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Living wills have an impact on pre-hospital lifesaving care
February 24, 2009A new study conducted at the Hamot Medical Center in Erie, Pennsylvania, and published by Elsevier in the February 2009 issue of The Journal of Emergency Medicine (http://www.elsevier.com/locate/jemermed) shows that there is a lack of education and understanding in what sets a living will in motion in a pre-hospital setting. Education and implementation of code status designations can clarify this confusion.
The use of living wills and their impact on patient care had not been adequately studied. Living wills have the potential to impact patient care for patients who call 911 in a medical emergency. The study aimed to determine how a living will is interpreted and assess how interpretation impacted lifesaving care.
Researchers Mirarchi, et.al., found that significant confusion and concern for patient safety exists in the pre-hospital setting due to the understanding and implementation of living wills and DNR (do not resuscitate) orders. When a living will is present with the patient experiencing a critical illness, it has the potential to limit or delay lifesaving care. This confusion can be mitigated by implementing clearly defined code status into the living will.
"The results of the study are important because they provide clarification as to when a living will is enacted and promotes patient care and safety. It ensures the provision of lifesaving care for those who call 911 for a medical emergency," according to lead researcher Ferdinando L. Mirarchi, DO, FAAEM, FACEP.
The results of this study suggest that the current structure of the living will leads the majority of pre-hospital health care providers to incorrectly assume a patient is a DNR. Living wills should not be considered synonymous with DNR orders.
DNR is misunderstood to define comfort care/end-of-life care, a confusion that can compromise lifesaving care. This confusion and concern for patient safety can be rectified by incorporating a clearly defined code status designation within the living will. Educational efforts and provider protocols must be reevaluated and implemented to ensure patient safety.
Elsevier
"The results of the study are important because they provide clarification as to when a living will is enacted and promotes patient care and safety. It ensures the provision of lifesaving care for those who call 911 for a medical emergency," according to lead researcher Ferdinando L. Mirarchi, DO, FAAEM, FACEP.
The results of this study suggest that the current structure of the living will leads the majority of pre-hospital health care providers to incorrectly assume a patient is a DNR. Living wills should not be considered synonymous with DNR orders.
DNR is misunderstood to define comfort care/end-of-life care, a confusion that can compromise lifesaving care. This confusion and concern for patient safety can be rectified by incorporating a clearly defined code status designation within the living will. Educational efforts and provider protocols must be reevaluated and implemented to ensure patient safety.
Elsevier
UNC project helps students with mental illnesses, support services prepare for 'what if' scenarios
Nationally, an estimated 15 percent of students experience some form of mental illness such as major depression while in college. Many often struggle with where to get support.
Survey compares views of trauma professionals, the public on dying from injuries
Most trauma professionals and members of the general public say they would prefer palliative care following a severe injury if physicians determined aggressive critical care would not save their lives, according to a report in the August issue of Archives of Surgery, one of the JAMA/Archives journals.
Long-term care fraught with uncertainties for elderly baby boomers
The continued decline of the nursing home - once the mainstay care for the frail elderly - and an upsurge in popularity of assisted living will lead to many dramatic changes in long-term care, according to a University of Florida expert and editor of a new book on the subject.
Study shows false memories complicate end-of-life treatment decisions
Advance directives, or living wills, may not effectively honor end-of-life wishes because life-sustaining treatment preferences often change over time without people being aware of the changes, according to a new study co-authored by UC Irvine researchers Peter Ditto and Elizabeth Loftus.
Demographic trends and family support for older people - no need to panic yet
A new study carried out by the London School of Economics and the London School of Hygiene & Tropical Medicine has revealed that the future crisis in family support for older people so feared by policy pundits and commentators will not make any real impact until 2030, when today's late 20- and 30-somethings hit retirement age. Concerns have been mounting that in years to come there will be fewer people around to provide informal care for elderly people, because of the drop in fertility rates and the tendency for women to delay the age at which they have children. There have been particular fears that those in the 80 plus age group, whose needs are greatest, will be the hardest hit. Mothers w
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