A Day in the Life: Recording of resuscitation status among elderly in-patients at a major rural referral hospital


Dr Stephanie Armstrong, Dr William Boneham, Professor Paul Finucane. 

Case

Patient autonomy has been a central tenant of medical practice extending to decisions regarding resuscitation. A point prevalence study was conducted examining the resuscitation, baseline cognition and functional status of all admitted patients in the acute services building of Wagga Wagga Rural Referral Hospital. There were 89 patients aged ≥ 65 years in the hospital on the day of the audit.  Of these, 28 (31%) were ‘young-old’ (aged 65-74 years), 37 (42%) were ‘older-old’ (aged 75-84 years) and 24 (27%) were ‘oldest-old’ (aged ≥ 85 years). Resuscitation status was documented for 25 (28%) of the 89 patients aged ≥ 65 years.  The rate of documentation of resuscitation status increased with chronological age from 5/28 (18%) in the young-old to 12/37 (32%) in the older-old and 8/24 (33%) in the oldest-old.  Rates of documentation of resuscitation status was twice as high on medical units (37%) than on surgical units (18%).  This study demonstrates the potential underutilization of formal NFR documentation in a population with a large burden of life limiting comorbidities and high risk for experiencing sequelae from invasive procedures.