Stolman C J, Gregory J J, Dunn D
Children's Hospital of New Jersey, Newark 07107.
HEC Forum. 1991;3(2):77-85. doi: 10.1007/BF00157782.
The do not resuscitate (DNR) policies of 100 New Jersey hospitals were investigated using a questionnaire to evaluate hospital characteristics, DNR documentation, decisionmaking, consent, satisfaction with present policies, and revision plans. Among responding hospitals, 78% indicated they had a policy, with--61% being established between 1984 and 1987. Twenty-two percent of hospitals with a DNR policy accepted oral orders, 39% accepted telephone orders, and 36% required written consent from a competent patient. Forty-nine percent of hospitals with a policy accepted qualified orders such as, "do not intubate." Sixty-two percent of responding hospitals were satisfied with their current policy. For 22 hospitals without a policy, 80% indicated dissatisfaction with their current practice. When hospitals with a DNR policy were compared to those without a policy, government supported hospitals were less likely to have a DNR policy than non-governmental hospitals (P = .04). Hospitals without a policy were more likely to perform "slow codes" than those with a policy (P = .007). A two-year follow-up survey found seven hospitals without DNR policies.
通过问卷调查对新泽西州100家医院的“不进行心肺复苏”(DNR)政策进行了调查,以评估医院特征、DNR文件记录、决策制定、同意情况、对现行政策的满意度以及修订计划。在做出回应的医院中,78%表示他们有相关政策,其中61%的政策是在1984年至1987年期间制定的。有DNR政策的医院中,22%接受口头医嘱,39%接受电话医嘱,36%要求有行为能力的患者提供书面同意。有政策的医院中,49%接受诸如“不插管”等限定医嘱。62%做出回应的医院对其现行政策感到满意。对于22家没有政策的医院,80%表示对其当前做法不满意。将有DNR政策的医院与没有政策的医院进行比较时,政府支持的医院比非政府医院更不太可能有DNR政策(P = 0.04)。没有政策的医院比有政策的医院更有可能实施“缓慢心肺复苏”(P = 0.007)。一项为期两年的跟踪调查发现有7家医院没有DNR政策。