1. From paper to paperless: Do electronic systems ensure safe and effective communication and documentation of DNACPR decisions?
- Author
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Harrington L, Price K, and Edmonds P
- Subjects
- Communication, Decision Making, Documentation, Electronics, Humans, Retrospective Studies, Cardiopulmonary Resuscitation, Resuscitation Orders
- Abstract
Introduction: An electronic resuscitation system, implemented in 2015, within electronic patient records (EPR) at King's College Hospital NHS Foundation Trust was studied, aiming to review and improve decision documentation and communication., Method: The study (January 2018 - June 2018) included all gerontology inpatients with electronic do not attempt cardiopulmonary resuscitation (e-DNACPR) decisions. Cases were identified weekly, followed by retrospective analysis of discharges. Amendments to the electronic system and improvements were implemented between cycles. CYCLE 1: One-hundred and thirty-three patients were included; 85% had an e-DNACPR form; 86% of all forms had senior doctor involvement; 68% evidenced patient/relative discussion; 13% documented multidisciplinary team (MDT) discussion., Interventions: A mandatory 'named nurse' field was added to the form and trust-wide education programme implemented. CYCLE 2: One-hundred and twenty-six patients were included; 100% had an e-DNACPR form; 93% evidenced senior doctor involvement; 71% evidenced patient/relative discussion; 57% documented MDT discussion., Conclusion: Changes to the process and trust-wide education resulted in more robust documentation and communication., (© Royal College of Physicians 2020. All rights reserved.)
- Published
- 2020
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