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Do not resuscitate

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  • 1. Do Not Resuscitate In the event of a cardiopulmonary arrest, cardiopulmonary resuscitation is administered to every patient unless a DNR order is written in the medical record by the physician When advanced directives exist and qualifying conditions are present, these directives are followed by the physician The attending physician discusses the decision with the patient, family members, or others involved in the care of the patient
  • 2. Do Not Resuscitate (continued) If the patient can not validly participate in the decision making, the physician attempts to obtain consensual opinions of all interested parties concerning what the patient’s wishes would be Consent of the family is not necessary if the decision is made by the patient – family disagreement is not sufficient to override the patient’s choice The physician writes the DNR order on the patient’s medical record by completing the “Resuscitative Treatment” physician order form available on ms piggy following the path> mspiggyPublicPhyOrdersFormsNursing
  • 3. Do Not Resuscitate (continued) When orders have been written to limit specific resuscitative treatments, the patient continues to receive full and consistent medical and nursing efforts in all other aspects of health care management If the patient is mentally incompetent, decisions not covered by advance directives are reached by appropriate surrogate decision makers as identified by Arkansas Law If conflict or dilemmas arise, the Ethics Committee assists in clarifying available options and improving communications
  • 4. Do Not Resuscitate (continued) Nursing communicates DNR status during shift reports and verifies by checking the medical record Place a “DNR” on the MedAct Nursing shift supervisor is notified of all patients with a DNR status Place the purple DNR armband on the patient The order to limit resuscitative treatments is subject to regular review and is amended or rescinded at any time as deemed appropriate by the physician
  • 5. Do Not Resuscitate (continued) When a DNR is written on the medical record no resuscitative treatment is done such as CPR or ACLS All other care is consistently delivered to all patients Limited resuscitative interventions are indicated on the “Resuscitative Treatment” order form DNR orders for those undergoing anesthesia require complete explanation and set guidelines for the patient, family, and staff prior to the scheduling of a surgical procedure Orders for DNR must be rewritten following surgery

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