DNR Orders Often Not Transmitted to ED by Extended Care Facilities

A small study finds poor emergency department and hospital documentation of do-not-resuscitate status, despite its being documented at the transferring facility.

Clinicians are ethically obligated to make a reasonable attempt to ascertain and then respect patients' wishes regarding their healthcare, including do-not-resuscitate (DNR) orders. In Ohio, state law requires that DNR orders be transported with patients transferred from one facility to another. In a study of 50 patients (mean age, 78 years) transferred from extended care facilities to an academic emergency department (ED) in Ohio, investigators determined status of DNR orders at the originating facility and in the ED or hospital after patient arrival.

DNR orders were on file at the originating facility for 68% of patients, but only 28% had DNR orders transported to the ED. An advance directive was noted by registration staff for 32% of pati…

Reviewing Author

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

DNR Orders Often Not Transmitted to ED by Extended Care Facilities

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Reviewing Author