Development and use of a decision aid for communication with hospitalized patients about cardiopulmonary resuscitation preference

Objective: To develop and evaluate a decision aid related to CPR decision-making for hospitalized patients. Methods: The development of the decision aid was guided by published recommendations; physicians, nurses, and a clinical ethicist were involved in the process. In-patients over age 55 with serious illnesses and their family were involved in pre-testing and evaluation. Results: Twenty-five patients and 11 family members participated. The majority (23/25, 92% of patients, 7/11, 64% of family) reported the information in the decision aid was 'Very' or 'Extremely' helpful in decisions. More than 70% of patients and family considered the aid to be "acceptable." The decision aid did not appear to bias towards or away from preferences for CPR. Participants did not report significant burden with use (median score 2/10; 1 = none, 10 = extremely upsetting). All patients and 10 family members recommended the aid be available to all patients. Conclusion: The decision aid was felt to be acceptable, feasible, and useful by participants. Future research should evaluate the impact of the decision aid on outcomes including quality of decision-making. Practice implications: The decision aid can be used to assist with CPR decision-making with seriously ill hospitalized patients. It is available for use on the CARENET website. (C) 2009 Elsevier Ireland Ltd. All rights reserved.