Anesthesiologist Perspectives/Opinions/Ethics on Intraoperative/Intraprocedural Code Status and Intraoperative/Intraprocedural Code Status Management Plans (AnesOpIntraDNR)

This survey aims to understand anesthesiologists' opinions on intraoperative/intraprocedural code status management (like for example, Do Not Resuscitate (DNR)) in various patient scenarios. Your valuable input will help us better understand current practices and preferences in the field.

The understanding of the perspectives of ASA (American Society of Anesthesiologists) member staff anesthesiologists and staff anesthesiologists in general on this matter is of critical importance in the field of anesthesiology as the intraoperative/intraprocedural patient population continues to collectively get older and sicker in the future.

Goal/Aims: The goal of this survey is to ascertain the perspectives of all active ASA member staff anesthesiologists and staff anesthesiologists in general on the matters of intraoperative/intraprocedural code status and intraoperative/intraprocedural code status management plans

Study Overview

• Status: Withdrawn
• Conditions: Physician's Role; Opinions

Detailed Description

Title: Anesthesiologist Perspectives on Intraoperative/Intraprocedural Code Status and Intraoperative/Intraprocedural Code Status Management Plans Introduction: This survey aims to understand anesthesiologists' opinions on intraoperative/intraprocedural code status management in various patient scenarios. Your valuable input will help us better understand current practices and preferences in the field.

Goal/Aims: The goal of this survey is to ascertain the perspectives of all active ASA members on the matters of intraoperative/intraprocedural code status and intraoperative/intraprocedural code status management plans.

Sample Size/Scope: All Active ASA member staff anesthesiologists and staff anesthesiologists in general in the United States of America

Face/Construct Validity:

Are the components of the measure (e.g., questions) relevant to what's being measured? Yes, the questions and structure of the questions are relevant for the intended purpose of ascertaining the respondent's perspectives on intraoperative/intraprocedural code status and intraoperative/intraprocedural code status management plans.

Does the measurement method seem useful for measuring the variable? Yes, the questions and structure of the questions are useful for the intended purpose of ascertaining the respondent's perspectives on intraoperative/intraprocedural code status and intraoperative/intraprocedural code status management plans.

Is the measure seemingly appropriate for capturing the variable? Yes, the questions and structure of the questions are appropriate for capturing the intended purpose of ascertaining the respondent's perspectives on intraoperative/intraprocedural code status and intraoperative/intraprocedural code status management plans.

All questions and question structures are consistent and thematically similar to previous studies/research cited.

Kerry Tanner, Chapter 6 - Survey designs, Editor(s): Kirsty Williamson, Graeme Johanson, Research Methods (Second Edition), Chandos Publishing, 2018, Pages 159-192, ISBN 9780081022207, https://doi.org/10.1016/B978-0-08-102220-7.00006-6.

Geyer ED, Miller R, Kim SS, Tobias JD, Nafiu OO, Tumin D. Quality and Impact of Survey Research Among Anesthesiologists: A Systematic Review. Adv Med Educ Pract. 2020 Aug 25;11:587-599. doi: 10.2147/AMEP.S259908. PMID: 32904509; PMCID: PMC7456338.

Sousa VEC, Dunn Lopez K. Towards Usable E-Health. A Systematic Review of Usability Questionnaires. Appl Clin Inform. 2017 May 10;8(2):470-490. doi: 10.4338/ACI-2016-10-R-0170. PMID: 28487932; PMCID: PMC6241759.

Kash BA, Cheon O, Halzack NM, Miller TR. Measuring Team Effectiveness in the Health Care Setting: An Inventory of Survey Tools. Health Serv Insights. 2018 Aug 24;11:1178632918796230. doi: 10.1177/1178632918796230. PMID: 30158825; PMCID: PMC6109848.

Patient Safety/Quality of Care: The results of this survey will be utilized to inform and empower the greater understanding and implementation of practices regarding intraoperative/intraprocedural code status and intraoperative/intraprocedural code status management plans for future policy matters in the field of anesthesiology.

