A Retrospective Analysis of Characteristics Favouring In-Hospital Resuscitation Plan Completion, Their Timing, and...

Area of Science:

• Medical research
• Healthcare quality improvement
• Patient safety

Background:

• Comprehensive resuscitation plans support patient autonomy and guide treatment.
• Characteristics and outcomes associated with resuscitation plans are not well understood.

Purpose of the Study:

• To identify factors associated with resuscitation plan completion and timing.
• To examine differences in mortality and ICU admissions based on resuscitation plan status.

Main Methods:

• Retrospective analysis of non-elective admissions at an Australian tertiary center (Jan-June 2021).
• Examined resuscitation plan completion timing (early <48h, late >48h).
• Assessed associations with mortality and Intensive Care Unit (ICU) admission.

Main Results:

• 42% of 13,718 admissions had a resuscitation plan; 89% were completed early.
• Patients without plans had significantly lower mortality (0.5%) but higher ICU admission rates (9.7%).
• Late plan completion (>48h) correlated with higher mortality (14%) and ICU admissions (25%).
• Factors for completion included medical unit, in-hours admission, older age, female gender, limited English, non-Indigenous status.
• Indigenous patients were often overlooked for documentation; 62% of ICU admissions lacked plans.

Conclusions:

• Significant disparities exist in resuscitation plan completion across patient groups.
• Early documentation is vital for patient autonomy and potentially better outcomes.
• Targeted interventions are needed to improve equitable documentation.