Living Wills Have an Impact on Pre-Hospital Lifesaving Care
Safety risk for patients with living wills can be minimized
Philadelphia, PA, 24 February 2009 – A new study conducted at the Hamot Medical Center in Erie, Pennsylvania, and published by Elsevier in the February 2009 issue of The Journal of Emergency Medicine shows that there is a lack of education and understanding in what sets a living will in motion in a pre-hospital setting. Education and implementation of code status designations can clarify this confusion.
The use of living wills and their impact on patient care had not been adequately studied. Living wills have the potential to impact patient care for patients who call 911 in a medical emergency. The study aimed to determine how a living will is interpreted and assess how interpretation impacted lifesaving care.
Researchers Mirarchi, et.al., found that significant confusion and concern for patient safety exists in the pre-hospital setting due to the understanding and implementation of living wills and DNR (do not resuscitate) orders. When a living will is present with the patient experiencing a critical illness, it has the potential to limit or delay lifesaving care. This confusion can be mitigated by implementing clearly defined code status into the living will.
“The results of the study are important because they provide clarification as to when a living will is enacted and promotes patient care and safety. It ensures the provision of lifesaving care for those who call 911 for a medical emergency,” according to lead researcher Ferdinando L. Mirarchi, DO, FAAEM, FACEP.
The results of this study suggest that the current structure of the living will leads the majority of pre-hospital health care providers to incorrectly assume a patient is a DNR. Living wills should not be considered synonymous with DNR orders.
DNR is misunderstood to define comfort care/end-of-life care, a confusion that can compromise lifesaving care. This confusion and concern for patient safety can be rectified by incorporating a clearly defined code status designation within the living will. Educational efforts and provider protocols must be reevaluated and implemented to ensure patient safety.
# # #
About The Journal of Emergency Medicine
The Journal of Emergency Medicine is an international, peer-reviewed publication featuring original contributions of interest to both the academic and practicing emergency physician. Published eight times per year, the Journal contains research papers and clinical studies as well as articles focusing on the training of emergency physicians and on the practice of emergency medicine. It is the official publication of the American Academy of Emergency Medicine and its Editor-in-Chief is Stephen R. Hayden, MD. The Journal of Emergency Medicine is available online at http://www.jem-journal.com.
Elsevier is a world-leading provider of scientific, technical and medical information products and services. The company works in partnership with the global science and health communities to publish more than 2,000 journals, including The Lancet and Cell, and close to 20,000 book titles, including major reference works from Mosby and Saunders. Elsevier’s online solutions include ScienceDirect, Scopus, Reaxys, ClinicalKey and Mosby’s Suite, which enhance the productivity of science and health professionals, and the SciVal suite and MEDai’s Pinpoint Review, which help research and health care institutions deliver better outcomes more cost-effectively.
A global business headquartered in Amsterdam, Elsevier employs 7,000 people worldwide. The company is part of Reed Elsevier Group plc, a world leading provider of professional information solutions. The group employs more than 30,000 people, including more than 15,000 in North America. Reed Elsevier Group plc is owned equally by two parent companies, Reed Elsevier PLC and Reed Elsevier NV. Their shares are traded on the London, Amsterdam and New York Stock Exchanges using the following ticker symbols: London: REL; Amsterdam: REN; New York: RUK and ENL.
+1 215 239 3711