Ask CCRM: To CPR or Not to CPR?

A flurry of media interest spurred by a “nurse’s” 911 call has raised questions in healthcare and aging services organizations about their own emergency response policies and procedures. This Ask CCRM discusses policies on resuscitation—despite the fact that what happened in this particular incident is still not entirely known.

Encouraging residents to have an advance directive, living will, or durable power of attorney for healthcare is a good place to start. These first two are written or oral communications about the wishes of individuals in advance of the need for resuscitation and are based on the Patient Self-Determination Act of 1990 (OBRA). These advance instructions must be initiated while the person is able to cognitively understand the implications of the directive and may be either written or oral, but written communications are more desirable. These communications may be revoked at any time.

Hospitals and assisted-living and skilled nursing organizations ask at admission whether the person has an advance directive. Physicians in practice settings may ask...