Code status definitions changing May 3
25 Apr 2021This will create a streamlined change in Epic
By: Dr. Kovid Trivedi and Ann Alway, RN, clinical nurse specialist
Starting next Monday, May 3, the way code status orders in Epic will change. This change in Epic will align Salem Health’s code policy with what is found on the Oregon POLST form, helping to streamline care when patients are admitted to Salem Health and reduce the confusion on terminology and status. In summary, the presence or absence of a pulse will determine the interventions. Moving forward, there will be only three options for status in Epic, summarized below.
Please note that these definitions do not apply to the peri-procedural period, about which the surgeon/proceduralist and the patient/decision-maker must have a separate, documented conversation clearly stipulating code status during that period.
1 - FULL CODE – In the event of cardiopulmonary arrest, start resuscitative efforts in accordance with accepted clinical standards (AHA ACLS).
2 - DNR – (Do Not Resuscitate) In the event of cardiopulmonary arrest, there will be no chest compressions, intubation, defibrillation, or administration of ACLS medications.
The patient AGREES to elective intubation and elective treatments.
3 - DNR/DNI – (Do Not Resuscitate/Do Not Intubate) In the event of cardiopulmonary arrest, there will be no chest compressions, intubation, defibrillation, or administration of ACLS medications.
The patient DOES NOT AGREE to elective intubation unless otherwise specified on a case-by-case basis (e.g. for a procedure). The patient does agree to elective treatments.
Patient’s arm band will include a DNR button & a separate “blue” DNI button in case of DNR/DNI status.