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Guidelines for perioperative do-not-resuscitate policies
David B Waisel1, Jeffrey P Burns, Judith A Johnson
1Department of Anesthesiology, Bader 3, Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA. david.waisel@tch.harvard.edu
Journal of Clinical Anesthesia
|October 24, 2002
Summary
Implementing perioperative reevaluation of do-not-resuscitate (DNR) orders presents challenges. This review outlines strategies for institutional policies to ensure flexible, patient-centered DNR care during surgery.
Area of Science:
- Medical Ethics
- Healthcare Policy
- Surgical Patient Care
Background:
- Do-not-resuscitate (DNR) orders require careful consideration during the perioperative period.
- Implementing consistent and effective DNR policies in surgical settings is complex.
- Existing challenges hinder the seamless reevaluation of DNR orders for patients undergoing surgery.
Purpose of the Study:
- To review the difficulties associated with perioperative DNR order reevaluation.
- To propose strategies for developing robust institutional perioperative DNR policies.
- To enhance patient safety and autonomy in surgical care.
Main Methods:
- Literature review of challenges in perioperative DNR implementation.
- Analysis of institutional policy requirements for DNR orders.
- Synthesis of best practices for perioperative DNR management.
Main Results:
- Perioperative DNR reevaluation faces implementation hurdles.
- Institutional policies must be flexible and patient-specific.
- Clear delineation of responsibilities and documentation is crucial.
Conclusions:
- Effective perioperative DNR policies require institutional commitment and clear guidelines.
- Policies should facilitate tailored DNR orders for individual patients.
- Standardized approaches can improve care and communication regarding DNR status in surgery.