Abstract
Background: This improvement activity was done within the Geriatrics/ Stroke department and aims to meet the following adopted standards: all DNACPR forms must be signed by a senior clinician and have clear documentation of the review status, if not “indefinite.’
Local problem: Incomplete DNACPR forms with lack of senior clinicians’ signature and unclear review status, which would affect clinical effectiveness of the document.
Methods: To gather baseline and post-intervention measurements, snapshot data was collected eighteen days apart to identify patients with a DNACPR in place that includes a senior clinician’s signature, and the appropriate review status based on the senior clinician’s plan.
Interventions: To implement changes, email communications were disseminated to Geriatrics/ Stroke team, and posters displayed in prominent locations around the respective hospital wards.
Results: A total of fifty patients were admitted to the Geriatrics and Stroke wards, of which thirty-four had a DNACPR form in place. Among these, 88.2% had a senior signed DNACPR form, while only 14.7% had the review status documented. Our goal was to achieve 90% of patients having a senior signature on their DNACPR forms and 45% having the appropriate review status at the end of the second cycle.
Conclusion: At the end of the second cycle, we successfully achieved our goal of ensuring that the majority of DNACPR forms had senior signatures and appropriate review status, demonstrating an effective improvement in compliance with the established standards for DNACPR documentation.