Keywords

end of life, hospice, racial disparities, resuscitation

 

Authors

  1. Fosler, Laura MS, RN, FNP-BC, ACHPN
  2. Staffileno, Beth A. PhD
  3. Fogg, Louis PhD
  4. O'Mahony, Sean MB, BCh, BAO

Abstract

Previous research has shown that African American and Latino populations prefer more aggressive care at end of life. The purpose of this retrospective chart review was to describe whether having a palliative care consultation affected acceptance of do-not-resuscitate (DNR) status and hospice in these populations. Data were extracted from the medical records of patients who received a palliative care consultation between March 2011 and July 2011. Data extracted were race, age, gender, primary disease process, DNR status at time of consult and at discharge, and whether the patient enrolled in hospice if eligible. Demographic variables were tabulated using descriptive statistics or frequency distributions where appropriate. t Tests and analyses of variance were conducted to examine differences between ethnic groups. The sample size was 199, of which 38% were African American and 15% Hispanic. Prior to consultation, there were statistically significant differences regarding DNR status; after consultation, there were no differences in acceptance of DNR among races. Statistically significant differences among ethnicities remained in hospice enrollment. The authors conclude that palliative care consultations make a significant difference in this patient population. Further research is needed to identify why having a palliative care consultation impacted the decision about code status.