Skip to main content
NCBI home page
Journal of the Royal Society of Medicine logoLink to Journal of the Royal Society of Medicine
. 1995 Mar;88(3):136–140.

Improving the documentation and appropriateness of cardiopulmonary resuscitation decisions.

C L Hignett 1, D R Forsyth 1, G D Connor 1
PMCID: PMC1295131  PMID: 7752156

Abstract

A criterion based audit was undertaken, over a 3 year period, to review the appropriateness of the decision to undertake cardiopulmonary resuscitation (CPR) and the recording of resuscitation status in a 112 bedded department of medicine for the elderly. Resuscitation status was not recorded in either nursing or medical notes of patients undergoing CPR during the first two 12 month audit periods, and was recorded in 71% in the final 12 month audit period. The auditors agreed in 91% of cases that CPR was either appropriate or inappropriate. In the third year of audit 40% of decisions to resuscitate were judged inappropriate.

Full text

PDF
136

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. AYERS W. R., DOYLE J. T. CARDIOPULMONARY RESUSCITATION. REVIEW OF ONE YEAR'S EXPERIENCE IN A GENERAL HOSPITAL. N Y State J Med. 1964 Aug 1;64:1929–1932. [PubMed] [Google Scholar]
  2. Aarons E. J., Beeching N. J. Survey of "do not resuscitate" orders in a district general hospital. BMJ. 1991 Dec 14;303(6816):1504–1506. doi: 10.1136/bmj.303.6816.1504. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bayliss R. I. Thou shalt not strive officiously. Br Med J (Clin Res Ed) 1982 Nov 13;285(6352):1373–1375. doi: 10.1136/bmj.285.6352.1373. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Bedell S. E., Delbanco T. L. Choices about cardiopulmonary resuscitation in the hospital. When do physicians talk with patients? N Engl J Med. 1984 Apr 26;310(17):1089–1093. doi: 10.1056/NEJM198404263101706. [DOI] [PubMed] [Google Scholar]
  5. Bedell S. E., Delbanco T. L., Cook E. F., Epstein F. H. Survival after cardiopulmonary resuscitation in the hospital. N Engl J Med. 1983 Sep 8;309(10):569–576. doi: 10.1056/NEJM198309083091001. [DOI] [PubMed] [Google Scholar]
  6. Blackhall L. J. Must we always use CPR? N Engl J Med. 1987 Nov 12;317(20):1281–1285. doi: 10.1056/NEJM198711123172009. [DOI] [PubMed] [Google Scholar]
  7. Bok S. Personal directions for care at the end of life. N Engl J Med. 1976 Aug 12;295(7):367–369. doi: 10.1056/NEJM197608122950706. [DOI] [PubMed] [Google Scholar]
  8. Buff D. D., Fleisher J. M., Roca J. A., Jaffri M., Wyrwinski P. M. Circadian distribution of in-hospital cardiopulmonary arrests on the general medical ward. Arch Intern Med. 1992 Jun;152(6):1282–1288. [PubMed] [Google Scholar]
  9. Doyal L., Wilsher D. Withholding cardiopulmonary resuscitation: proposals for formal guidelines. BMJ. 1993 Jun 12;306(6892):1593–1596. doi: 10.1136/bmj.306.6892.1593. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Dyer Clare. High Court says advance directives are binding. BMJ. 1993 Oct 23;307(6911):1023–1024. [PubMed] [Google Scholar]
  11. Füsgen I., Summa J. D. How much sense is there in an attempt to resuscitate an aged person? Gerontology. 1978;24(1):37–45. doi: 10.1159/000212235. [DOI] [PubMed] [Google Scholar]
  12. George A. L., Jr, Folk B. P., 3rd, Crecelius P. L., Campbell W. B. Pre-arrest morbidity and other correlates of survival after in-hospital cardiopulmonary arrest. Am J Med. 1989 Jul;87(1):28–34. doi: 10.1016/s0002-9343(89)80479-6. [DOI] [PubMed] [Google Scholar]
  13. Gulati R. S., Bhan G. L., Horan M. A. Cardiopulmonary resuscitation of old people. Lancet. 1983 Jul 30;2(8344):267–269. doi: 10.1016/s0140-6736(83)90244-1. [DOI] [PubMed] [Google Scholar]
