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Interpretation of do-not-resuscitate order appears to vary among pediatric physicians

Date:
August 26, 2013
Source:
American Medical Association (AMA)
Summary:
Clinicians use the do-not-resuscitate (DNR) order not only as a guide for therapeutic decisions during a cardiopulmonary arrest but also as a surrogate for broader treatment directives, according to a new study.

Clinicians use the do-not-resuscitate (DNR) order not only as a guide for therapeutic decisions during a cardiopulmonary arrest but also as a surrogate for broader treatment directives, according to a study by Amy Sanderson M.D., of Boston Children's Hospital, M.A., and colleagues.

A total of 107 physicians and 159 nurses responded to a survey regarding their attitudes and behaviors about DNR orders for pediatric patients. There was substantial variability in the interpretation of the DNR order. Most clinicians (66.9 percent) reported that they considered that a DNR order indicated limitation of resuscitative measures only on cardiopulmonary arrest.

In reality, however, more than 85 percent reported that care changes beyond response to cardiopulmonary arrest, varying from increased attention to comfort to less clinician attentiveness. In addition, most clinicians reported that resuscitation status discussions take place later in the illness course than is ideal, according to the study results.

"Interventions aimed at improving clinician knowledge and skills in advance care discussions as well as the development of orders that address overall goals of care may improve care for children with serious illness," the study concludes.


Story Source:

The above story is based on materials provided by American Medical Association (AMA). Note: Materials may be edited for content and length.


Journal Reference:

  1. Amy Sanderson et al. Clinician Perspectives Regarding the Do-Not-Resuscitate OrderPerspectives Regarding DNR OrdersPerspectives Regarding DNR Orders. JAMA Pediatrics, 2013; DOI: 10.1001/jamapediatrics.2013.2204

Cite This Page:

American Medical Association (AMA). "Interpretation of do-not-resuscitate order appears to vary among pediatric physicians." ScienceDaily. ScienceDaily, 26 August 2013. <www.sciencedaily.com/releases/2013/08/130826180258.htm>.
American Medical Association (AMA). (2013, August 26). Interpretation of do-not-resuscitate order appears to vary among pediatric physicians. ScienceDaily. Retrieved October 21, 2014 from www.sciencedaily.com/releases/2013/08/130826180258.htm
American Medical Association (AMA). "Interpretation of do-not-resuscitate order appears to vary among pediatric physicians." ScienceDaily. www.sciencedaily.com/releases/2013/08/130826180258.htm (accessed October 21, 2014).

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