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79 Improving DNAR discussions: a qualitative quality improvement project
  1. Ruth C Porther and
  2. Charles A Haywood Smith
  1. Aneurin Bevan Health Board


Background Patients often do not recall all the key points in discussion with healthcare professionals, perhaps even more so when discussing topics like a Do Not Resuscitate (DNAR) decision. If communication in these potentially emotional situations can be enhanced using patient leaflets compared to discussion alone, perhaps it would be worth considering using them more often in future. The aim of this project was to ascertain whether at least 50% of participants felt that using the All Wales patient leaflets improved their understanding of CPR and DNAR decisions.

Method 10 patients and loved ones who were present for the initial DNAR discussion were surveyed. A questionnaire elicited whether they felt their understanding of CPR and DNAR decisions was good before reading the leaflet and if it improved after. This involved 8 participants on the Medical Assessment Unit at the Royal Gwent Hospital and 2 on a Care of the Elderly ward at Nevill Hall Hospital who had documented DNAR discussions.

Results 50% felt the leaflet improved their understanding and that it would have benefited them at the time of discussion. 70% felt it was a useful reference and 40% asked to keep the leaflet after the encounter. Anecdotally, cases where participants particularly found it useful were those where death was not imminent, large numbers of family members were involved and had different views and in complex advance care planning

Conclusion The data gathered from this small, qualitative project suggest there may be a role for patient information leaflets on DNAR decisions when used in the right context.

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