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Emergency medical services and do not attempt resuscitation directives among patients with out-of-hospital cardiac arrest

COUNTS, Catherine R. ; BLACKWOOD, Jennifer ; WINCHELL, Ryan ; DRUCKER, Christopher ; JENNERICH, Ann L. ; FEDER, Sylvia ; POMPEO, Kathy ; WALDRON, Jody ; SAYRE, Michael R. ; KUDENCHUK, Peter J. ; REA, Thomas
Resuscitation, 19/11/2020, Pagination inconnue

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Predictors of do-not-resuscitate order utilization in decompensated cirrhosis hospitalized patients - a nationwide inpatient cohort study

KABARIA, Savan ; GUPTA, Kapil ; BHURWAL, Abhishek ; PATEL, Anish V. ; RUSTGI, Vinod K.
Annals of hepatology, 04/11/2020, Pagination inconnue

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Thème : Soins.

HEPATOLOGIE ; TESTAMENT VIE ; ETUDE COHORTE

INTRODUCTION AND OBJECTIVES: Decompensated cirrhosis carries high inpatient morbidity and mortality. Consequently, advance care planning is an integral aspect of medical care in this patient population. Our study aims to identify do-not-resuscitate (DNR) order utilization and demographic disparities in decompensated cirrhosis patients.
PATIENTS OR MATERIALS AND METHODS: Nationwide Inpatient Sample was used to extract the cohort of patients from January 1st, 2016 to December 31st, 2017, based on the most comprehensive and recent data. The first cohort included hospitalized patients with decompensated cirrhosis. The second cohort included patients with decompensated cirrhosis with at least one contraindication for liver transplantation.
RESULTS: A cohort of 585,859 decompensated cirrhosis patients was utilized. DNR orders were present in 14.2% of hospitalized patients. DNR utilization rate among patients with relative contraindication for liver transplantation was 15.0%. After adjusting for co-morbid conditions, disease severity, and inpatient mortality, African-American and Hispanic patient populations had significantly lower DNR utilization rates. There were regional, and hospital-level differences noted. Moreover, advanced age, advanced stage of decompensated cirrhosis, inpatient mortality, and relative contraindications for liver transplantation (metastatic neoplasms, dementia, alcohol misuse, severe cardiopulmonary disease, medical non-adherence) were independently associated with increased DNR utilization rates.
CONCLUSIONS: The rate of DNR utilization in patients with relative contraindications for liver transplantation was similar to patients without any relative contraindications. Moreover, there were significant demographic and hospital-level predictors of DNR utilization. This information can guide resource allocation in educating patients and their families regarding prognosis and outcome expectations.

Origine : PubMed

Nurses' opinions on do-not-resuscitate orders

GUL, Senay ; BAGCIVAN, Gülcan ; AKSU, Miray
OMEGA JOURNAL OF DEATH AND DYING, 23/10/2020, Pagination inconnue

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Variation in the design of do not resuscitate orders and other code status options - a multi-institutional qualitative study

BATTEN, Jason N. ; BLYTHE, Jacob A. ; WIETEN, Sarah ; COTLER, Miriam Piven ; KAYSER, Joshua B. ; PORTER-WILLIAMSON, Karin ; HARMAN, Stephanie ; DZENG, Elizabeth ; MAGNUS, David
BMJ quality and safety, 20/10/2020, Pagination inconnue

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Thème : Soins.

TESTAMENT VIE ; ETATS-UNIS ; RECHERCHE QUALITATIVE ; TARIFICATION ACTIVITE

BACKGROUND: US hospitals typically provide a set of code status options that includes Full Code and Do Not Resuscitate (DNR) but often includes additional options. Although US hospitals differ in the design of code status options, this variation and its impacts have not been empirically studied.
DESIGN AND METHODS: Multi-institutional qualitative study at 7 US hospitals selected for variability in geographical location, type of institution and design of code status options. We triangulated across three data sources (policy documents, code status ordering menus and in-depth physician interviews) to characterise the code status options available at each hospital. Using inductive qualitative methods, we investigated design differences in hospital code status options and the perceived impacts of these differences.
RESULTS: The code status options at each hospital varied widely with regard to the number of code status options, the names and definitions of code status options, and the formatting and capabilities of code status ordering menus. DNR orders were named and defined differently at each hospital studied. We identified five key design characteristics that impact the function of a code status order. Each hospital's code status options were unique with respect to these characteristics, indicating that code status plays differing roles in each hospital. Physician participants perceived that the design of code status options shapes communication and decision-making practices about resuscitation and life-sustaining treatments, especially at the end of life. We identified four potential mechanisms through which this may occur: framing conversations, prompting decisions, shaping inferences and creating categories.
CONCLUSIONS: There are substantive differences in the design of hospital code status options that may contribute to known variability in end-of-life care and treatment intensity among US hospitals. Our framework can be used to design hospital code status options or evaluate their function.

