Divergence in DNACPR and resuscitation policies: institutional survey in England.

IF 2 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES BMJ Supportive & Palliative Care Pub Date : 2025-03-03 DOI:10.1136/spcare-2024-005263

Emily Fitton, Karen Chumbley, Caroline Barry, Aneta Bartova, Ben Troke, Wayne Martin

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Abstract

Objectives: Our objective was to analyse the policies of hospitals and care homes in England as regards the use of do not attempt cardiopulmonary resuscitation (DNACPR) recommendations. We sought to identify (i) variations among policies at different institutions, and (ii) divergence of local policies from national guidance, particularly with reference to decisions either (a) to initiate cardiopulmonary resuscitation (CPR) despite the presence of a DNACPR recommendation, or (b) not to initiate CPR in the absence of a DNACPR recommendation.

Methods: We conducted a survey of 14 DNACPR and/or resuscitation policies, drawn from care homes, NHS trusts and hospices.

Results: Many of the policies we surveyed diverge significantly from national guidance. Some require that CPR be administered in all cases where no DNACPR recommendation has been made. Others fail to specify that CPR may be appropriate even in the presence of a DNACPR recommendation.

Conclusions: Local DNACPR policies currently place both patients and healthcare professionals at significant risk.

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来源期刊

BMJ Supportive & Palliative Care Medicine-Medicine (miscellaneous)

CiteScore

4.60

自引率

7.40%

发文量

170

期刊介绍： Published quarterly in print and continuously online, BMJ Supportive & Palliative Care aims to connect many disciplines and specialties throughout the world by providing high quality, clinically relevant research, reviews, comment, information and news of international importance. We hold an inclusive view of supportive and palliative care research and we are able to call on expertise to critique the whole range of methodologies within the subject, including those working in transitional research, clinical trials, epidemiology, behavioural sciences, ethics and health service research. Articles with relevance to clinical practice and clinical service development will be considered for publication. In an international context, many different categories of clinician and healthcare workers do clinical work associated with palliative medicine, specialist or generalist palliative care, supportive care, psychosocial-oncology and end of life care. We wish to engage many specialties, not only those traditionally associated with supportive and palliative care. We hope to extend the readership to doctors, nurses, other healthcare workers and researchers in medical and surgical specialties, including but not limited to cardiology, gastroenterology, geriatrics, neurology, oncology, paediatrics, primary care, psychiatry, psychology, renal medicine, respiratory medicine.