A survey study of healthcare workers on do not Attempt cardiopulmonary resuscitation practice and policy in Ireland

Aim

Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) codes record the decision to withhold CPR in cases of circulatory arrest. These decisions involve various clinical, ethical and legal complexities promoting increased focus on the decision-making process. This research sought to capture healthcare workers perspective on DNACPR practices and policies in Ireland.

Methods

A cross-sectional descriptive survey utilising a questionnaire developed and piloted for this study to gather responses on open and closed questions. Data were analysed using SPSS and content analysis. Study is reported in line with the Consensus-Based Checklist for Reporting of Survey Studies reporting guidelines.

Results

784 participants including doctors, nurses, paramedics and other healthcare workers completed the questionnaire. 80.5 % (n = 625) of participants rated their knowledge of DNACPR decision-making as fair or better. 77.5 % (n = 601) of participants understood DNACPR to mean ‘no chest compressions, defibrillation or artificial ventilation in the event of cardiopulmonary arrest’. A majority of participants (60.2 % n = 467) had experienced a degree of conflict related to a DNACPR decision. 245 (31.25%) participants provided comments which addressed issues such as communication, education, pressure surrounding DNACPR decisions, the role of national guidelines/documentation, and legal concerns.

Conclusion

The findings reveal gaps in healthcare workers' understanding and familiarity with DNACPR policies, highlighting the need for improved patient involvement and proactive discussions. Effective communication and comprehensive training are crucial, as communication remains a significant barrier. While national policies can provide clarity, increasing awareness and understanding of these policies among healthcare workers is essential.