University of Utah School of Medicine
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.
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.
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.
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.