Skerritt U, Pitt B
Intensive Care Unit, Park Royal Centre for Mental Health, London, UK.
Int J Geriatr Psychiatry. 1997 Jun;12(6):667-70.
The main objective was to discover who had 'Do Not Resuscitate' (DNR) status, why, how, when and by whom these decisions were made.
DESIGN, SETTING AND PATIENTS: The medical and nursing notes of all inpatients (139) (age range 16-100 years) in an inner city district general hospital on a single day were examined to determine the resuscitation status, age, sex, and diagnosis of each patient.
A decision not to resuscitate had been taken in 28 (20%) of the cases. 'Do Not Resuscitate' (DNR) patients were significantly older and more likely to suffer from malignant and cardiorespiratory disease. Patients with dementia and other psychiatric disorders were not significantly more often labelled DNR. Evidence of consultation for these decisions was lacking and the recording erratic.
(1) There is a great need to devise and implement comprehensive guidelines. (2) There is need for appropriate and comprehensive documentation outlining the reasons why and how the decision was taken, who was consulted and review date. (3) This is an important area for audit.
主要目的是查明哪些人具有“不要复苏”（DNR）状态，以及这些决定是由谁做出的、为何做出、如何做出、何时做出。
设计、地点和患者：对某市中心区综合医院一天内所有住院患者（139例，年龄范围16至100岁）的医疗和护理记录进行检查，以确定每位患者的复苏状态、年龄、性别和诊断。
28例（20%）病例做出了不进行复苏的决定。“不要复苏”（DNR）患者年龄显著更大，更有可能患有恶性疾病和心肺疾病。患有痴呆症和其他精神疾病的患者被标记为DNR的频率并没有显著更高。缺乏这些决定的会诊证据，记录也不稳定。
（1）迫切需要制定和实施全面的指导方针。（2）需要有适当且全面的文件记录，概述做出该决定的原因和方式、咨询了谁以及复查日期。（3）这是审计的一个重要领域。
