Guidelines ignored on resuscitation decisions
Hospital consultants are still not involved in the vast majority of “do not resuscitate” (DNR) orders despite national guidelines, according to a new report.
A team of consultants and specialists registrars who reviewed the performance at one London hospital also found that the decision making process leading up to such orders was poorly documented and that there was no record of discussions with the patients concerned.
The team, which reports its findings in the Journal of the Royal College of Physicians (1999;33: 348-50), says that the results are disappointing and urges consultants and senior nurses to be more involved in DNR decision making.
DNR instructions, statements made in advance that a patient should not have cardiopulmonary resuscitation in the event of a cardiac arrest, are more informally based in Britain than in a number of other countries, including the United States, where it is embodied in law in some states.