title: [A project to improve the "do not resuscitation" consent completeness rate for terminal cancer patients].
abstract: BACKGROUND
  Signed do-not-resuscitate (DNR) consent is the essential first step for terminal cancer patients to choose palliative care and a quality marker of terminal care. DNR consent completeness helps deliver correct information, ensure consent legal validity, reduce medical disputes, and protect patient and family rights. The DNR consent completeness rate during May and June 2005 was only 33.9% in our hospital. Reasons indicated for this low rate included: (1) lack of a standard operating procedure for DNR consent; (2) multiple DNR consent versions; (3) lack of DNR-related education; and (4) lack of monitoring procedures. Our team developed a project to resolve these problems and improve terminal care quality.
  
  
  OBJECTIVE
  The goal of this project was to increase the rate of DNR consent completeness from 33.9% to 80%.
  
  
  METHODS
  The plan, implemented between August and December 2009, included the following components: (1) establish standard guidelines for DNR consent; (2) simplify and unify DNR consent procedures; (3) provide DNR education for hospital staff; and (4) establish a DNR consent monitoring system.
  
  
  RESULTS
  The DNR consent completeness rate rose from 33.9% to 90%. The goal of this project was thus achieved.
  
  
  CONCLUSIONS
  This project effectively improved the DNR consent completeness rate at our hospital. The project ensured patients a good death and enhanced terminal care quality and patient satisfaction. Our experience may provide a reference to help other hospitals increase DNR their consent completeness rates.
authors.affiliation: Department of Nursing, National Taiwan University Hospital, Hsin-Chu Branch, Taiwan, ROC.
authors.forename: Ju-Fen
authors.initials: JF
authors.lastname: Cheng
authors.forename: Pei-Chun
authors.initials: PC
authors.lastname: Chou
authors.forename: Ya-Ching
authors.initials: YC
authors.lastname: Lin
authors.forename: Kuei-Yen
authors.initials: KY
authors.lastname: Wen
authors.forename: Chin-Yen
authors.initials: CY
authors.lastname: Liu
authors.forename: Ru-Yun
authors.initials: RY
authors.lastname: Wen
mesh_terms: D006801:Humans; D016414:Resuscitation Orders / Q000941:ethics / Q000331:legislation & jurisprudence*
keywords: completeness; do not resuscitate (DNR); good death