Divergence in DNACPR and resuscitation policies- Institutional survey in England

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Fitton, Emily, Chumbley, Karen, Barry, Caroline, Bartova, Aneta, Troke, Ben and Martin, Wayne (2025) Divergence in DNACPR and resuscitation policies- Institutional survey in England. BMJ Supportive and Palliative Care. ISSN 2045-435X

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Abstract

Objectives: Our objective was to analyse the policies of hospitals and care homes in England as regards the use of do not attempt cardiopulmonary resuscitation (DNACPR) recommendations. We sought to identify (i) variations among policies at different institutions, and (ii) divergence of local policies from national guidance, particularly with reference to decisions either (a) to initiate cardiopulmonary resuscitation (CPR) despite the presence of a DNACPR recommendation, or (b) not to initiate CPR in the absence of a DNACPR recommendation. Methods: We conducted a survey of 14 DNACPR and/or resuscitation policies, drawn from care homes, NHS trusts and hospices. Results: Many of the policies we surveyed diverge significantly from national guidance. Some require that CPR be administered in all cases where no DNACPR recommendation has been made. Others fail to specify that CPR may be appropriate even in the presence of a DNACPR recommendation. Conclusions: Local DNACPR policies currently place both patients and healthcare professionals at significant risk.

Item Type:	Article
Additional Information:	This work was funded by Arts and Humanities Research Council (AH/V012770/1 Ensuring Respect for Human Rights in Locked-Down Care Homes).
Uncontrolled Keywords:	advance care planning,end of life care,medicine (miscellaneous),oncology(nursing),medical–surgical ,/dk/atira/pure/subjectarea/asjc/2700/2701
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Centres > Public Health
Related URLs:	http://www.scopus.com/inward/record.url?...
Depositing User:	LivePure Connector
Date Deposited:	20 Aug 2025 16:30
Last Modified:	24 Aug 2025 06:30
URI:	https://ueaeprints.uea.ac.uk/id/eprint/100186
DOI:	10.1136/spcare-2024-005263

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