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Background: A resuscitation plan is a medically authorised order to use or withhold resuscitation interventions. Absence of appropriate resuscitation orders exposes patients to the risk of invasive medical interventions that may be of questionable benefit depending on individual circumstances. Aims: To describe among junior doctors: (i) self‐reported confidence discussing and completing resuscitation plans; (ii) knowledge of resuscitation policy including whether resuscitation plans are legally enforceable and key triggers for completion; and (iii) the factors associated with higher knowledge of triggers for completing resuscitation plans. Methods: A cross‐sectional survey was conducted at five hospitals. Junior doctors on clinical rotation were approached at scheduled training sessions, before or after ward rounds or at change of rotation orientation days and provided with a pen‐and‐paper survey. Results: A total of 118 junior doctors participated. Most felt confident discussing (79%; n = 92) and documenting (87%; n = 102) resuscitation plans with patients. However, only 45% (n = 52) of doctors correctly identified that resuscitation plans are legally enforceable medical orders. On average, doctors correctly identified 6.8 (standard deviation = 1.8) out of 10 triggers for completing a resuscitation plan. Doctors aged >30 years were four times more likely to have high knowledge of triggers for completing resuscitation plans (odds ratio 4.28 (95% confidence interval 1.54–11.89); P = 0.0053). Conclusion: Most junior doctors feel confident discussing and documenting resuscitation plans. There is a need to improve knowledge about legal obligations to follow completed resuscitation plans, and about when resuscitation plans should be completed to ensure they are completed with patients who are most at risk. [ABSTRACT FROM AUTHOR]

Background: Māori in New Zealand (NZ) are disproportionately affected by chronic kidney disease (CKD) and experience lower life expectancy on community dialysis compared with non‐Māori. We previously identified a higher renal replacement therapy (RRT) requirement for Māori in our intensive care unit (ICU), the tertiary referral centre for NZ's Te Manawa Taki region. Aim: To describe mortality outcomes by ethnicity in the population requiring RRT in our ICU. Methods: Retrospective audit of the Australia and NZ Intensive Care Society database for adult admissions to our general ICU from Te Manawa Taki between 2014 and 2018. Patients were stratified by non‐RRT requirement (non‐RRT), RRT‐requiring acute kidney injury (AKI‐RRT) and RRT‐requiring end‐stage renal disease (ESRD). Results: Relative to the population of Te Manawa Taki, Māori were over‐represented across all strata, especially ESRD (61.8%), followed by AKI‐RRT (35.0%) and non‐RRT (32.4%) (P < 0.001). There was no excess mortality by ethnicity in any stratum. Crude in‐ICU mortality was similar by ethnicity among AKI‐RRT (30.8% among Māori, vs 31.5%; P = 1.000) and ESRD (16.4% among Māori, vs 20.6%; P = 0.826). This trend remained at 1 year. Adjusted for clinically selected variables, neither AKI‐RRT nor ESRD mortality was predicted by Māori ethnicity, both in‐ICU and at 1 year. Irrespective of ethnicity, AKI‐RRT patients had highest in‐ICU mortality (31.2%; P < 0.001), while ESRD had highest 1‐year mortality (46.1%; P < 0.001). Conclusion: Increased RRT requirement among Māori in our ICU is due to higher representation among ESRD. We did not demonstrate excess mortality by ethnicity in any stratum. AKI‐RRT had higher in‐ICU mortality than ESRD, but this reversed at 1 year. [ABSTRACT FROM AUTHOR]