  14. Gunasekera N. P., Tiller D. J., Clements L. T., Bhattacharya B. K. Elderly patients' views on cardiopulmonary resuscitation. Age Ageing. 1986 Nov;15(6):364–368. doi: 10.1093/ageing/15.6.364. [DOI] [PubMed] [Google Scholar]
  15. Hahn R. G., Hutchinson J. C., Conte J. E., Jr Cardiopulmonary resuscitation in a university hospital. An analysis of survival and cost. West J Med. 1979 Oct;131(4):344–348. [PMC free article] [PubMed] [Google Scholar]
  16. Hershey C. O., Fisher L. Why outcome of cardiopulmonary resuscitation in general wards is poor. Lancet. 1982 Jan 2;1(8262):31–34. doi: 10.1016/s0140-6736(82)92567-3. [DOI] [PubMed] [Google Scholar]
  17. Johnson A. L., Tanser P. H., Ulan R. A., Wood T. E. Results of cardiac resuscitation in 552 patients. Am J Cardiol. 1967 Dec;20(6):831–835. doi: 10.1016/0002-9149(67)90397-9. [DOI] [PubMed] [Google Scholar]
  18. KOUWENHOVEN W. B., JUDE J. R., KNICKERBOCKER G. G. Closed-chest cardiac massage. JAMA. 1960 Jul 9;173:1064–1067. doi: 10.1001/jama.1960.03020280004002. [DOI] [PubMed] [Google Scholar]
  19. Kennelly B. M. Analysis of a 2-year-old resuscitation service. Resuscitation. 1974;3(4):229–239. doi: 10.1016/0300-9572(74)90012-4. [DOI] [PubMed] [Google Scholar]
  20. Miles S. H., Cranford R., Schultz A. L. The do-not-resuscitate order in a teaching hospital: considerations and a suggested policy. Ann Intern Med. 1982 May;96(5):660–664. doi: 10.7326/0003-4819-96-5-660. [DOI] [PubMed] [Google Scholar]
  21. O'Keeffe S. T., Noel J., Lavan J. N. Cardiopulmonary resuscitation preferences in the elderly. Eur J Med. 1993 Jan;2(1):33–35. [PubMed] [Google Scholar]
  22. O'Keeffe S., Redahan C., Keane P., Daly K. Age and other determinants of survival after in-hospital cardiopulmonary resuscitation. Q J Med. 1991 Dec;81(296):1005–1010. doi: 10.1093/qjmed/81.3.1005. [DOI] [PubMed] [Google Scholar]
  24. Peatfield R. C., Sillett R. W., Taylor D., McNicol M. W. Survival after cardiac arrest in hospital. Lancet. 1977 Jun 11;1(8024):1223–1225. doi: 10.1016/s0140-6736(77)92435-7. [DOI] [PubMed] [Google Scholar]
  25. Polta T. A. Cardiopulmonary resuscitation at McKennan Hospital. S D J Med. 1973 May;26(5):17–22. [PubMed] [Google Scholar]
  26. Schade S. G., Muslin H. Do not resuscitate decisions: discussions with patients. J Med Ethics. 1989 Dec;15(4):186–190. doi: 10.1136/jme.15.4.186. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Scott R. P. Cardiopulmonary resuscitation in a teaching hospital. A survey of cardiac arrests occurring outside intensive care units and emergency rooms. Anaesthesia. 1981 May;36(5):526–530. doi: 10.1111/j.1365-2044.1981.tb10290.x. [DOI] [PubMed] [Google Scholar]
  28. Shmerling R. H., Bedell S. E., Lilienfeld A., Delbanco T. L. Discussing cardiopulmonary resuscitation: a study of elderly outpatients. J Gen Intern Med. 1988 Jul-Aug;3(4):317–321. doi: 10.1007/BF02595786. [DOI] [PubMed] [Google Scholar]
  29. Stewart K., Abel K., Rai G. S. Resuscitation decisions in a general hospital. BMJ. 1990 Mar 24;300(6727):785–785. doi: 10.1136/bmj.300.6727.785. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Stolman C. J., Gregory J. J., Dunn D., Levine J. L. Evaluation of patient, physician, nurse, and family attitudes toward do not resuscitate orders. Arch Intern Med. 1990 Mar;150(3):653–658. [PubMed] [Google Scholar]
  31. Taffet G. E., Teasdale T. A., Luchi R. J. In-hospital cardiopulmonary resuscitation. JAMA. 1988 Oct 14;260(14):2069–2072. [PubMed] [Google Scholar]
  32. Wildsmith J. A., Dennyson W. G., Myers K. W. Results of resuscitation following cardiac arrest. A review from a major teaching hospital. Br J Anaesth. 1972 Jul;44(7):716–720. doi: 10.1093/bja/44.7.716. [DOI] [PubMed] [Google Scholar]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press

RESOURCES