Do-not-resuscitate orders for critically ill patients in intensive care

Yuan-May Chang, Chin Feng Huang, Chia Chin Lin

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

End-of-life decision making frequently occurs in the intensive care unit (ICU). There is a lack of information on how a do-not-resuscitate (DNR) order affects treatments received by critically ill patients in ICUs. The objectives of this study were: (1) to compare the use of life support therapies between patients with a DNR order and those without; (2) to examine life support therapies prior to and after the issuance of a DNR order; and (3) to determine the clinical factors that influence the initiation of a DNR order in ICUs in Taiwan. A prospective, descriptive, and correlational study was conducted. A total of 202 patients comprising 133 (65.8%) who had a DNR order, and 69 (34.1%) who did not, participated in this study. In the last 48 hours of their lives, patients who had a DNR order were less likely to receive life support therapies than those who did not have a DNR order. Older age, being unmarried, the presence of an adult child as a surrogate decision maker, a perceived inability to survive ultimate discharge from the ICU, and longer hospitalization in the ICU were significant predictors of issuing a DNR order for critically ill patients. This study will draw attention to how, when, and by whom, critically ill patients' preferences about DNR are elicited and honored.

Original languageEnglish
Pages (from-to)445-455
Number of pages11
JournalNursing Ethics
Volume17
Issue number4
DOIs
Publication statusPublished - 2010

Keywords

  • Do not resuscitate
  • Intensive care unit
  • Life support care
  • Taiwan

ASJC Scopus subject areas

  • Issues, ethics and legal aspects
  • Medicine(all)

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