Data collection for the identified patients occurred only once with the pre- or post-intervention data collection. Secondary data collection would only occur if the patient were to undergo a code status change again with another procedure during the same hospital stay while admitted to the identified units.

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Authors
Golden, Natalie C.
Issue Date
2024-05-09
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Do Not Resucitate , DNR , Discordant CPR , Cardiopulmonary resuscitation
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Abstract
Discordant CPR continues to occur in hospitals across the U.S leading to undesirable patient health outcomes, patient dissatisfaction, and related legal and malfeasance difficulties. In hospitals where discordant CPR occurs, a gap in code status order versus action was identified. Many hospitals choose to invoke a Full code status prior to patients undergoing procedure or surgery in contrast to the patient’s elected code status of MDNR or DNR. After procedure, the code status is not returned to the original order and discordant CPR can occur. An intervention was introduced using a smartphrase in the EMR. The intervention alerted providers to evaluate the code status order and return to the original order when appropriate. An increase in return to original code status order post- procedure was achieved. No discordant CPR events occurred for those patients whose code status order was not returned to the original.
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Creighton University
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Copyright is retained by the Author. A non-exclusive distribution right is granted to Creighton University
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