Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001) · 2025
Evaluation of Client Communication Regarding Cardiopulmonary Resuscitation and Do-Not-Resuscitate Orders: A Survey Study.
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Horowitz Anna M, Conner Bobbi J, Hofmeister Erik H
Аннотация
OBJECTIVE: To document veterinary professionals' experiences discussing CPR and do-not-resuscitate (DNR) orders with clients.
DESIGN: Internet-based survey.
SETTING: Various small animal clinical practices.
SUBJECTS: A total of 547 veterinary professionals, including veterinarians, medical support staff, and nonmedical support staff.
MEASUREMENTS AND MAIN RESULTS: An electronic survey was distributed containing multiple-choice, Likert-type, and open-ended questions. Likert-type questions of interest were compared among groups of two using a Mann-Whitney U-test or a Kruskal-Wallis test with Dunn's test for post hoc analysis for groups of three or more. An ordinal regression model was fitted to explore factors that best predict greater comfort with discussing CPR, making recommendations, and offering specific advice. Most respondents (63.9%) reported working in hospitals with protocols for discussing CPR/DNR with clients, and the presence of a protocol increased the self-reported comfort with discussing CPR/DNR with clients (Estimate = 0.789, 95% CI: 0.354-1.224; p < 0.001). Respondents reported that most conversations about CPR/DNR are led by veterinarians (37.2%) or veterinary technicians/assistants (37.1%), followed by nonmedical support staff, such as receptionists or practice managers without medical training (23.1%), students (1.7%), and unspecified others (0.8%). From the open-ended questions, respondents commonly shared that they have never received formal training in how to discuss CPR/DNR with clients; rather, they learned from mentors or colleagues on the job. A greater number of years in emergency practice was correlated with greater self-reported comfort with making specific recommendations about CPR/DNR (Estimate = 0.067, 95% CI: 0.03-0.103; p < 0.001).
CONCLUSIONS: Veterinary professionals' comfort with discussing code status with clients appears to benefit from both formal protocols and accumulated experience in emergency practice. The lack of formal training highlights a gap that could be addressed to support more effective and confident communication in critical care discussions, potentially improving veterinary staff well-being.
DESIGN: Internet-based survey.
SETTING: Various small animal clinical practices.
SUBJECTS: A total of 547 veterinary professionals, including veterinarians, medical support staff, and nonmedical support staff.
MEASUREMENTS AND MAIN RESULTS: An electronic survey was distributed containing multiple-choice, Likert-type, and open-ended questions. Likert-type questions of interest were compared among groups of two using a Mann-Whitney U-test or a Kruskal-Wallis test with Dunn's test for post hoc analysis for groups of three or more. An ordinal regression model was fitted to explore factors that best predict greater comfort with discussing CPR, making recommendations, and offering specific advice. Most respondents (63.9%) reported working in hospitals with protocols for discussing CPR/DNR with clients, and the presence of a protocol increased the self-reported comfort with discussing CPR/DNR with clients (Estimate = 0.789, 95% CI: 0.354-1.224; p < 0.001). Respondents reported that most conversations about CPR/DNR are led by veterinarians (37.2%) or veterinary technicians/assistants (37.1%), followed by nonmedical support staff, such as receptionists or practice managers without medical training (23.1%), students (1.7%), and unspecified others (0.8%). From the open-ended questions, respondents commonly shared that they have never received formal training in how to discuss CPR/DNR with clients; rather, they learned from mentors or colleagues on the job. A greater number of years in emergency practice was correlated with greater self-reported comfort with making specific recommendations about CPR/DNR (Estimate = 0.067, 95% CI: 0.03-0.103; p < 0.001).
CONCLUSIONS: Veterinary professionals' comfort with discussing code status with clients appears to benefit from both formal protocols and accumulated experience in emergency practice. The lack of formal training highlights a gap that could be addressed to support more effective and confident communication in critical care discussions, potentially improving veterinary staff well-being.