Medical Residents' Practices and Perceptions toward Do-Not-Resuscitate (DNR) OrderMuneerah Albugami*, Habib Bassil, Ulrike Laudon, Abeer Ibrahim, Abdelazeim Elamin, Usama ElAlem, Mumin Siddiquee, Muhammad Sohaib Khan and Ahmed Alshehri
Internal Medicine Consultant, Director of Women’s Health Fellowship Program, Department of Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
- *Corresponding Author:
- Muneerah Albugami
Internal Medicine Consultant, Director of Women’s Health Fellowship Program
Department of Medicine, King Faisal Specialist Hospital & Research Centre
P.O. 3354, Riyadh 11211
E-mail: [email protected]
Received date: December 02, 2016; Accepted date: January 23, 2017; Published date: January 27, 2017
Citation: Albugami M, Bassil H, Laudon U, Ibrahim A, Elamin A, et al. (2017) Medical Residentsâ Practices and Perceptions toward Do-Not- Resuscitate (DNR) Order. J Palliat Care Med 7: 295. doi:10.4172/2165-7386.1000295
Copyright: © 2017 Albugami M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
The knowledge and implementation skills of the DNR order amongst physicians in training appear to be quite variable. Few studies had assessed residents' views on this complex topic. Our objective was to describe the medical residents’ practices and perceptions toward DNR order. A 26 question survey was distributed to medical residents during the academic day activity. Only 56 residents completed the questionnaire (75% response rate). 61.40% of the residents understood the definition of DNR order. 85.96% thought physicians shouldn’t order diagnostic tests for DNR patients and 92.98% thought physicians shouldn’t give blood products and antibiotics to DNR patients. 45.61% thought DNR order would lead to poor care. 36.84% thought physician alone should decide about the DNR decision. 45.61% answered that DNR order never discussed with patients. 64.91% answered that consultant discussed DNR order with patients. 42.11% of residents were involved in the discussion of DNR order. 66.67% answered that time to decide about the DNR order on day of admission. 42.11% answered there was variation between consultants regarding the care of DNR patient. 43.86% answered there was variation in the clinical care before and after DNR order was placed. 87.72% thought here was a need for formal training in DNR discussion. 68.42% didn’t know if KFSH and RC had clinical guidelines for DNR patients care.
Conclusion: (1) Majority of the residents had misunderstanding regarding DNR patient care and comfortable care. There is a need for developing a structured residency program curriculum to address resident skills in end-oflife care. (2) Encouraged discussions DNR issues in the outpatient setting could prevent unwanted resuscitation in the acute setting. (3) Efforts are needed to increase patients and their families’ awareness about the meaning of DNR order. (4) There is a need to unify and improve quality of care provided to DNR patients by developing specific strategies within a framework of goals of care.