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Perceptions of care following initiation of do-not-resuscitate orders.

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Citation: Journal of Critical Care. 69:154008, 2022 Jun.PMID: 35278875Institution: MedStar Washington Hospital CenterDepartment: Nursing | Surgery/Burn ServicesForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Intensive Care Units | *Resuscitation Orders | Communication | Electric Countershock | HumansYear: 2022 ISSN:

0883-9441

Name of journal: Journal of critical careAbstract: CONCLUSIONS: Surgical staff expressed more concern about care after DNR status than their ICU counterparts. Determining whether care actually changes clinically warrants further investigation. Copyright Published by Elsevier Inc.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.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.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).All authors: Chung KK, Dishman SE, Driggers KE, Johnson LS, Johnson LS, McLawhorn MM, Olsen CH, Ryan ABOriginally published: Journal of Critical Care. 69:154008, 2022 Mar 09.Fiscal year: FY2022 Digital Object Identifier:

https://dx.doi.org/10.1016/j.jcrc.2022.154008

Date added to catalog: 2022-05-11

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Title notes ( 5 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	35278875	Available		35278875

CONCLUSIONS: Surgical staff expressed more concern about care after DNR status than their ICU counterparts. Determining whether care actually changes clinically warrants further investigation. Copyright Published by Elsevier Inc.

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.

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.

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).

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