Impact of a treatment escalation/limitation plan on non-beneficial interventions and harms in patients during their last admission before in-hospital death, using the Structured Judgment Review Method.

ABSTRACT:

Objectives

To assess the effect of using a treatment escalation/limitation plan (TELP) on the frequency of harms in 300 patients who died following admission to hospital.

Design

A retrospective case note review of 300 unselected, consecutive deaths comprising: (1) patients with a TELP in addition to a do-not-attempt cardiopulmonary resuscitation order (DNACPR); (2) those with DNACPR only; and (3) those with neither. Patient deaths were classified retrospectively as 'expected' or 'unexpected' using the Gold Standard Framework Prognostic Indicator Guidance.

Setting

Medical, surgical and intensive care units of a district general hospital.

Outcomes

The primary outcome was the between-group difference in rates of harms, non-beneficial interventions (NBIs) and clini

SUBMITTER: Lightbody CJ 

PROVIDER: S-EPMC6252685 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature