1. QI Project: Perioperative DNR Policy
WHO?
&
MAY 8, 2017
WHAT?
QI Project: Perioperative DNR Policy
Residents: Andy Gruel, Sam Wallum, Lyndsey Graber
Advisors: Cristina Wood, Marina Shindell

2. Those with a DNR sometimes need surgery also
WHAT??
The Perioperative DNR Policy [ ]
Those with a DNR sometimes need surgery also

4. … Many involving communication breakdown and policy confusion
Including: events of DNR patients receiving full CPR !!
… Many involving communication breakdown and policy confusion
At LEAST 9 KNOWN Perioperative QI Events involving patients with DNR status going to the OR recently
Why…

5. {GASP!}

6. 10 min. Educational Presentation on Current Policy
How:
ed·u·cate /’ejə,kāt/
To give intellectual, moral, and social instruction to (someone, especially a child), typically at a school or university.
synonyms: teach, school, tutor, instruct, coach, train, drill, Moreguide, inform, enlighten, inculcate, indoctrinate, upskill, formaledify
10 min. Educational Presentation on Current Policy
TO: #1 Anesthesia Providers
#2 AIP Pre-op Nurses
#3 AIP PACU Nurses
#4 AOP Pre-op and PACU Nurses
Included: Pre-Test Questions, Post-Test Questions, and Free-text Suggestion Section

9. Free-Text Feedback Decreased knowledge of the process
Unclear who is assigned to do what
Code status should be addressed before patient is in Pre-op
Free-Text Feedback
Stressful for providers and patients
Not every patient has any kind of code status order during their admission
Extremely time consuming and confusing process

11. Additional Project Results#1
Meeting with hospital DNR Policy review/QI Group
Additional Project Results #2
Possible addition to Pre-op RN questions to add specific DNR text #4
Discussion with Timeout QI group about addition of code status
Possible code status addition to Surgery Teams’ Admit orders #3
Looking into patient DNR status button in Anesthesia Pre-op evaluation #5

13. Dr. Cristina Wood
Dr. Marina Shindell
Gabrielle Ingalsbe
Dr. Tobias Eckle
Dr. Melanie Donnelly
Dr. Allison Brainard