title: Documentation of cardiopulmonary resuscitation decisions in a New Zealand hospital: A prospective observational study.
abstract: BACKGROUND
  Documentation of cardiopulmonary resuscitation (CPR) decisions is often poor. Lack of documented decisions risks inappropriate CPR and staff, patient and family distress.
  
  
  OBJECTIVE
  To examine documented evidence of CPR decisions.
  
  
  METHODS
  Using a prospective observational design, case notes of current patients in 16 wards were reviewed for documented evidence of CPR decisions. Data were collected over a consecutive two-day period in April 2015.
  
  
  RESULTS
  151 patients case notes were reviewed; 41 (27.2%) patients had documented decisions and 110 (72.8%) had no decisions documented. When compared to patients with no documented decisions, those with documented decisions were older (p≤0.001), had a greater number of admission days at time of data collection (p=0.02) and more comorbidities (p≤0.001). In those with documented decisions, advancing age was related to a greater number of comorbidities (p=0.02) but not to an increased number of admission days at time of data collection (p=0.81). In the non-documented group advancing age was related to both an increased number of admission days at time of data collection (p≤0.001) and a greater number of comorbidities (p≤0.001).
  
  
  CONCLUSIONS
  Documentation of CPR decisions is suboptimal. Improving documentation reduces staff, patient and family distress and allows appropriate and dignified end of life care.
authors: Patient at Risk Team, Critical Care Complex Middlemore Hospital, Auckland, New Zealand. Electronic address: duplank@middlmore.co.nz.
authors: Kate L
authors: KL
authors: Duplan
authors: Critical Care Complex, Middlemore Hospital, Auckland, New Zealand; School of Nursing, Massey University, New Zealand.
authors: Alison M
authors: AM
authors: Pirret
mesh_terms: D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000451:nursing*; D003657:Decision Making; D004282:Documentation / Q000592:standards*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D011446:Prospective Studies; D012189:Retrospective Studies
keywords: Cardiac arrest; Cardiac arrest documentation; Cardiopulmonary resuscitation decisions; Do not attempt resuscitation orders