Do-Not-Resuscitate (DNR)orders for Critically Ill Patients in the Hospital
Bedell, Susanna E.
Maher, Patricia L.
Cleary, Paul D.
JAMA. 1986 Jul 11; 256(2): 233-237.
Records of 521 patients who suffered cardiopulmonary arrest during a 12-month period at the Harvard-affiliated Beth Israel Hospital were examined to determine compliance with the hospital's policy on do-not-resuscitate (DNR) orders. Seventy-five percent of the DNR patients were older and more likely to have a malignancy or an abnormal mental status than those on whom resuscitation was attempted. Families of 86% of the patients, but only 22% of the patients themselves, participated in the DNR decisions, which often were made after the patient was comatose. Some form of medical care was withdrawn or withheld from 28% of the patients after they had been designated DNR. The authors evaluated their data according to the four elements of the hospital's DNR policy--physician record keeping; involvement of patients, health personnel, and families in decision making; selection of patients designated DNR; and effect of a DNR order on subsequent medical care. (KIE abstract)
Age Factors; Cancer; Critically Ill; Decision Making; Dementia; Evaluation; Health; Health Personnel; Heart Diseases; Hospitals; Institutional Policies; Nurses; Patient Care; Patient Participation; Patients; Physicians; Records; Resuscitation; Resuscitation Orders; Selection for Treatment; Statistics; Survey; Withholding Treatment;
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Do-Not-Resuscitate Orders in Patients Hospitalized With Acute Myocardial Infarction: The Worcester Heart Attack Study Jackson, Elizabeth A.; Yarzebski, Jorge L.; Goldberg, Robert J.; Wheeler, Brownell; Gurwitz, Jerry H.; Lessard, Darleen M.; Bedell, Susanna E.; Gore, Joel M. (2004-04-12)BACKGROUND: Coronary heart disease is the leading cause of death in Americans. Despite increased interest in end-of-life care, data regarding the use of do-not-resuscitate (DNR) orders in acutely ill cardiac patients remain ...