CPR-Directive Conversations in the Emergency Department: The Opinion of Elderly Patients

Authors

Kelvin H. Kramp Dr., Elisabeth-Tweesteden ZiekenhuisFollow
Rutger de Hond, Elisabeth-Tweesteden Ziekenhuis, TilburgFollow
Mirwais Mehrab, Erasmus Medical Center, RotterdamFollow
Martijn Van Hooft, Elisabeth-Tweesteden Ziekenhuis, TilburgFollow
Roger A.P.A. Hessels, Elisabeth-Tweesteden Ziekenhuis, TilburgFollow

Abstract

Background: The average age of patients admitted to the emergency department (ED) continues to rise. Many face difficult discussions about cardiopulmonary resuscitation (CPR) and end-of-life decisions.

Objectives: This study aimed to determine which healthcare professionals elderly patients admitted via the ED preferred to discuss their CPR-directive with and their opinion about the ED as a setting for discussing their CPR-directive.

Methods: A mixed-methods study with an explanatory sequential design was conducted. A questionnaire was administered to 100 patients >65 years of age admitted to nursing wards via the ED that had a CPR-directive conversation during admission 24-48 hours earlier. Patients who indicated that they preferred to discuss their CPR-directive conversation with a physician working in the ED were invited for follow-up semi-structured interviews.

Results: General practitioners (GP) were the most preferred healthcare professionals for a conversation about CPR-directives (64%). However, physicians working in the ED were the second most preferred medical professionals (51%) together with medical specialists (51%). Only 6% of patients did not consider a physician in the ED as a suitable option for these conversations. Interviewed patients saw a physician consultation in the ED as an opportunity to: 1) check and update their CPR-directive, 2) get information about the content and consequences of CPR considering their current health status, and 3) prevent the use of undesired medical treatment during admission.

Conclusions: Although GPs were the most preferred healthcare professionals with whom to discuss CPR preferences, an unexpectedly large proportion of the investigated population preferred to discuss their choices with a physician working in the ED. These patients considered these discussions to be a crucial part of patient-centered healthcare.

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Recommended Citation

Kramp, Kelvin H. Dr.; de Hond, Rutger; Mehrab, Mirwais; Van Hooft, Martijn; and Hessels, Roger A.P.A. (2022) "CPR-Directive Conversations in the Emergency Department: The Opinion of Elderly Patients," Journal of Geriatric Emergency Medicine: Vol. 3: Iss. 2, Article 1.
DOI: https://doi.org/10.17294/2694-4715.1028
Available at: https://institutionalrepository.aah.org/jgem/vol3/iss2/1