International Conference on Emergency & Acute Care Medicine
Northwest London Hospital NHS Trust, London, United Kingdom
Title: Do-Not-Attempt-Cardiopulmonary-Resuscitation practices in acute care for older adults – a qualitative study
Biography: Sofia Lokman Cavill
Background: Older adults are more likely to receive Do-not-attempt-cardiopulmonary-resuscitation (DNACRP) orders when they are admitted to hospitals compared to younger patients, yet little is known of the impact these orders have on the every day care of older patients.
Objectives: To understand staff perceptions on issues surrounding current DNACPR practices involving older adults in the acute setting, and elicit the influences of DNACPR decisions on care for older adults.
Design: A qualitative approach was used. Semi-structured interviews were conducted with 15 health professionals from multiple disciplines, working in geriatric medicine wards, in a district general National Health Service (NHS) hospital in the United Kingdom (UK).
Results: All participants supported the use of DNACPR orders in older adults but agree on the unintended repercussions to care beyond what the order stipulates. Four key themes have been identified surrounding DNACPR practices in older adults including: complex decision-making, challenging discussions, staff’s reflections of its impact on care and its benefits to geriatric medicine.
Conclusion: Hospital DNACPR practices in older adults can be variable with DNACPR decisions having unintended negative influences to care. Nevertheless, staff in geriatric medicine strongly support its use in older adults which staff felt led to a more holistic care with discussions often used as platforms for conversations on wider aspects of care. Perhaps incorporating DNACPR decisions into formal care plans, and increasing staff education on resuscitation policies may help standardize practices and remedy its negative influence on care.