ArticleJournal of hospital medicine2015
Frequency and clinical relevance of inconsistent code status documentation.
Article in Journal of hospital medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
What it found
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Who cites it
15 citing papers in PubMed, 26 citations in OpenAlex.
- Early Palliative Care Consultation in the Medical ICU: A Cluster Randomized Crossover Trial.Critical care medicine · 2019Trial
- Impact of the COVID-19 Public Health Crisis and a Structured COVID Unit on Physician Behaviors in Code Status Ordering.The American journal of hospice & palliative care · 2024Article
- Change in Code Status Orders of Hospitalized Adults With COVID-19 Throughout the Pandemic: A Retrospective Cohort Study.Journal of palliative medicine · 2023Article
- The Medical Orders for Scope of Treatment (MOST) form completion: a retrospective study.BMC health services research · 2022Article
- Code Status Blues: Do Legal Nudges Discourage Doctors From Ordering Do-Not-Resuscitate?The Permanente journal · 2022Article
- If Your Heart Were to Stop: Characterization and Comparison of Code Status Orders in Adult Patients Admitted with COVID-19.Journal of palliative medicine · 2022Article
- Locating Advance Care Planning Documents in the Electronic Health Record during Emergency Care.Journal of pain and symptom management · 2022Article
- "Get the DNR": residents' perceptions of goals of care conversations before and after an e-learning module.Canadian medical education journal · 2022Article
- Code status at time of rapid response activation - Impact on escalation of care?Resuscitation plus · 2021Article
- Discordant Cardiopulmonary Resuscitation and Code Status at Death.Journal of pain and symptom management · 2021Article
- Admission to intensive care: A qualitative study of triage and its determinants.Health services research · 2019Article
- Code Status Reconciliation to Improve Identification and Documentation of Code Status in Electronic Health Records.Applied clinical informatics · 2017Article
- Making progress with code status documentation.Journal of hospital medicine · 2015Article
- Moving from "Do Not Resuscitate" Orders to Standardized Resuscitation Plans and Shared-Decision Making in Hospital Inpatients.Gerontology & geriatric medicineReview
- The Crossroads of Geriatric Cardiology and Cardio-Oncology.Current geriatrics reportsReview
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAccurate and complete documentation of hospitalized patients' code status is important to ensure that healthcare providers take appropriate action in the event of a cardiac arrest.
objectiveDetermine the frequency and clinical relevance of incomplete and inconsistent code status documentation.
designPoint-prevalence study.
settingAcademic medical centers. PATIENTS: Patients admitted to general internal medicine wards. MEASUREMENTS: Frequency and clinical relevance of inconsistent code status documentation across 5 documentation sources.
resultsThirty-eight (20%; 95% confidence interval [CI], 14%-26%) of 187 patients had complete and consistent code status documentation. Another 27 (14%; 95% CI, 9%-19%) patients had no code status documentation. The remaining 122 (65%; 95% CI, 58%-72%) patients had at least 1 code status documentation inconsistency. Of these, 38 (20%; 95% CI, 14%-26%) patients had a clinically relevant code status documentation inconsistency. Multivariate logistic regression analysis demonstrated that increased age (odds ratio [OR] = 1.07 [95% CI, 1.05-1.10] for every 1-year increase in age, P < 0.001) and patients receiving comfort measures (OR = 9.39 [95% CI, 1.35-65.19], P = 0.02) were independently associated with a clinically relevant code status documentation inconsistency.
conclusionsIncomplete and inconsistent documentation of code status occurred frequently in hospitalized patients, especially elderly patients and patients receiving comfort measures. Having multiple, poorly integrated code status documentation sources leads to a significant number of concerning inconsistencies that create opportunities for healthcare providers to inappropriately deliver or withhold resuscitative measures that conflict with patients' expressed wishes. Institutions need to be aware of this potential documentation hazard and take steps to minimize code status documentation inconsistencies.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.