Call for uniform patients’ revival plan

Variation between “not for resuscitation” orders across Melbourne hospitals could lead to patients being resuscitated against their wishes, researchers say.

The orders are used to communicate a patient’s wish that they should not be resuscitated if they suffer a cardiac arrest in hospital.

A study of three public and two private hospitals found wide variation in the orders and how staff were alerted an order was in place.

The study led by Cabrini Hosp­ital physician Michele Levinson found each hospital had its own unique “not for resuscitation” form which contained different information including how the decision was made and who had authorised it.

One hospital’s order stated CPE included chest compressions, in­tubation, ventilation and emer­gency cardiac drugs, while other hospitals allowed patients to record their views on some treat­ments separately.

Alerts to an order also varied, with one hospital using coloured dots on a paper-based medical his­tory and others including alerts on electronic medical records.

Associate Professor Levinson said the differences could make it difficult for staff who worked across various hospitals to find orders in a timely way.

The study’s authors said “not for resuscitation” documents should be standardised and should be filed in the same place and have a uni­form alert system.

The study is published in the Internal Medicine Journal.