In this study we completed development and formal evaluation in an acute care hospital of a decision aid related to cardiac resuscitation preference, with the overall goal of using it in clinical practice to facilitate communication.
We understood from our previous work that seriously ill hospitalized patients might have poor knowledge of CPR, the most common end of life decision, and will likely vary in their attitudes regarding their role in decisions about treatment. Communication about cardiac resuscitation decision making is challenging for clinicians and patients. There are no guidelines on optimal communication strategies about resuscitation preference and no published decision aides for use with hospitalized patients.
The development of our tool was guided by recommendations published in the International Patient Decision Aid Standards Collaboration by the Ottawa Health Decision Centre. The content and format were based on available evidence, previous research, and focus groups. Physicians, a clinical ethicist, nurses, and seriously ill hospitalized patients >55 years and their family caregivers were involved in the development and evaluation of this decision aid; they felt it to be acceptable, feasible, and useful. The aid did not appear to bias subjects to consider one treatment preference over another. Future research should evaluate its impact of the aid on outcomes and quality of decision making.
CPR Decision Aid