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Setup and Execution of the Rapid Cycle Deliberate Practice Death Notification Curriculum
Published on: August 5, 2020
Knowledge and implementation of the DNR in internal medicine teaching programs
José Ramírez-Rivera1, Carlos Cánova-Díaz, Robert Hunter-Mellado
1Department of Medicine Ramón Ruiz Arnau Hospital and Universidad Central del Caribe PO Box 60327 Bayamón, PR. ramirez.r629@gmail.com
Puerto Rico Health Sciences Journal
|May 26, 2010
Summary
Physician knowledge and skills regarding do not resuscitate (DNR) orders vary significantly across Puerto Rico. Improving DNR implementation and understanding in medical residency programs is crucial for patient care.
Area of Science:
- Medical Education
- Clinical Ethics
- Healthcare Policy
Background:
- Knowledge and skills concerning do not resuscitate (DNR) orders are inconsistent among physicians in training.
- Variability in DNR understanding can impact end-of-life care decisions and patient autonomy.
Purpose of the Study:
- To evaluate the knowledge and implementation skills of medical residents regarding DNR orders.
- To identify regional differences in DNR understanding and practice within Puerto Rico's teaching hospitals.
Main Methods:
- A validated instrument was developed to assess resident knowledge and skills related to DNR orders.
- The assessment was implemented across 8 accredited teaching hospitals in Puerto Rico, with 136 residents participating.
Main Results:
- Most residents (93.3%) agreed DNR orders should be in medical records and (88.1%) that suggesting DNR to terminally ill patients is appropriate.
- Discrepancies were observed in determining responsibility for DNR orders and in decisions to initiate CPR in critical patients, with regional variations noted.
Conclusions:
- Significant differences exist in the knowledge and implementation skills of medical residents across Puerto Rico's health regions regarding DNR orders.
- Enhancing DNR knowledge and implementation is necessary across all medical residency training programs.
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