Researchers found only 26 percent of cardiology programs have formal policies governing physicians' regard for patients' do-not-resuscitate wishes, a study published Aug. 10 in the Journal of the American Geriatrics Society found.
The study interviewed transcatheter aortic valve replacement coordinators at 52 programs across Washington and California. Seventy-eight percent of programs suspended DNR status until after the procedure, but reinstatement differed: 38 percent reinstated within 48 hours while 44 percent reinstated at the time of patients' discharge. Eighteen percent did not reinstate until 30 days or more post-procedure, and only six programs maintained DNR desires while performing TAVR.
The researchers concluded that the findings indicate hospitals and cardiology programs need to implement a standard practice that is clearly communicated to physicians, patients and their families.
"One great strength of cardiology is that the field relies strongly on research, including randomized controlled trials and outcomes studies, to determine the best ways to treat disease. So it was very surprising to see such variability in clinical decision-making among the programs we studied," Gwen Bernacki, MD, lead author and an assistant professor of cardiology at the University of Washington School of Medicine said in an Aug. 15 news release from the school.