CPR in the nursing home: fool's errand or looming dilemma?
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Authors
Lyons, D
Gormley, N
Zulfiquar, W
Silverman, M
Philpot, M
Issue Date
2011-03-23
Type
Journal Article
Language
en
Keywords
Alternative Title
Abstract
The indications for CPR (cardiopulmonary resuscitation) have expanded greatly since the technique was introduced and theoretically it can be attempted on all prior to death. Policy initiatives (such as the British Medical Association/Royal College of Nursing guidelines) have attempted to provide a clinical rationale for the withholding of inappropriate CPR. Traditionally a care home was felt to be an inappropriate environment to attempt CPR but increased use of advance directives may bring the issue to the fore in this setting.
We elicited the views of managers of care homes regarding resuscitation strategies in hypothetical situations and in actual practice.
A purpose designed questionnaire in two parts was compiled, gathering factual information and employing a Likert scale to gauge opinion about this issue. The survey was conducted among 187 continuing care homes in South London the subjects being the care managers of the homes surveyed.
Responses were obtained from 86 care homes. Care managers would resuscitate 66% of cases of witnessed cardiac arrest but few efforts were reported. Policies in assigning 'Do not resuscitate' orders were referred to by only 9% of homes but 80% of facilities would welcome them, yet 50% would exclude the patient from this discussion. Clear policy guidelines are required for continuing care homes, and advance statements about CPR as part of residents care plans could reduce inappropriate resuscitative efforts and hospital transfers.
We elicited the views of managers of care homes regarding resuscitation strategies in hypothetical situations and in actual practice.
A purpose designed questionnaire in two parts was compiled, gathering factual information and employing a Likert scale to gauge opinion about this issue. The survey was conducted among 187 continuing care homes in South London the subjects being the care managers of the homes surveyed.
Responses were obtained from 86 care homes. Care managers would resuscitate 66% of cases of witnessed cardiac arrest but few efforts were reported. Policies in assigning 'Do not resuscitate' orders were referred to by only 9% of homes but 80% of facilities would welcome them, yet 50% would exclude the patient from this discussion. Clear policy guidelines are required for continuing care homes, and advance statements about CPR as part of residents care plans could reduce inappropriate resuscitative efforts and hospital transfers.
Description
Citation
Lyons, D., Gormley, N., Zulfiquar, W., Silverman, M., & Philpot, M. (2011). CPR in the nursing home: fool's errand or looming dilemma?. Irish journal of medical science, 180(3), 673–678. https://doi.org/10.1007/s11845-011-0704-6
Publisher
License
Journal
Irish journal of medical science
Volume
180
Issue
3
PubMed ID
ISSN
1863-4362