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image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Journal of Hospital ...arrow_drop_down
image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao
Journal of Hospital Medicine
Article . 2015 . Peer-reviewed
License: Wiley Online Library User Agreement
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Frequency and clinical relevance of inconsistent code status documentation

Authors: Adina S, Weinerman; Irfan A, Dhalla; Alex, Kiss; Edward E, Etchells; Robert C, Wu; Brian M, Wong;

Frequency and clinical relevance of inconsistent code status documentation

Abstract

BACKGROUNDAccurate and complete documentation of hospitalized patients' code status is important to ensure that healthcare providers take appropriate action in the event of a cardiac arrest.OBJECTIVEDetermine the frequency and clinical relevance of incomplete and inconsistent code status documentation.DESIGNPoint‐prevalence study.SETTINGAcademic medical centers.PATIENTSPatients admitted to general internal medicine wards.MEASUREMENTSFrequency and clinical relevance of inconsistent code status documentation across 5 documentation sources.RESULTSThirty‐eight (20%; 95% confidence interval [CI], 14%‐26%) of 187 patients had complete and consistent code status documentation. Another 27 (14%; 95% CI, 9%‐19%) patients had no code status documentation. The remaining 122 (65%; 95% CI, 58%‐72%) patients had at least 1 code status documentation inconsistency. Of these, 38 (20%; 95% CI, 14%‐26%) patients had a clinically relevant code status documentation inconsistency. Multivariate logistic regression analysis demonstrated that increased age (odds ratio [OR] = 1.07 [95% CI, 1.05‐1.10] for every 1‐year increase in age, P < 0.001) and patients receiving comfort measures (OR = 9.39 [95% CI, 1.35–65.19], P = 0.02) were independently associated with a clinically relevant code status documentation inconsistency.CONCLUSIONSIncomplete and inconsistent documentation of code status occurred frequently in hospitalized patients, especially elderly patients and patients receiving comfort measures. Having multiple, poorly integrated code status documentation sources leads to a significant number of concerning inconsistencies that create opportunities for healthcare providers to inappropriately deliver or withhold resuscitative measures that conflict with patients' expressed wishes. Institutions need to be aware of this potential documentation hazard and take steps to minimize code status documentation inconsistencies. Journal of Hospital Medicine 2015;10:491–496. © 2015 Society of Hospital Medicine

Keywords

Aged, 80 and over, Male, Academic Medical Centers, Documentation, Middle Aged, Hospitalization, International Classification of Diseases, Humans, Female, Aged

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
24
Top 10%
Top 10%
Top 10%
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