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Compliance with Do-Not-Resuscitate Orders for Hospitalized Patients Transported to Radiology Departments

John E. Heffner, MD; and Celia Barbieri, MS
[+] Article, Author, and Disclosure Information

From Mercy Health Services Research Group, St. Joseph's Hospital and Medical Center, Phoenix, Arizona; and University of Arizona Health Sciences Center, Tucson, Arizona. Acknowledgments: The authors thank the members of the radiology departments who participated in the study. Requests for Reprints: John E. Heffner, MD, Department of Medicine, Room 812 CSB, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425. Current Author Addresses: Dr. Heffner: Department of Medicine, Room 812 CSB, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1998;129(10):801-805. doi:10.7326/0003-4819-129-10-199811150-00010
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Background: Little is known about the effectiveness of do-not-resuscitate (DNR) orders during transport of hospitalized patients away from their rooms.

Objective: To determine compliance with DNR orders in radiology departments.

Design: Observational study.

Setting: 248 hospital-based radiology departments.

Participants: 248 radiology department representatives.

Measurements: 10-item questionnaire examining the response of radiology personnel to patients with DNR orders who experience cardiopulmonary arrest.

Results: Written DNR protocols and structured procedures for communicating DNR status were used by 18.5% (CI, 13.7% to 23.4%) and 18.1% (CI, 13.3% to 23.0%) of departments, respectively. Medical chart review was the only source of information on DNR status for 41.5% (CI, 35.4% to 47.7%) of departments. It was found that 20.2% of respondents (CI, 15.2% to 25.2%) would resuscitate patients with DNR orders and that 38.3% (CI, 32.3% to 44.4%) had resuscitated patients with DNR orders in the past.

Conclusions: Most radiology departments do not have formal procedures to prevent patients from undergoing unwanted or inappropriate resuscitative interventions, and DNR orders are frequently overruled.





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