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 - 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
KW - Intensive Care Units
KW - Humans
KW - Electric Countershock
KW - Resuscitation Orders
KW - Communication
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
SP - 154008
JO - Journal of Critical Care
JF - Journal of Critical Care
M1 - 154008
ER -