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- Paul Diggory, Lisa Cauchi, David Griffith, Valerie Jones, Enas Lawrence, Anand Mehta, Paul O'Mahony, and Jane Vigus.
- Department of Medicine for the Elderly, Mayday University Hospital, Croydon, London, UK. paul.diggory@mayday.nhs.uk
- Resuscitation. 2003 Feb 1; 56 (2): 159-65.
AbstractCurrent guidelines advise discussion with patients before issuing a 'do not attempt resuscitation' (DNAR) order. We report five audit cycles of cardiopulmonary resuscitation (CPR) documentation after introducing a proforma, the last cycle following the latest guidelines. In first audit data were collected from 75 patient discharges. CPR decisions were documented in 27 (36%). Four subsequent point prevalence audits carried out on all inpatients following proforma introduction showed documentation improved to 102/109 (94%), 135/148 (91%), 131/140 (94%) and 102/119 (86%) in cycles two, three, four and five, respectively. The last three audits also revealed that consultants consistently made more DNAR orders than trainee doctors. However, following the introduction of the latest guidelines the proportion of patients in whom a decision was made, and the percentage of those decisions that were DNAR, fell.
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