• S B Stillwell, J Woletz, M R Piedmonte, and M J Popovich.
• Cleveland Clinic Foundation, Ohio, USA.
• Am. J. Crit. Care. 1997 Sep 1;6(5):400-5.

BackgroundThe meaning of do-not-resuscitate orders and their impact on nursing care have been a source of confusion, and the results of the few studies that have examined nursing care of ICU patients with these orders have been conflicting.ObjectivesTo assess nursing workload associated with caring for patients with do-not-resuscitate orders and to better understand the patients and selected events associated with these orders.MethodSixty patients from medical, surgical, and neuroscience ICUs met the criteria for the study. The Medicus Systems Corporation InterAct 2000 Workload and Productivity System was used to classify patients by type; the results reflected the number of hours of nursing care required per 24 hours. Data on patient type for 1 day before and 1 day after do-not-resuscitate orders were written were available for 31 of the 60 patients. These data were analyzed.ResultsThe number of hours of nursing care required 1 day before and 1 day after a do-not-resuscitate order did not change. The amount of nursing care remained the same or increased for 74% (23/31) of the patients after the order was written. Patients were classified as types IV (n = 8), V (n = 20), and VI (n = 3) after the order was written.ConclusionsA high level of nursing care was required for this group of critically ill patients, and the do-not-resuscitate order did not alter the number of hours of nursing care required after the order was written.

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