Do not attempt cardiopulmonary resuscitation documentation: a quality improvement project
Abstract
Objectives: This quality improvement project looked at enhancing do not attempt cardiopulmonary resuscitation (DNACPR) documentation in a Welsh National Health Service trust. Methods: A full clinical review cycle was carried out, evaluating 50 DNACPR forms in each data collection, totalling 100 forms. The all Wales DNACPR audit template was used to ensure standardised audit criteria. After completion of the first data collection, several changes were introduced: a new version national form was adopted by the trust; a series of education events was launched to improve understanding of the all Wales DNACPR policy. Electronic learning resources, such as the TalkCPR videos and electronic staff record modules, were widely disseminated. Results: The evaluation of data demonstrated consistency in completion of forms. The introduction of the new national form in phase 2 of the audit resulted in clearer documentation of discussions held with patients and their significant others and documented reasons why and when conversations had not taken place. Conclusion: Documentation of DNACPR discussions in the trust demonstrably improved in several domains. A central electronic record for advance and future care plans, accessible by all relevant healthcare providers, patients and carers, may be an effective way of improving further on the current paper-based model.
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A quality improvement project looking at improving DNACPR documentation in Wales showed that the introduction of a new national form resulted in clearer documentation of discussions held with patients and those close to the patient and documented reasons why and when conversations had not taken place.
“In addition, a quality improvement project looking at improving DNACPR documentation in Wales showed that the introduction of a new national form resulted in clearer documentation of discussions held with patients and those close to the patient and documented reasons why and when conversations had not taken place.87”
From Do not attempt cardiopulmonary resuscitation decision-making process: scoping review (2025) · cites this paper as [87]
Cites
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DNACPR decisions: challenging and changing practice in the wake of the Tracey judgment
Fritz, Z., Cork, N., Dodd, A., & Malyon, A. (2014) · Clinical Medicine · doi:10.7861/clinmedicine.14-6-571 · Cited by 37 · see citing works
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Self-citationCoronavirus pandemic: compassionate communities and information technology
Abel, J., & Taubert, M. (2020) · BMJ Supportive & Palliative Care · doi:10.1136/bmjspcare-2020-002330 · Cited by 28 · see citing works
Self-citationTaubert, M., Noble, S., & Nelson, A. (2011) · BMJ Supportive & Palliative Care · doi:10.1136/bmjspcare-2011-000015 · Cited by 26 · see citing works
Self-citationAdvance and future care planning: strategic approaches in Wales
Taubert, M., & Bounds, L. (2022) · BMJ Supportive & Palliative Care · doi:10.1136/bmjspcare-2021-003498 · Cited by 15 · see citing works
Self-citation‘Do Not Attempt CPR’ and the concept of harm
Taubert, M., & Baker, J. I. (2020) · Medicine · doi:10.1016/j.mpmed.2020.07.016 · Cited by 5 · see citing works
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Do not attempt cardiopulmonary resuscitation decision-making process: scoping review
Doody, O., Davidson, H., & Lombard, J. (2025) · BMJ Supportive & Palliative Care · doi:10.1136/spcare-2023-004573 · Cited by 10 · see citing works
“87”
- Authors
- Haire, E., Bralesford, C., Botting, J., Beasant, E., & Taubert, M.
- Affiliations
- Velindre Cancer Centre (GB)
- Corresponding author
- Taubert, Mark
- Venue
- BMJ Supportive & Palliative Care
- Publisher
- BMJ
- Published
- 2023-05-31
- Volume
- 14
- Issue
- e1
- Pages
- e1453-e1457
- ISSN
- 2045-435X (ISSN-L)
- 2045-4368
- OpenAlex
- W4378806098
- Cited by
- 1
- References
- 9
- Citations by year
- 2024: 1
- FWCI
- 0.26
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- BMJ Supportive & Palliative Care (publishedVersion)
- PubMed (publishedVersion)
- ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Emergency Medicine › Cardiac Arrest and Resuscitation
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Keywords
- DNACPR, advance care planning, electronic health records, employee training, quality improvement, end-of-life discussions, clinical audit
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