Code status and resuscitation options in the electronic health record

RESUSCITATION

卷:87

Article

Bhatia, Haresh L.¹  Patel, Neal R.^1,2  Choma, Neesha N.³  Grande, Jonathan⁴  Giuse, Dario A.^1,4  Lehmann, Christoph U.^1,2 

[1] Vanderbilt Univ, Sch Med, Dept Biomed Informat, Nashville, TN 37212 USA

[2] Vanderbilt Univ, Sch Med, Dept Pediat, Nashville, TN 37212 USA

[3] Vanderbilt Univ, Sch Med, Dept Med, Nashville, TN 37212 USA

[4] Vanderbilt Univ, Sch Med, Informat Ctr, Nashville, TN 37212 USA

关键词: Advance directives;    Code status;    End of life care;    Electronic health record;    Provider communication;   

DOI  :  10.1016/j.resuscitation.2014.10.022

来源: Elsevier

【 摘 要 】

Aim: The advance discussion and documentation of code-status is important in preventing undesired cardiopulmonary resuscitation and related end of life interventions. Code-status documentation remains infrequent and paper-based, which limits its usefulness. This study evaluates a tool to document code-status in the electronic health records at a large teaching hospital, and analyzes the corresponding data. Methods: Encounter data for patients admitted to the Medical Center were collected over a period of 12 months (01-APR-2012-31-MAR-2013) and the code-status attribute was tracked for individual patients. The code-status data were analyzed separately for adult and pediatric patient populations. We considered 131,399 encounters for 83,248 adult patients and 80,778 encounters for 55,656 pediatric patients in this study. Results: 71% of the adult patients and 30% of the pediatric patients studied had a documented code-status. Age and severity of illness influenced the decision to document code-status. Demographics such as gender, race, ethnicity, and proximity of primary residence were also associated with the documentation of code-status. Conclusion: Absence of a recorded code-status may result in unnecessary interventions. Code-status in paper charts may be difficult to access in cardiopulmonary arrest situations and may result in unnecessary and unwanted interventions and procedures. Documentation of code-status in electronic records creates a readily available reference for care providers. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

【 授权许可】

Free