Improving ceiling of care decisions and documentation for oncology patients. Issue 2 (17th October 2020)

• Record Type: Journal Article
• Authors: Khan, Ameer Hamid A.; Al Omran, Yasser; James, Harry; Bhattacharya, Madhumita
• Is Part Of: International journal of surgery short reports. Volume 5:Issue 2(2020)
• Page Start: e19
• Page End: e19
• Publication Date: 2020-10-17
• Subjects: Resuscitation -- Ceiling of care -- DNACPR -- Decisions -- Documentation -- NCEPOD -- Oncology; 617
• DOI: 10.1097/SR9.0000000000000019
• Languages: English
• ISSNs: 2468-7340

Abstract

Abstract : Hospitalized medically unwell patients can be at risk of in-hospital cardiac arrest and previous studies have demonstrated poor survival after in-hospital cardiac arrests, even despite cardiopulmonary resuscitation (CPR). The rate of success is even lower in patients with metastatic malignancy. Since CPR remains the standard treatment for in-hospital cardiac arrest patients, a "do not attempt cardiopulmonary resuscitation" order (DNACPR) needs to be in place to avoid inappropriate resuscitations in patients with poor chances of in-hospital cardiac arrest survival. More recently, ceiling of care documents such as a Medical Advance Plan have also been developed to provide clinicians a framework for individualised treatment escalation. In this study, we examined the uptake of both national National Confidential Enquiry into Patient Outcome and Death (NCEPOD) and local guidelines to ensure that all acutely admitted oncology patients at a single centre had a CPR status and a Medical Advance Plan.