Priority: The understanding of the perspectives of ASA member staff anesthesiologists and staff anesthesiologists in general on this matter is of critical importance in the field of anesthesiology as the intraoperative/intraprocedural patient population continues to collectively get older and sicker in the future.

• Study Type: Observational

Contacts and Locations

Study Locations

• United States
  • Texas
    • Dallas, Texas, United States, 75390
      • University of Texas Southwestern Medical Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

ASA Active Member Anesthesiologists in the United States of America

Description

Inclusion Criteria:

• Active Member of ASA
• Anesthesiologist
• Clinical Practice in United States of America

Exclusion Criteria:

• Participant refusal
• Inability to access survey instrument

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Aggregate Responses to Questions on Survey of ASA Members and Anesthesiologists	Aggregate Responses to Questions on Survey of ASA Members and Anesthesiologists	One year

Collaborators and Investigators

• Sponsor: Joseph Hendrix
• Investigators: Principal Investigator: Joseph Hendrix, MD, University of Texas

Publications and helpful links

General Publications

• Clemency MV, Thompson NJ. "Do not resuscitate" (DNR) orders and the anesthesiologist: a survey. Anesth Analg. 1993 Feb;76(2):394-401.
• Gu X, Eshkevari L, Powell T, Titus AJ, O'Guin C. Certified Registered Nurse Anesthetists' Management of the Perioperative Do-Not-Resuscitate Order: Evaluating Trends in Required Reconsideration. AANA J. 2021 Dec;89(6):491-499.
• Burkle CM, Swetz KM, Armstrong MH, Keegan MT. Patient and doctor attitudes and beliefs concerning perioperative do not resuscitate orders: anesthesiologists' growing compliance with patient autonomy and self determination guidelines. BMC Anesthesiol. 2013 Jan 15;13:2. doi: 10.1186/1471-2253-13-2.
• Hiestand D, Beaman M. Perioperative Do-Not-Resuscitate Suspension: The Patient's Perspective. AORN J. 2019 Mar;109(3):326-334. doi: 10.1002/aorn.12612.
• Baumann M, Killebrew S, Zimnicki K, Balint K. Do-Not-Resuscitate Orders in the Perioperative Environment: A Multidisciplinary Quality Improvement Project. AORN J. 2017 Jul;106(1):20-30. doi: 10.1016/j.aorn.2017.05.002.
• Kim C, Keneally R. The Do Not Resuscitate (DNR) order in the perioperative setting: practical considerations. Curr Opin Anaesthesiol. 2021 Apr 1;34(2):141-144. doi: 10.1097/ACO.0000000000000974.
• Baldor DJ, Smyrnios NA, Faris K, Guilarte-Walker Y, Celik U, Torres U. A Controlled Study in CPR-Survival in Propensity Score Matched Full-Code and Do-Not-Resuscitate ICU Patients. J Intensive Care Med. 2022 Oct;37(10):1363-1369. doi: 10.1177/08850666221114052. Epub 2022 Jul 11.

Study record dates

Study Major Dates

• Study Start (Estimated): September 1, 2023
• Primary Completion (Estimated): December 1, 2024
• Study Completion (Estimated): March 1, 2025

Study Registration Dates

• First Submitted: May 20, 2023
• First Submitted That Met QC Criteria: May 20, 2023
• First Posted (Actual): May 31, 2023

Study Record Updates

• Last Update Posted (Actual): August 1, 2023
• Last Update Submitted That Met QC Criteria: July 27, 2023
• Last Verified: July 1, 2023

More Information

Terms related to this study

• Keywords: Intraoperative; Resuscitation; Ethics; Anesthesiologist; DNR (Do Not Resuscitate); DNAR (Do Not Attempt Resuscitation); Intraprocedural
• Other Study ID Numbers: STU-2023-0329 (Other Identifier: UTSW IRB certification approval as EXEMPT)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: This is an anonymous survey study where no individual identifying information is ever captured, stored, or analyzed at any time during the study. Only the aggregate data is captured, stored, and analyzed.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No