Physicians' do-not-resuscitate decisions and documentation in a community hospital.
Physician documentation of the participants in do-not-resuscitate (DNR) decisions and the equitability of DNR decisions were studied in a 450-bed community hospital in San Francisco. All 333 patients who received written DNR orders and the 108 physicians who made DNR decisions were studied. Of the sampled records, 45% contained no documentation of who participated in the DNR decision. Only 38% of the documented records showed that patients were involved in the DNR decision. In the remaining cases (62%), families were involved as surrogate decision makers. The rate of physicians' DNR decision-making varied according to physician specialty: Oncologists, neurologists, gastroenterologists, and pulmonologists had the highest rates, while surgeons, cardiologists, and general practitioners had the lowest.
Lipton
H L
HL
Division of Clinical Pharmacy, San Francisco 94143.
D003657:Decision Making; D004282:Documentation; D004992:Ethics, Medical; D006745:Hospital Bed Capacity, 300 to 499; D006764:Hospitals, Community; D006801:Humans; D007258:Informed Consent; D010358:Patient Participation; D010820:Physicians; D012151:Resuscitation; D012495:San Francisco