@article{7aa85612855440929f39b47a4b2762ad,
title = "Certified Registered Nurse Anesthetists' Management of the Perioperative Do-Not-Resuscitate Order: Evaluating Trends in Required Reconsideration",
abstract = "Required reconsideration or review of do-not-resuscitate (DNR) orders perioperatively is recommended by the American Association of Nurse Anesthesiology and other organizations instead of automatic suspension of the DNR. A survey on perioperative DNR orders developed for a 2000 study by Coopmans and Gries was amended, reviewed by an expert panel, reformatted for web-based layout, and emailed to a random sample of 3,000 practicing Certified Registered Nurse Anesthetists (CRNAs) in the United States. From 207 returned responses, most CRNAs (63.5%) initially reported unfamiliarity with required reconsideration. After receiving a definition of the term, more CRNAs reported familiarity and past education on the concept. Chi-square analyses showed that familiarity with required reconsideration was associated with potential refusal to care for patients with active DNR orders (P=.004). CRNAs reported education or training on required reconsideration as uncommon and often informal. The survey found significant changes in reported perioperative DNR orders at practice institutions between the original survey by Coopmans and Gries and the present study. CRNAs' responses from the present survey indicate significant increases in policies of required review with patient involvement and policies of informed routine suspension (P<.001). Findings also revealed a significant decrease in reported policies of uninformed routine suspension (P<.001).",
keywords = "Anesthesiology, do-not-resuscitate, perioperative advance directives, required reconsideration, required review",
author = "Xuanni Gu and Ladan Eshkevari and Tia Powell and Titus, {Alexander J.} and Crystal O'Guin",
note = "Funding Information: Name: Xuanni Gu, DNAP, CRNA Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: This author received a grant from the AANA Foundation{\textquoteright}s Dean and Fred Hayden Student Research Scholarship while studying at Georgetown University, and the grant monies were used to purchase mailing lists. Name: Ladan Eshkevari, PhD, CRNA, LAc, FAAN Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: None. Name: Tia Powell, MD Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: None. Name: Alexander J. Titus, PhD Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: None. Name: Crystal O{\textquoteright}Guin, DNP, CRNA Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: None. The authors did not discuss off-label use within the article. Disclosure statements are available for viewing upon request. Publisher Copyright: {\textcopyright} 2021 AANA Publishing Inc.. All rights reserved.",
year = "2021",
month = dec,
language = "English (US)",
volume = "89",
pages = "491--499",
journal = "AANA Journal",
issn = "0094-6354",
publisher = "AANA Publishing Inc.",
number = "6",
}