Establishing incidence and administrative protocols for do not resuscitate orders

An order not to resuscitate refers only to CPR and does not imply the omission of any other type of medical care. Institutional DNR policies should include specific statements reflecting resuscitation for those without DNR orders, the patients' wishes, medical conditions, roles of family, protocol describing the process for DNR orders, scope of DNR orders, and frequency of review of DNR orders. The most common reasons for not having written DNR protocols were that directors of nursing did not have guidelines for or did not feel qualified to develop policies, and that they were not sure of the legal implications of such policies. An interagency ethics committee can serve as an advisory committee, but all medical and nursing decisions should be made by the appropriate professional, based on agency policy.