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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
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
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
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  review and is amended or rescinded at any time as deemed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
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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Do not resuscitate

  • 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