Expert review of cardiopulmonary resuscitation (CPR) in hospital

Abstract

The recent NCEPOD report (2012a) on patients undergoing CPR following cardiorespiratory arrest in hospital raises a number of important care quality and patient safety issues related to CPR. Some examples include the taking of an adequate patient medical history during the initial admission process, healthcarer recognition of patients’ deteriorating condition, adequacy of patient monitoring and proper documentation. Fundamentally important legal and ethical issues are also raised, such as patients’ informed consent to CPR, the need to agree the ‘ceilings of treatment’ with the patient, the poor patient survival rate after CPR in hospital, and the need to avoid futile CPR attempts during the patient’s dying process. Do nurses and doctors think that they have a duty to do everything that they can to prolong the process of dying? There is a need for nurses, doctors and managers to accept that death does not always represent a failure of health care, and that enabling people to die as well as possible is one of the core functions of the NHS.