Levinson W, Shepard M A, Dunn P M, Parker D F
Good Samaritan Hospital and Medical Center in Portland, OR 97210.
J Am Geriatr Soc. 1987 Dec;35(12):1059-62. doi: 10.1111/j.1532-5415.1987.tb04921.x.
Growing public debate regarding no cardiopulmonary resuscitation (no-CPR) policies in acute care hospitals, together with recent changes in the patient population of long-term care facilities, has led nursing homes to examine their need for resuscitation policies. To determine current cardiopulmonary resuscitation policies and procedures in nursing homes, medical directors and directors of nursing service in long-term care facilities in Portland, Oregon, were surveyed. Seventy-five percent responded; of these, only 41% reported having a resuscitation policy. Of those with no policy, 70% thought one was needed. Most nursing homes reported that resuscitation was infrequently discussed with patients and families. When a no-CPR determination was made, it was usually documented in the patient's chart. Training in basic life support was required for registered nurses in two thirds of the facilities. Few homes had equipment necessary for advanced life support. It is recommended that: a) nursing homes develop cardiopulmonary resuscitation policies; b) resuscitation orders be made part of the medical record; and c) nursing home personnel increase their ability to perform basic life support.
急性护理医院中关于不进行心肺复苏（no-CPR）政策的公开辩论日益激烈，再加上长期护理机构患者群体最近的变化，促使养老院审视其制定复苏政策的必要性。为了确定养老院当前的心肺复苏政策和程序，对俄勒冈州波特兰市长期护理机构的医疗主任和护理服务主任进行了调查。75%的人做出了回应；其中，只有41%的人报告有复苏政策。在没有政策的机构中，70%的人认为需要制定一项政策。大多数养老院报告称，很少与患者及其家属讨论复苏问题。当做出不进行心肺复苏的决定时，通常会记录在患者的病历中。三分之二的机构要求注册护士接受基本生命支持培训。很少有养老院配备高级生命支持所需的设备。建议：a）养老院制定心肺复苏政策；b）将复苏医嘱纳入病历；c）养老院工作人员提高进行基本生命支持的能力。