Origine : PubMed

Forgoing life sustaining treatment decision-making in critically ill children - parental views and factor’s influence

NURNANINGSIH, Nurnaningsih ; SETIYARINI, Sri ; AL MIRZANAH, Syafa’atun ; PADMAWATI, Retna Siwi ; JUFFRIE, Mohammad
Clinical ethics, 21/10/2020, p. 1-6

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Implantable cardioverter defibrillator management at the end of life - a teachable moment

KELLY, Samuel A. ; KABIR, Ryan ; KESHVANI, Neil
JAMA internal medicine, 26/10/2020, Pagination inconnue

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Covid-19 and the lawfulness of bulk do not attempt resuscitation orders

GRIFFITH, Richard
British journal of nursing, 24/09/2020, vol.29, n°17, p. 1042-1043

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Reduction in potentially inappropriate interventions in trauma patients following a palliative care consultation

WYCECH, Joanna ; FOKIN, Alexander A. ; KATZ, Jeffrey K. ; TYMCHAK, Alexander ; TEITZMAN, Richard L. ; KOFF, Susan ; PUENTE, Ivan
JOURNAL OF PALLIATIVE MEDICINE, 23/09/2020, Pagination inconnue

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The experience of do-not-resuscitate orders and end-of-life care discussions among physicians

FAN, Sheng-Yu ; HSIEH, Jyh-Gang
International journal of environmental research and public health, 20/09/2020, vol.17, n°18, p. 1-10

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Suicide and “do not resuscitate” - an ethical dilemma

SHAKOOR, Muhammad Tariq ; AHAD, Abdul ; AYUB, Samia ; KRUER, James
Clinical ethics, 13/09/2020, Pagination inconnue

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The relationship between death and do not resuscitation attitudes among intensive care nurses

MALAK-KOLAEI, Farzaneh Safari ; SANAGOO, Akram ; PAHLAVANZADEH, Bagher ; AKRAMI, Forouzan ; JOUYBARI, Leila ; JAHANSHAHI, Reza
OMEGA JOURNAL OF DEATH AND DYING, 16/09/2020, Pagination inconnue

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Understanding perceptions and factors involved in do not resuscitate (DNR) decision making in the emergency department of a low-resource country - a mixed-methods study protocol

AZIZI, Kiran ; WAHEED, Shahan ; BAROLIA, Rubina ; AHMED, Naveed ; ISMAIL, Madiha
BMJ Open, 14/09/2020, vol.10, n°9, p. 1-5

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Patient reluctance to accept Do Not Resuscitate order - impact on clinical care

AL FARHAN, Amal ; AL HARTHI, Manal ; BIN MOSA, Manerh ; MOUKADDEM, Afaf ; AL JAHDALI, Hamdan ; SHAMOU, Jinan ; AL SAYYARI, Abdulla ; BAHAROON, Salim
Eastern Mediterranean health journal, 25/08/2020, vol.26, n°8, p. 933-938

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The effect of practice toward do-not-resuscitate among Taiwanese nursing staff using path modeling

WU, Li-Fen ; CHANG, Li-Fang ; HUNG, Yu-Chun ; LIN, Chin ; TZOU, Shiow-Jyu ; CHOU, Lin-Ju ; PAN, Hsueh-Hsing
International journal of environmental research and public health, 2020, vol.17, n°17, p. 1-12

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Use of do-not-resuscitate orders for critically ill patients with ESKD

DANZIGER, John ; ANGEL ARMENGOL DE LA HOZ, Miguel ; CELI, Leo Anthony ; COHEN, Robert A. ; MUKAMAL, Kenneth J.
Journal of the American Society of Nephrology, 10/2020, vol.30, n°10, p. 2393-2399

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Do-not-resuscitate orders in patients with community-acquired pneumonia - a retrospective study

EGELUND, Gertrud Baunbæk ; JENSEN, Andreas Vestergaard ; PETERSEN, Pelle Trier ; ANDERSEN, Stine Bang ; LINDHARDT, Bjarne Ørskov ; ROHDE, Gernot ; RAVN, Pernille ; VON PLESSEN, Christian
BMC pulmonary medicine, 24/07/2020, vol.20, n°1, p. 1-8

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Usage of do-not-attempt-to-resuscitate orders in a Swedish community hospital - patient involvement, documentation and compliance

BERTILSSON, Emilie ; SEMARK, Birgitta ; SCHILDMEIJER, Kristina ; BREMER, Anders ; CARLSSON, Jörg
BMC medical ethics, 01/08/2020, vol.21, n°1, p. 1-6

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The ethics of DNR-decisions in oncology and hematology care - a qualitative study

PETTERSSON, Mona ; HEDSTROM, Mariann ; HOGLUND, Anna T.
BMC medical ethics, 31/07/2020, vol.21, n°1, p. 1-9

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Treatment restrictions and the risk of death in patients with ischemic stroke or intracerebral hemorrhage

REININK, Hendrik ; KONYA, Burak ; GEURTS, Marjolein ; KAPPELLE, L. Jaap ; VAN DER WORP, H. Bart
Stroke, 09/2020, vol.15, n°9, p. 2683-2689

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Survey of end-of-life care in intensive care units in Ain Shams university hospitals, Cairo, Egypt

AZAB, Sonya M. S. ; ABDUL-RAHMAN, Samia A. ; ESMAT, Ibrahim M.
HEC forum, 13/08/2020, Pagination inconnue

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