2023 article
In-Hospital Code Status Updates: Trends Over Time and the Impact of COVID-19
Sahebi-Fakhrabad, A., Kemahlioglu-Ziya, E., Handfield, R., Wood, S., Patel, M. D., Page, C. P., & Chang, L. (2023, December 18). AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE.
author keywords: DNR; patient code status; COVID-19; resource allocation; end of life; ICU; emergency department
TL;DR:
The COVID-19 pandemic's influence on shifting patient preferences towards full code status underscores the need for adaptable documentation practices and highlights the importance of regular updates and discussions regarding code status to enhance patient care and resource allocation in ICU and ED settings.
(via Semantic Scholar)
UN Sustainable Development Goal Categories
3. Good Health and Well-being
(Web of Science)
Source: Web Of Science
Added: January 16, 2024
Objective The primary objective was to evaluate if the percentage of patients with missing or inaccurate code status documentation at a Trauma Level 1 hospital could be reduced through daily updates. The secondary objective was to examine if patient preferences for DNR changed during the COVID-19 pandemic. Methods This retrospective study, spanning March 2019 to December 2022, compared the code status in ICU and ED patients drawn from two data sets. The first was based on historical electronic medical records (EHR), and the second involved daily updates of code status following patient admission. Results Implementing daily updates upon admission was more effective in ICUs than in the ED in reducing missing code status documentation. Around 20% of patients without a specific code status chose DNR under the new system. During COVID-19, a decrease in ICU patients choosing DNR and an increase in full code (FC) choices were observed. Conclusion This study highlights the importance of regular updates and discussions regarding code status to enhance patient care and resource allocation in ICU and ED settings. The COVID-19 pandemic’s influence on shifting patient preferences towards full code status underscores the need for adaptable documentation practices. Emphasizing patient education about DNR implications and benefits is key to supporting informed decisions that reflect individual health contexts and values. This approach will help balance the considerations for DNR and full code choices, especially during health care crises.