Intraoperative code status: Moving from misinformation to respect for patient autonomy
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View abstract on PubMed
Summary
This summary is machine-generated.A simulation curriculum improved surgical residents' understanding and confidence in discussing intraoperative do not resuscitate (DNR) status. This training reduced misconceptions about DNR orders needing rescission before surgery, respecting patient autonomy.
Area Of Science
- Medical Education
- Surgical Training
- Patient Autonomy
Background
- Intraoperative code status, specifically do not resuscitate (DNR) status, presents challenges for patients and providers.
- Existing research indicates a deficit in understanding intraoperative DNR policies among healthcare professionals.
- Limited studies have utilized simulation-based education to train surgical residents in managing patient requests regarding intraoperative DNR status.
Purpose Of The Study
- To implement a simulation-based curriculum for surgical residents.
- To enhance residents' ability to navigate discussions about intraoperative DNR status.
- To uphold patient autonomy while addressing intraoperative DNR concerns.
Main Methods
- A needs assessment survey was administered to anesthesiology and surgery residents regarding intraoperative code status practices and policies.
- A simulation-based curriculum was developed, involving surgery residents interacting with standardized patients requesting intraoperative DNR status.
- Post-training surveys were used to evaluate the curriculum's effectiveness.
Main Results
- Needs assessment revealed significant misconceptions: 56.5% of surgery residents believed DNR must be rescinded for elective surgery, and 52.1% for emergent surgery.
- Post-training surveys showed a statistically significant increase in residents' confidence in discussing intraoperative DNR status (P < .001).
- A statistically significant reduction in the misconception that DNR orders must be rescinded before surgery was observed (P < .01).
Conclusions
- A simulation-based curriculum effectively addressed the need for clear communication regarding intraoperative DNR policy.
- The curriculum enhanced residents' confidence and understanding of intraoperative DNR status and related ethics.
- Future research will evaluate the curriculum's impact on clinical practice and patient outcomes through follow-up surveys.
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