Doctors' attitudes towards the introduction and clinical operation of do not resuscitate orders (DNRs) in Ireland.

Abstract

Do not resuscitate orders (DNRs) are documents which state that should a patient suffer from cardiopulmonary failure, resuscitation should not be attempted. Internationally, DNRs are often misunderstood and used inappropriately in a clinical setting. The aim of this paper was to determine the current understanding of DNRs and their clinical operation among hospital doctors in Ireland. A cross-sectional, questionnaire-based study was conducted involving doctors from the Cork teaching hospitals. The questionnaire sought information regarding understanding of DNRs and their clinical operation, as well as attitudes regarding the current absence of relevant Irish guidelines. The questionnaire also collected information regarding demographics, clinical specialty, and level of experience. 45.9% (47/103) of all doctors stated that their clinical knowledge was sufficient to draft a DNR, but 48.7% of this group (n=23) chose the incorrect definition for a DNR when provided with three separate options. Thirty-five percent (n=36) of all doctors surveyed demonstrated an incorrect understanding of a DNR. Neither specialty nor experience level had any effect on level of understanding of DNRs (p>0.05). 93.2% (n=96) agreed that there is a need for introduction of domestic guidelines regarding DNRs. 57.6% (n=59) would draft more DNRs in the event that such domestic guidelines were in place. A substantial proportion of hospital doctors surveyed demonstrated an incomplete understanding of DNRs and their clinical operation. However, the overwhelming majority of the present sample believe that domestic guidelines are needed on the matter.