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| Content Provider | PubMed Central |
|---|---|
| Author | Calam, B. Andrew, R. |
| Abstract | OBJECTIVE: To determine the proportion of patients on a family practice ward who had "code status" orders and end-of-life discussions documented on their charts in the first week of admission. To examine the correlation between a tool predicting the likelihood of benefit from cardiopulmonary resuscitation (CPR) and actual end-of-life decisions made by family physicians and their patients. DESIGN: Cross-sectional descriptive study using a retrospective chart review. SETTING: A 14-bed teaching ward where family physicians admit and manage their own patients in an urban tertiary care teaching hospital. PARTICIPANTS: Patients admitted to the ward for 7 or more days between December 1, 1995, and August 31, 1996. MAIN OUTCOME MEASURES: Frequency of documented "do not resuscitate" (DNR) or "full code" orders and documented end-of-life discussions. Prognosis-after-resuscitation (PAR) score. RESULTS: In the 103 charts reviewed, code status orders were entered within 7 days for 60 patients (58%); 31 were DNR, and 29 were full code. Discussion of code status was documented in 25% of charts. The PAR score for 40% of patients was higher than 5, indicating they were unlikely to survive to discharge from hospital should they require CPR. There was a significant association between PAR scores done retrospectively and actual code status decisions made by attending family physicians (P < .005). CONCLUSIONS: End-of-life discussions and decisions were not fully documented in patients' charts, even though patients were being cared for in hospital by their family physicians. A PAR score obtained during the first week of admission could assist physicians in discussing end-of-life orders with their patients. |
| Ending Page | 346 |
| Starting Page | 340 |
| File Format | |
| ISSN | 17155258 |
| e-ISSN | 17155258 |
| Journal | Canadian Family Physician |
| Volume Number | 46 |
| Language | English |
| Publisher | College of Family Physicians of Canada |
| Publisher Date | 2000-02-01 |
| Access Restriction | Open |
| Rights Holder | College of Family Physicians of Canada |
| Subject Keyword | Research in Higher Education |
| Content Type | Text |
| Resource Type | Article |
| Subject | Family Practice |
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