Do-Not-Resuscitate Orders in the Neonatal ICU: Experiences and Beliefs Among Staff

Objectives: Studies in adult patients have shown that do-not-resuscitate orders are often associated with decreased medical intervention. In neonatology, this phenomenon has not been investigated, and how do-not-resuscitate orders potentially affect clinical care is unknown. Design: Retrospective medical record data review and staff survey responses about neonatal ICU do-not-resuscitate orders. Setting: Four academic neonatal ICUs. Subjects: Clinical staff members working in each neonatal ICU. Interventions: Survey response collection and analysis. Measurements and Main Results: Participating neonatal ICUs had 14–48 beds and 120–870 admissions/yr. Frequency range of do-not-resuscitate orders was 3–11 per year. Two-hundred fifty-seven surveys were completed (46% response). Fifty-nine percent of respondents were nurses; 20% were physicians. Over the 5-year period, 44% and 17% had discussed a do-not-resuscitate order one to five times and greater than or equal to 6 times, respectively. Fifty-seven percent and 22% had cared for one to five and greater than or equal to 6 patients with do-not-resuscitate orders, respectively. Neonatologists, trainees, and nurse practitioners were more likely to report receiving training in discussing do-not-resuscitate orders or caring for such patients compared with registered nurses and respiratory therapists (p

from Emergency Medicine via xlomafota13 on Inoreader https://ift.tt/2J88oIz