Quality of resuscitation orders in general medical patients

Abstract

The documentation of NFR in a patient's admission notes is associated with increased in-hospital mortality and LOS. This is only partly explicable in terms of these patients' greater age and co-morbidity.

Use of resuscitation plans at a tertiary Australian hospital: room for improvement

“…11,12 Review of a pre-existing advance care plan was rarely recorded as part of the consultation process in formulating an ARP. for endoscopy, dialysis or chemotherapy) on the same calendar day.…”

Inadequate resuscitation documentation in older patients' clinical case notes

“…The quality of care of patients with ‘not for resuscitation’ documented can be inferior, including increased risk of death . In Australia, there is no consistent approach, protocol or policy about documenting or communicating resuscitation decisions .…”

“…6 The quality of care of patients with 'not for resuscitation' documented can be inferior, 7 including increased risk of death. 8 In Australia, there is no consistent approach, protocol or policy about documenting or communicating resuscitation decisions. 9 Advance care planning can improve end-of-life care for older people admitted to the hospital if their wishes are documented and followed, resulting in increased satisfaction with care and less likelihood of anxiety, depression and posttraumatic stress in the surviving relatives.…”

Advance care planning documentation strategies; goals‐of‐care as an alternative to not‐for‐resuscitation in medical and oncology patients. A pre–post controlled study on quantifiable outcomes

“…This was based on comparable earlier studies with ACP completion rates of between 15 and 34% in medical patients. 6,7,[9][10][11] Using a 95% confidence level and 80% power, this meant a minimum of 590 patients in each arm, allowing for a 10% lost-to-follow up rate through medical chart unavailability.…”

“…Sample size calculations were based on achieving a 7–8% change in the percentage ACP forms completed within 48 h of admission and 48 h of inpatient death, assuming that baseline rates were 25%. This was based on comparable earlier studies with ACP completion rates of between 15 and 34% in medical patients . Using a 95% confidence level and 80% power, this meant a minimum of 590 patients in each arm, allowing for a 10% lost‐to‐follow up rate through medical chart unavailability.…”