Heffner J E, Barbieri C
Mercy Health Services Research Group, St. Joseph's Hospital and Medical Center, Phoenix, Arizona 85001, USA.
Ann Intern Med. 1998 Nov 15;129(10):801-5. doi: 10.7326/0003-4819-129-10-199811150-00010.
Little is known about the effectiveness of do-not-resuscitate (DNR) orders during transport of hospitalized patients away from their rooms.
To determine compliance with DNR orders in radiology departments.
Observational study.
248 hospital-based radiology departments.
248 radiology department representatives.
10-item questionnaire examining the response of radiology personnel to patients with DNR orders who experience cardiopulmonary arrest.
Written DNR protocols and structured procedures for communicating DNR status were used by 18.5% (CI, 13.7% to 23.4%) and 18.1% (CI, 13.3% to 23.0%) of departments, respectively. Medical chart review was the only source of information on DNR status for 41.5% (CI, 35.4% to 47.7%) of departments. It was found that 20.2% of respondents (CI, 15.2% to 25.2%) would resuscitate patients with DNR orders and that 38.3% (CI, 32.3% to 44.4%) had resuscitated patients with DNR orders in the past.
Most radiology departments do not have formal procedures to prevent patients from undergoing unwanted or inappropriate resuscitative interventions, and DNR orders are frequently overruled.
对于住院患者在离开病房转运期间的“不要复苏”（DNR）医嘱的有效性，人们了解甚少。
确定放射科对DNR医嘱的依从性。
观察性研究。
248个医院放射科。
248名放射科代表。
一份包含10个条目的问卷，用于调查放射科人员对经历心肺骤停的DNR医嘱患者的反应。
分别有18.5%（95%CI，13.7%至23.4%）和18.1%（95%CI，13.3%至23.0%）的科室使用了书面DNR方案以及用于传达DNR状态的结构化程序。41.5%（95%CI，35.4%至47.7%）的科室将病历审查作为DNR状态的唯一信息来源。结果发现，20.2%的受访者（95%CI，15.2%至25.2%）会对有DNR医嘱的患者进行复苏，并且38.3%（95%CI，32.3%至44.4%）的受访者过去曾对有DNR医嘱的患者进行过复苏。
大多数放射科没有正式程序来防止患者接受不必要或不适当的复苏干预，并且DNR医嘱经常被忽视。
