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Informed Consent Model for Code Status Discussion

CC BY-NC-ND

Informed Consent Model for Code Status Discussion

University of Utah School of Medicine
Author(s):  
Shaida Brandon
POGOe Id: 
21684
Date Posted: 
06/07/2013
Date Reviewed/Updated for Clinical Accuracy: 
09/05/2013
Ok Peer reviewed Peer reviewed
Abstract: 

The "Informed Consent Model for Code Status Discussion" educational product is a competency-based interactive experience designed to educate participants regarding the components of an effective code status discussion and improve their skills in conducting these critical discussions. The program highlights studies outlining the efficacy of CPR in a variety of clinical settings, provides an efficient and effective outline for code status discussions, affords participants an opportunity to examine how they currently conduct these discussions, and provides a carefully devised example of phrases participants can use to provide patients with information to facilitate informed decision making regarding code status.

Educational objectives: 

After participation in the training experience, the participant will be able to:
1. Explain the percent survival to hospital discharge after cardiopulmonary resuscitation (CPR) for a variety of clinical situations.
2. List at least 3 phrases to avoid and alternative phrases to use when discussing code status with adults with advanced illness and limited prognosis.
3. Conduct an effective goals-of-care discussion regarding code status.

Additional information/Special implementation requirements or guidelines: 

Effectiveness and Significance

The presentation has been well received in small groups and in large conference settings. The educational session was one of the highest rated presentations at the Utah State Advance Care Planning and POLST Conference that was attended by over 50 health professionals representing numerous disciplines. The educational session has also been shared in small groups with the Internal Medicine Interns (n=39) at the University of Utah during their 2011-2012 geriatrics rotation. 17 interns completed a voluntary, confidential pre- and post-experience survey, which assessed their self-efficacy regarding code status utilizing a 5-point Likert scale for measurement (1= strongly disagree, 2=disagree, 3=neutral, 4=agree, 5=strongly agree). Prior to the educational session, interns had a “neutral” response to the statement “I feel comfortable conducting a code status discussion” (mean Likert Score of 3.18 SD 1.07); after the educational session interns' Likert scores for the same statement improved to 4.59 SD 0.5.

 

Lessons Learned

Health professionals are expected to discuss code status with patients but many of them do not feel prepared for these discussions. Language used in these discussions can have unwanted consequences.

Learning resource types: 
Estimated time to complete: 
1 hour
Conflict of Interest Disclosure: 
Yes, I (we) have conflict of interest to disclose.
Conflict Description: 
Dr. Shaida Talebreza Brandon was supported by funds from the Department of Health and Human Services (DHHS), Health Resources and Services Administration (HRSA), Bureau of Health Professions (BHPr), under Geriatric Academic Career Award grant number K01HP20498 “Developing Expertise in Interdisciplinary Geriatric End-of-Life Education” for $374,954.40. The information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by the DHHS, HRSA, BHPR, or the U.S. Government.
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Suggested Citation:
Dr. Shaida Brandon. Informed Consent Model for Code Status Discussion. POGOe - Portal of Geriatrics Online Education; 2013 Available from: https://pogoe.org/productid/21684