 |
|
Cardiopulmonary Resuscitation Policies and PracticesA Statewide Nursing Home Study
Louis L. Brunetti, MD, JD;
Matthew J. Weiss, DO, MPH;
Stephanie A. Studenski, MD, MPH;
Elizabeth C. Clipp, PhD
Arch Intern Med. 1990;150(1):121-126.
Abstract
| |
• We determined the prevalence of written cardiopulmonary resuscitation policies in North Carolina nursing homes and evaluated their content according to predetermined criteria. Questionnaires were mailed to 236 state-registered facilities. Two hundred nine nursing homes (88.5%) responded to the questionnaire; 83% reported having a written policy, and half (86 nursing homes) provided copies. Nine often nursing homes reported that cardiopulmonary resuscitation was performed at their institution, and a similar number (92%) permitted physician orders restricting cardiopulmonary resuscitation. Written policies were systematically compared with 10 model criteria. Policy content varied substantially. More than half of the policies contained provisions for authorization, informed consent, documentation, competency, review, and applicability of do not resuscitate orders. Less than half contained criteria for autonomy, treatment alternatives, dignity and quality of care, and patient identification. Nursing homes that had written policies were newer, larger, and for-profit; had a greater proportion of skilled nursing care beds; and were more likely to have both Medicare and Medicaid certification. The variations in these policies place nursing home residents at risk for having important personal rights limited or ignored. Inclusion of these 10 policy criteria in a comprehensive cardiopulmonary resuscitation policy would represent an important step toward enhancing the quality of decision making by nursing home residents.
(Arch Intern Med. 1990;150:121-126)
Author Affiliations
From the Divisions of General Internal Medicine (Dr Brunetti) and Geriatrics (Drs Weiss, Studenski, and Clipp), Duke University Medical Center, and the Geriatric Research, Education and Clinical Center, Veterans Administration Medical Center (Drs Studenski and Clipp), Durham, NC.
Footnotes
Accepted for publication July 28,1989.
Presented in part at the 11th Annual Meeting of the Society for General Internal Medicine, Washington, DC, April 28,1988.
Reprint requests to Department of Medicine, Charlotte Memorial Hospital and Medical Center, PO Box 32861, Charlotte, NC 28232-2861 (Dr Brunetti).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Policies on Medical Decisions Concerning the End of Life in Dutch Health Care Institutions
Haverkate and van der Wal
JAMA 1996;275:435-439.
ABSTRACT
|
