Resucitation Outcomes in the Netherlands: Flash Mob Research on the Subject of Patient Experiences Regarding Do Not Resuscitate Orders.
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 1,136
- 试验地点
- 12
- 主要终点
- Prevalence of DNR-orders
研究概览
简要总结
The aim of this study is to gain insight in patients' experiences regarding do not resuscitate conversations and decisions. A multicentre flash mob investigation will be conducted in which data will be obtained over the course of two weeks using electronic questionnaires that patients will fill out. General demographic data and a brief quality of life assessment (EQ-5D) will be collected. Whether a DNR converstation has taken place will be noted, along with patients' experiences with this conversation. Lastly the patient will be asked about his/her expectations of survival after cardiopulmonary resuscitation.
详细描述
Rationale: In-hospital cardiac arrest, associated with a survival to discharge of 15.0%, results in a good neurologic discharge in 9.1% - 30.0% of patients. Therefore it is recommended to engage in advanced care planning with patients, to discuss do-not-resuscitate (DNR) directives. In current knowledge, there are no published data about the prevalence of these DNR orders and associated factors in hospitalized patients in the Netherlands. Also, the conversation about DNR are sometimes perceived as awkward or untimely by patients.
Objective: The primary goal is to estimate prevalence DNR order in Dutch hospitals. A secondary goal is to assess what geographical, patient and disease factors are associated with DNR status. Furthermore patient experience in the conversation leading to DNR-orders is of interest.
Study design: A cross-sectional point prevalence study, in 10 participating hospitals of the ROUTiNE project.
Study population: Patients who plan to be admitted for more than 24 hours to the participating hospitals, aged 18 or older, who are responsive and conscious.
Main study parameters/endpoints: The prevalence of DNR orders, expressed as number per 1000 beds.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Cross Sectional
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •All patients admitted to the participating hospitals with a planned admission >24 hours at the moment this study takes place.
排除标准
- •• Refusal to participate
- •<18 years of age
- •Admitted in outpatient clinic and day treatment centres (e.g. haemodialysis)
- •Admitted <24 hours, as defined by not sleeping overnight in hospital
- •No reliable proxy in the following situations:
- •Unable to answer questions (e.g. unconscious, cognitively impaired, delirious)
- •Language barrier (with no interpreter or family member)
- •The following hospital departments are excluded:
- •Intensive care unit
- •Coronary/acute cardiac care unit
- •Obstetrics
- •Paediatrics
- •Stroke unit
- •Dialysis (outpatient dialysis)
- •Day-care wards/short-stay (i.e. <1 day)
- •Palliative care
结局指标
主要结局
Prevalence of DNR-orders
时间窗: 1 day
Percentage of DNR-orders in the total cohort as noted in the electronic patient file
次要结局
- DNR-order discussion experience(1 day)
- DNR-order discrepancy(1 day)
- DNR-order discussion prevalence(1 day)
- Quality of life(1 day)
研究者
Marc Schluep
principal investigator/medical doctor
Erasmus Medical Center