Improving decision-making and documentation relating to do not attempt resuscitation orders

Introduction: Do not attempt resuscitation (DNAR) decision-making and recording in case notes can be poor. We have audited current practices pertaining to DNAR orders in a district hospital before and after the introduction of a standardised order form (SOF). Methodology: DNAR decisions in medical case notes were audited before and after the introduction of a SOF. All aspects of the decision were scrutinised against recommended guidelines (BMA/RCN/RC (UK) London: BMA, 1999). Results: Case notes of 156 patients were examined. A total of 62 (39.7%) had combined case note and SOF documentation (Gp1), while 94 (60.3%) had case note documentation only (Gp2). Some 61/62 (98.4%) of DNAR indications in Gp1 were in accordance with guidelines versus 81/94 (86.2%) in GP2 ( P