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review and is amended or rescinded at any time as deemed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