ArticleBMC medical ethics2020
Usage of do-not-attempt-to-resuscitate orders in a Swedish community hospital - patient involvement, documentation and compliance.
Article in BMC medical ethics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Validation and comparison of two prearrest prediction scores for in-hospital cardiac arrest survival.Resuscitation plus · 2026Article
- Evaluation of adherence to national regulations for documentation of limitations of life-sustaining treatments after a limited intervention at a Swedish hospital.Resuscitation plus · 2026Article
- Prediction of cardiac arrest in patients with heart failure in Sweden: a registry study with development of a machine learning model.BMJ open · 2026Observational
- Equal cardiac arrest care - a qualitative study of healthcare professionals' experiences.BMC medical ethics · 2026Article
- Treatment limitations and participation in elderly patients - the gap between medical-ethical guidelines and clinical practice: a cross sectional-study from Sweden.BMC geriatrics · 2025Article
- To withhold resuscitation - The Swedish system's rules and challenges.Resuscitation plus · 2023Article
- Article
- Use of conditional medical orders to minimize moral, ethical, and legal risk in critical care.Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management · 2022Article
- Low adherence to legislation regarding Do-Not-Attempt-Cardiopulmonary-Resuscitation orders in a Swedish University Hospital.Resuscitation plus · 2021Article
- Do-not-attempt-resuscitation orders: attitudes, perceptions and practices of Swedish physicians and nurses.BMC medical ethics · 2021Observational
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Authors and funding
5 authors.
Funding
Abstract
backgroundTo characterize patients dying in a community hospital with or without attempting cardiopulmonary resuscitation (CPR) and to describe patient involvement in, documentation of, and compliance with decisions on resuscitation (Do-not-attempt-to-resuscitate orders; DNAR).
methodsAll patients who died in Kalmar County Hospital during January 1, 2016 until December 31, 2016 were included. All information from the patients' electronic chart was analysed.
resultsOf 660 patients (mean age 77.7 ± 12.1 years; range 21-101; median 79; 321 (48.6%) female), 30 (4.5%) were pronounced dead in the emergency department after out-of-hospital CPR. Of the remaining 630 patients a DNAR order had been documented in 558 patients (88.6%). Seventy had no DNAR order and 2 an explicit order to do CPR. In 43 of these 70 patients CPR was unsuccessfully attempted while the remaining 27 patients died without attempting CPR. In 2 of 558 (0.36%) patients CPR was attempted despite a DNAR order in place. In 412 patients (73.8%) the DNAR order had not been discussed with neither patient nor family/friends. Moreover, in 75 cases (13.4%) neither patient nor family/friends were even informed about the decision on code status.
conclusionsIn general, a large percentage of patients in our study had a DNAR order in place (88.6%). However, 27 patients (4.3%) died without CPR attempt or DNAR order. DNAR orders had not been discussed with the patient/surrogate in almost three fourths of the patients. Further work has to be done to elucidate the barriers to discussions of CPR decisions with the patient.
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