Cardiopulmonary resuscitation. Values and decisions--a comparison of health care professionals

Abstract

The authors studied the effect of various patient factors (biomedical, mental status, and psychosocial) on the decision to perform cardiopulmonary resuscitation by internal medicine house staff and registered nurses. Clinical vignettes were utilized to assess the likelihood of initiation of cardiopulmonary resuscitation (CPR) by the respondents. In most cases, these factors had similar significant effects on decisions to initiate CPR by both physicians and nurses. However, some differences in the likelihood of performing CPR were found between the physician and nurse populations, particularly in the areas of mental status and institutionalization. Dementia, mental retardation, and nursing home status all caused residents to be significantly less likely to initiate CPR than nurses (P less than 0.001). This study demonstrates that biomedical, mental status, and psychosocial patient factors have a significant impact on the decision to initiate CPR by both internal medicine residents and nurses. These decisions apparently are rooted in similar criteria, although the basis for the differences between the two groups warrants further study.