TY - JOUR
T1 - Perceptions of care following initiation of do-not-resuscitate orders
AU - Driggers, Kathryn E.
AU - Dishman, Sydney E.
AU - Chung, Kevin K.
AU - Olsen, Cara H.
AU - Ryan, Andrea B.
AU - McLawhorn, Melissa M.
AU - Johnson, Laura S.
N1 - Funding Information:
We thank Dr. Norine McGrath (University of Washington), Dr. Nneka Sederstrom (University of Minnesota), Mr. Jason Lesandrini (WellStar Health System), Mr. Charlie Sederstrom (Clinical Nurse Educator, Medica), and Dr. Max Hockstein (Medstar Washington Hospital Center) for their critical appraisal of the survey developed for this study.
Publisher Copyright:
© 2022
PY - 2022/6
Y1 - 2022/6
N2 - Purpose: Documenting do-not-resuscitate (DNR) status in the surgical intensive care unit (ICU) can be controversial; some providers believe that DNR orders change care. This survey evaluates current perceptions. Materials and methods: IRB approved survey consisting of 31 validated questions divided into 3 factors (1. palliation, 2. active treatment, and 3. trust/communication). Individual questions were compared using Fisher's exact-tests and factors were compared via t-tests. Results: Both surgical and ICU staff believe care decreases after DNR order initiation (43%). More surgical staff report decreased care aggressiveness versus ICU staff (63% vs 25%, p < 0.005 and Factor 2, 25.8 versus 29.8, p < 0.001), and felt that electrical cardioversion outside of the setting of ACLS would not be performed (57% vs 24%, p < 0.005). Conclusions: Surgical staff expressed more concern about care after DNR status than their ICU counterparts. Determining whether care actually changes clinically warrants further investigation.
AB - Purpose: Documenting do-not-resuscitate (DNR) status in the surgical intensive care unit (ICU) can be controversial; some providers believe that DNR orders change care. This survey evaluates current perceptions. Materials and methods: IRB approved survey consisting of 31 validated questions divided into 3 factors (1. palliation, 2. active treatment, and 3. trust/communication). Individual questions were compared using Fisher's exact-tests and factors were compared via t-tests. Results: Both surgical and ICU staff believe care decreases after DNR order initiation (43%). More surgical staff report decreased care aggressiveness versus ICU staff (63% vs 25%, p < 0.005 and Factor 2, 25.8 versus 29.8, p < 0.001), and felt that electrical cardioversion outside of the setting of ACLS would not be performed (57% vs 24%, p < 0.005). Conclusions: Surgical staff expressed more concern about care after DNR status than their ICU counterparts. Determining whether care actually changes clinically warrants further investigation.
KW - Advance care planning
KW - Advance directives
KW - Cardiopulmonary resuscitation
KW - Critical care
KW - Resuscitation orders
UR - http://www.scopus.com/inward/record.url?scp=85125935614&partnerID=8YFLogxK
U2 - 10.1016/j.jcrc.2022.154008
DO - 10.1016/j.jcrc.2022.154008
M3 - Article
C2 - 35278875
AN - SCOPUS:85125935614
SN - 0883-9441
VL - 69
JO - Journal of Critical Care
JF - Journal of Critical Care
M1 - 154008
ER -