Barriers to implementing a policy not to attempt resuscitation in acute medical admissions: prospective, cross sectional study of a successive cohort.
OBJECTIVE
To establish whether acutely unwell patients admitted to hospital wish to participate in discussions about resuscitation.


METHODS
Prospective, cross sectional study of a successive cohort of patients.


METHODS
Admission through the emergency department.


METHODS
374 adult patients.


METHODS
Whether acutely unwell patients wished to participate in discussions about resuscitation.


RESULTS
Of the total sample, 74 patients consented to take part in the study and provide full data. Of the remaining patients, 189 could not be approached for practical reasons and 111 did not wish to participate. Of the 74 patients who read the leaflet, 65 (88%) reported having little or no prior knowledge, 70 (96%) understood it, 56 (77.8%) preferred for resuscitation decisions to be discussed with them, and 55 (77.5%) did not mind discussing resuscitation within 24 hours of admission and overall showed a decline in their anxiety score.


CONCLUSIONS
Many patients admitted through the emergency department for medical reasons cannot participate in their decision not to attempt resuscitation within 24 hours of admission. Patients who were willing to participate rated the information leaflet that was provided positively.
Department of Gastroenterology, University Hospital Lewisham, London SE13 6LH.
H
H
Fidler
C
C
Thompson
A
A
Freeman
D
D
Hogan
G
G
Walker
J
J
Weinman
D000328:Adult; D001294:Attitude to Health; D015331:Cohort Studies; D003142:Communication; D003430:Cross-Sectional Studies; D006291:Health Policy; D006801:Humans; D016134:Organizational Policy; D010353:Patient Education as Topic; D010358:Patient Participation; D016414:Resuscitation Orders / Q000523:psychology*