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Bryant J, Waller A, Pickles R, et al. Knowledge and confidence of junior medical doctors in discussing and documenting resuscitation plans: a cross-sectional survey. Intern Med J. 2021;51(12):2055-2060doi: 10.1111/imj.14994.
Bryant, J., Waller, A., Pickles, R., Hullick, C., Price, E., White, B., Willmott, L., Bowman, A., Knight, A., Ryall, M. A., & Sanson-Fisher, R. (2021). Knowledge and confidence of junior medical doctors in discussing and documenting resuscitation plans: a cross-sectional survey. Internal medicine journal, 51(12), 2055-2060. https://doi.org/10.1111/imj.14994
Bryant, Jamie, et al. "Knowledge and confidence of junior medical doctors in discussing and documenting resuscitation plans: a cross-sectional survey." Internal medicine journal vol. 51,12 (2021): 2055-2060. doi: https://doi.org/10.1111/imj.14994
Bryant J, Waller A, Pickles R, Hullick C, Price E, White B, Willmott L, Bowman A, Knight A, Ryall MA, Sanson-Fisher R. Knowledge and confidence of junior medical doctors in discussing and documenting resuscitation plans: a cross-sectional survey. Intern Med J. 2021 Dec;51(12):2055-2060. doi: 10.1111/imj.14994. PMID: 32687240.
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Intern Med J. 2021 Dec;51(12):2055-2060. doi: 10.1111/imj.14994.

Knowledge and confidence of junior medical doctors in discussing and documenting resuscitation plans: a cross-sectional survey.

Internal medicine journal

Jamie Bryant, Amy Waller, Rob Pickles, Carolyn Hullick, Emma Price, Ben White, Lindy Willmott, Alison Bowman, Anne Knight, Mary-Ann Ryall, Rob Sanson-Fisher

Affiliations

  1. Health Behaviour Research Collaborative, University of Newcastle, Newcastle, New South Wales, Australia.
  2. School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia.
  3. Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, New South Wales, Australia.
  4. Hunter Medical Research Institute, Newcastle, New South Wales, Australia.
  5. Hunter New England Local Health District, John Hunter Hospital, Newcastle, New South Wales, Australia.
  6. Australian Centre for Health Law Research, Queensland University of Technology, Brisbane, Queensland, Australia.
  7. Department of Rural Health, Manning Education Centre, University of Newcastle, Newcastle, New South Wales, Australia.
  8. Central Coast Clinical School, University of Newcastle, Newcastle, New South Wales, Australia.

PMID: 32687240 DOI: 10.1111/imj.14994

Abstract

BACKGROUND: A resuscitation plan is a medically authorised order to use or withhold resuscitation interventions. Absence of appropriate resuscitation orders exposes patients to the risk of invasive medical interventions that may be of questionable benefit depending on individual circumstances.

AIMS: To describe among junior doctors: (i) self-reported confidence discussing and completing resuscitation plans; (ii) knowledge of resuscitation policy including whether resuscitation plans are legally enforceable and key triggers for completion; and (iii) the factors associated with higher knowledge of triggers for completing resuscitation plans.

METHODS: A cross-sectional survey was conducted at five hospitals. Junior doctors on clinical rotation were approached at scheduled training sessions, before or after ward rounds or at change of rotation orientation days and provided with a pen-and-paper survey.

RESULTS: A total of 118 junior doctors participated. Most felt confident discussing (79%; n = 92) and documenting (87%; n = 102) resuscitation plans with patients. However, only 45% (n = 52) of doctors correctly identified that resuscitation plans are legally enforceable medical orders. On average, doctors correctly identified 6.8 (standard deviation = 1.8) out of 10 triggers for completing a resuscitation plan. Doctors aged >30 years were four times more likely to have high knowledge of triggers for completing resuscitation plans (odds ratio 4.28 (95% confidence interval 1.54-11.89); P = 0.0053).

CONCLUSION: Most junior doctors feel confident discussing and documenting resuscitation plans. There is a need to improve knowledge about legal obligations to follow completed resuscitation plans, and about when resuscitation plans should be completed to ensure they are completed with patients who are most at risk.

© 2020 Royal Australasian College of Physicians.

Keywords: cross sectional survey; junior medical doctor; legal knowledge; resuscitation planning

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