wards, a total of 220, were investigated on one specific day by interviewing the physicians and nurses responsible for their care. Results: We found a discrepancy in doctors' and nurses' perception concerning the appropriateness of CPR in selected patients. CPR was judged by doctors to be inappropriate for 45 patients (20%). Out of these 45 patients, only 24 had a written do-not-resuscitate order in their medical record, in most cases noted as a code word or sign only. Rarely were the patient or his/her relatives involved in the decision-making process. Conclusion: We conclude that a decision to refrain from resuscitation is often not made, even when considered medically and ethically justifiable. Also, the use of coded information as a sole indicator for a patient not to be resuscitated is still common practice. The patient or his/her relatives are rarely involved in this decision.

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author
publishing date
type
Contribution to journal
publication status
published
keywords
Cardiopulmonary resuscitation, CPR, Do not resuscitate order, Ethics
in
Acta Anaesthesiologica Scandinavica
volume
41
issue
10
pages
4 pages
publisher
Wiley-Blackwell
external identifiers
  • scopus:0030657564
ISSN
0001-5172
DOI
10.1111/j.1399-6576.1997.tb04642.x
language
English
LU publication?
no
id
8fe778fe-c59c-42f3-bed9-c4498c71c47a
date added to LUP
2019-06-29 23:11:34
date last changed
2019-08-14 13:49:18
@article{8fe778fe-c59c-42f3-bed9-c4498c71c47a,
  abstract     = {<p>Background: Cardiopulmonary resuscitation (CPR) has the potential to save many lives. Used indiscriminately though, it may be harmful and not in the best interest of the patient. An advance directive to refrain from resuscitation in selected patients is probably not uncommon in Sweden, but guidelines ruling this are still generally lacking. This study was performed to evaluate the use and documentation of do-not-resuscitate orders in a Swedish university hospital. Methods: Adult inpatients at 7 medical, 3 surgical and 2 neurological wards, a total of 220, were investigated on one specific day by interviewing the physicians and nurses responsible for their care. Results: We found a discrepancy in doctors' and nurses' perception concerning the appropriateness of CPR in selected patients. CPR was judged by doctors to be inappropriate for 45 patients (20%). Out of these 45 patients, only 24 had a written do-not-resuscitate order in their medical record, in most cases noted as a code word or sign only. Rarely were the patient or his/her relatives involved in the decision-making process. Conclusion: We conclude that a decision to refrain from resuscitation is often not made, even when considered medically and ethically justifiable. Also, the use of coded information as a sole indicator for a patient not to be resuscitated is still common practice. The patient or his/her relatives are rarely involved in this decision.</p>},
  author       = {Friberg, H. and Adolfsson, A. and Lundberg, D.},
  issn         = {0001-5172},
  keyword      = {Cardiopulmonary resuscitation,CPR,Do not resuscitate order,Ethics},
  language     = {eng},
  month        = {01},
  number       = {10},
  pages        = {1263--1266},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Anaesthesiologica Scandinavica},
  title        = {Decisions not to resuscitate in a Swedish university hospital},
  url          = {http://dx.doi.org/10.1111/j.1399-6576.1997.tb04642.x},
  volume       = {41},
  year         = {1997},
}