P-22: The use of video aids in code status discussions: a pilot single-centre quality improvement study.
Mr. Yassmin Behzadian
Dr. William Cumming,
Dr. Rebecca Kruisselbrink
Topic: Quality improvement
Informed consent has long been heralded as one of the pillars of modern medicine. Obtaining consent is held to the highest of standards to ensure recognition of patients’ autonomy and respect of patients’ beliefs, values and preferences. When admitted to the hospital, patients’ preferences regarding cardiopulmonary resuscitation (CPR) and intubation are to be obtained. This discussion about “code status” has a significant effect on patients’ decision making processes and enables patients to make decisions that are in accordance with their values. However, despite the emphasis on informed consent in the delivery of optimal patient care, health care continues to fall short when it comes to physician-patient discussions regarding code status.
The aim of this pilot study was to assess the effects of an educational video on code status preferences and knowledge of CPR.
Patients were selected for participation from the Internal Medicine Clinical Teaching Unit at Grand River Hospital in Kitchener, Ontario. Participants were selected based on a set of inclusion and exclusion criteria. After providing consent, participants first completed a Pre-Video Questionnaire and subsequently watched a 5 minute educational video on an iPad. After watching the video, participants completed the Post-Video Questionnaire. Both the Pre and Post Video Questionnaires included a series of multiple choice questions, short answers and a brief CPR knowledge quiz.
There was a significant difference in the CPR knowledge quiz scores before the intervention (M= 60.00, SD=17.89) and after the intervention (M=81.25, SD=22.47) conditions; t(15) = 3.9995, p=0.0012. At baseline, the proportion of participants requesting CPR was greater than those requesting no CPR (75% vs. 25%). Following administration of the intervention, this difference increased with 93.8% of patients requesting CPR and 6.2% declining it.
The video implemented in this study provides an effective way of improving patients’ understanding of CPR. This is significant as obtaining information is the first step in making an informed decision. Overall, video aids are not meant to replace discussions of code status, but rather to enhance them.