A Randomized Controlled Trial of a CPR and Intubation Video Decision Support Tool for Hospitalized Patients

Area of Science:

• Medical Ethics
• Patient Decision-Making
• Advance Care Planning

Background:

• Discussions regarding cardiopulmonary resuscitation (CPR) and intubation are crucial for advance care planning in seriously ill patients but are often avoided.
• Effectively communicating complex medical information to patients is essential for informed decision-making.

Purpose of the Study:

• To evaluate the impact of a video decision tool on patients' preferences for CPR and intubation.
• To assess the tool's effect on patients' knowledge, medical orders, and communication with healthcare providers.

Main Methods:

• A prospective randomized trial involving 150 seriously ill hospitalized patients over 60 with advanced illness.
• Intervention group (N=75) received a 3-minute video on CPR and intubation plus verbal communication of preferences.
• Control group (N=75) received usual care.

Main Results:

• Intervention group showed significantly higher rates of not wanting CPR (64% vs. 32%) and intubation (72% vs. 43%).
• More patients in the intervention group had orders to withhold CPR (57% vs. 19%) and intubation (64% vs. 19%).
• Intervention group had more documented discussions (81% vs. 43%) and higher knowledge scores (4.11 vs. 2.45).

Conclusions:

• A video decision tool effectively informed seriously ill patients about CPR and intubation.
• The tool increased patient preference against these interventions and facilitated shared decision-making.
• This approach improved patient knowledge and resulted in more aligned medical orders.