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dc.contributor.authorSulmasy, Daniel P.
dc.contributor.authorTerry, Peter B.
dc.contributor.authorFaden, Ruth R.
dc.contributor.authorLevine, David M.
dc.date.accessioned2019-09-25T11:59:01Z
dc.date.available2019-09-25T11:59:01Z
dc.date.created2016-02-05 14:03
dc.date.issued2015-05-05
dc.identifieroai:repository.library.georgetown.edu:10822/751154
dc.identifier10.1007/BF02600306
dc.identifierJournal of General Internal Medicine. 1994 Nov; 9(11): 622-626.
dc.identifier0884-8734
dc.identifierhttp://worldcatlibraries.org/registry/gateway?version=1.0&url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&atitle=Long-Term+Effects+of+Ethics+Education+on+the+Quality+of+Care+For+patients+Who+Have+Do-Not-Resuscitate+Orders&title=Journal+of+General+Internal+Medicine.++&volume=9&issue=11&pages=622-626&date=1994&au=Sulmasy,+Daniel+P.
dc.identifierhttp://dx.doi.org/10.1007/BF02600306
dc.identifierhttp://hdl.handle.net/10822/751154
dc.identifier.urihttp://hdl.handle.net/20.500.12424/265363
dc.description.abstractOBJECTIVE: To assess the long-term clinical impact of a broad-based ethics education program for medical houseofficers with specific emphasis on appropriate care for patients who have do-not-resuscitate (DNR) orders. DESIGN: Prospective, with an initial randomized phase. SETTING: The medical service of a university teaching hospital. PARTICIPANTS: Medical houseofficers and their inpatients. INTERVENTIONS: A pilot program in 1988, and a full program with a two-year curricular cycle from 1989 to 1991. MEASUREMENTS AND MAIN RESULTS: The authors measured compliance with specific standards of care by reviewing charts of patients who had DNR orders at baseline (n = 39, 1988), after the pilot phase (n = 57, 1989), and at the end of the first curricular cycle (n = 56, 1991), noticing who wrote the DNR order, whether the reasons for the order and appropriate consent were documented, and whether there was documented attention to any of 11 concurrent care concerns (CCCs), such as spiritual needs, the appropriateness of tube feedings or pressors, and adjustment of analgesic dose. The percentage of DNR orders written by houseofficers increased from 26% in 1988 to 67% in 1991 (p less than 0.01). The percentage of charts documenting the rationale and consent for the DNR order was consistently high. The percentage of charts documenting attention to any CCC increased from 68% in 1988 to 86% in 1991 (p less than 0.01). The mean number of CCCs addressed per DNA order increased from 1.34 in 1988 to 2.14 in 1991. The mean number of CCCs addressed per DNR order for patients who had AIDS increased from 0.89 in 1988 to 2.25 in 1991 (p = 0.03). CONCLUSIONS: The quality of care for patients who had DNR orders, both overall and for those who had AIDS, improved over long-term observation in the setting of an ethics education program for medical houseofficers. The results suggest that ethics education may alter physician practices and improve patient care.
dc.format.mediumArticle
dc.languageen
dc.language.isoeng
dc.sourceBRL:MEDKIE/95156144
dc.subjectAids
dc.subjectArtificial Feeding
dc.subjectBlood
dc.subjectBlood Transfusions
dc.subjectConsent
dc.subjectDNA
dc.subjectDNR Orders
dc.subjectDrugs
dc.subjectEducation
dc.subjectEthics
dc.subjectEvaluation
dc.subjectEvaluation Studies
dc.subjectHealth
dc.subjectHealth Care
dc.subjectHospitals
dc.subjectInformed Consent
dc.subjectInstitutional Policies
dc.subjectMedical Education
dc.subjectMedical Ethics
dc.subjectPatient Care
dc.subjectPatients
dc.subjectQuality of Health Care
dc.subjectRenal Dialysis
dc.subjectResuscitation
dc.subjectResuscitation Orders
dc.subjectResidency
dc.subjectStandards
dc.titleLong-Term Effects of Ethics Education on the Quality of Care for Patients Who Have Do-Not-Resuscitate Orders
ge.collectioncodeBB
ge.dataimportlabelOAI metadata object
ge.identifier.legacyglobethics:6450321
ge.identifier.permalinkhttps://www.globethics.net/gel/6450321
ge.lastmodificationdate2016-03-21 12:46
ge.submissions0
ge.oai.exportid148650
ge.oai.repositoryid7270
ge.oai.setnameBioethics Research Library
ge.oai.setnameBioethicsLine
ge.oai.setspeccom_10822_503786
ge.oai.setspeccol_10822_713699
ge.oai.streamid2
ge.setnameGlobeEthicsLib
ge.setspecglobeethicslib
ge.linkhttp://worldcatlibraries.org/registry/gateway?version=1.0&url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&atitle=Long-Term+Effects+of+Ethics+Education+on+the+Quality+of+Care+For+patients+Who+Have+Do-Not-Resuscitate+Orders&title=Journal+of+General+Internal+Medicine.++&volume=9&issue=11&pages=622-626&date=1994&au=Sulmasy,+Daniel+P.
ge.linkhttps://dx.doi.org/10.1007/BF02600306
ge.linkhttp://hdl.handle.net/10822/751154


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