0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
ARTICLE |

The Effects of a Hospital Policy and State Legislation on Resuscitation Orders for Geriatric Patients

Timothy E. Quill, MD; Nancy M. Bennett, MD, MS
Arch Intern Med. 1992;152(3):569-572. doi:10.1001/archinte.1992.00400150089016.
Text Size: A A A
Published online

In 1983, The Genesee Hospital, Rochester, NY, enacted a do-not-resuscitate (DNR) policy that was revised in 1988 because of complex state legislation. Using a retrospective chart review, we studied DNR ordering for all patients older than 79 years who died in the hospital during the 6 months before the policy and compared it with two 6-month intervals after the policy and three 6-month intervals after the law. The hospital policy was associated with an increase in explicit ordering of DNR from 21% in 1982 to 76% for the 2 years thereafter. A further nonsignificant increase to 84% was seen in the 3 years after the law. When cardiopulmonary resuscitation (CPR) was ordered, it was performed in 29% before the policy, 56% in the 2 years after, and 92% for the 3 years after the law. We reviewed all CPR attempts for 1988 and found that the overall survival rate for patients older than 79 years was 39% and probably was the result of careful patient selection. Our hospital policy was not adversely affected and may even have been enhanced by the New York State legislation. Despite this progress, we found that less than 25% of decisions about CPR or DNR were the result of informed decision making by patients themselves.

(Arch Intern Med. 1992;152:569-572)

Topics

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 29

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();