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review and is amended or rescinded at any time as deemed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