• Journal of critical care · Jun 2022

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

    • Kathryn E Driggers, Sydney E Dishman, Kevin K Chung, Cara H Olsen, Andrea B Ryan, Melissa M McLawhorn, and Laura S Johnson.
    • Walter Reed National Military Medical Center, Bethesda, MD, United States of America. Electronic address: Kathryn.E.Driggers.mil@mail.mil.
    • J Crit Care. 2022 Jun 1; 69: 154008.

    PurposeDocumenting 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 MethodsIRB 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.ResultsBoth 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).ConclusionsSurgical staff expressed more concern about care after DNR status than their ICU counterparts. Determining whether care actually changes clinically warrants further investigation.Published by Elsevier Inc.

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