The Patients Association has today called for an urgent review of the way Do Not Attempt CPR (DNACPR) orders are managed following the release of research by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD).
The report highlights inconsistencies and confusion surrounding the issuing of DNACPR orders, and the use of CPR on patients, including:
· 53% of hospitals had leaflets on DNACPR and 22% had leaflets on resuscitation, but as many as 25% of hospitals had no information at all.
· In 90% of cases no decision was recorded in the patient’s notes in relation to CPR status.
· 7 patients (1.2%) of patients were given CPR even though they had been placed on an end of life pathway which meant clinicians believed that they would not recover from their illness and should be made comfortable in their last days.
· In 31.9% of patients whose care was judged to be less than good the care given was adjudged to have contributed to the death of the patient.
· In 7/10 cases the care given was adjudged by an expert panel to be less than good.
· 52 patients that had a DNACPR order were given CPR when they suffered a cardiac arrest.
In November last year the Patients Association published a report into poor care in hospital wards, and some of those cases highlighted concerns around the communication between patients and Clinicians in relation to DNACPR orders. The issue of communication is also raised in the NCEPOD report.
Speaking about the report Katherine Murphy, Chief Executive of the Patients Association said “This report indicates that there is a huge degree of confusion about the way DNACPR orders are being handled within the NHS. Patients and relatives deserve to have all of their options communicated to them in full, and then to take the decision that they feel is best for them. Once that decision has been taken they should be able to trust clinicians to implement it. Where appropriate it is also really important that relatives and carers are involved in the decision making process.
Instead this report shows that there isn’t enough communication about patient’s options, with up to 25% of hospitals having no information on it. It shows patients that have been judged to have no chance of survival, and placed on end of life pathways, by clinicians being given CPR anyway. Even more worryingly, there are 52 shocking cases where patients are given CPR a DNACPR order being placed in their records. The Patient Association supports NCEPOD’s call for consistent decision making and better communication. Patients need to feel they can trust the DNACPR system, and this report shakes that trust considerably.”
- The Patients Association is a campaigning charity, listening to patients and speaking up for change. It has been working for nearly 50 years to make sure that the patient voice is heard and listened to by policy makers.
- For further information please contact the Patients Association on 02084239111
- To see our report into elderly care visit http://www.patients-association.com/Default.aspx?tabid=210