Documentation of Code Status for Elderly Patients Admitted to a Hospital

Abstract

Introduction: Determining resuscitation preferences (code status) for hospitalized older adults has been identified as an indicator of quality of care by the Assessing Care of Vulnerable Elders (ACOVE) Project. Objectives: The primary objective of this study is to determine the rate of Advance Care Directives (code status) documentation among older patients hospitalized on the medical and cardiology units of the Hamilton General Hospital between July 1st 2009 to the end of June 2010. The secondary objective is to determine factors associated with the documentation rate of Code Status in the study group. Methods: This was a retrospective cross-sectional study (chart review) conducted at the Inpatient Medical and Cardiology Units of Hamilton General Hospital, among all patients aged of 65 years or older admitted between July 1st 2009 and June 30 2010, and with complete charts. Data of 100 patients randomly chosen through computer program were collected and analyzed. Results: This study shows that 39% of the sample only had there code status documented, the strongest indicator of being documented were heart failure, dementia, admit time (during regular hours) and admit location (ICU/CCU). Conclusion: Documentation of code status was low although is known to be one of the quality indicators in care of the elderly. It needs to be discussed and addressed more with residents and clinical clerks, study shows that some factors may increase or decrease the documentations.