{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T05:51:54Z","timestamp":1778910714350,"version":"3.51.4"},"reference-count":6,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T00:00:00Z","timestamp":1755129600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Respecting patient wishes regarding resuscitation is fundamental to providing patient-centered care. Despite best practice guidelines for code status management for patients undergoing invasive procedures with existing Do Not Resuscitate (DNR) orders, compliance is low. Our interdisciplinary team created a workflow for code status management of inpatients with active DNR orders undergoing cardiac catheterization (CC) or electrophysiology (EP) procedures. Representatives from nursing, cardiology, surgery, palliative care, internal medicine, and information technology (IT) were involved. We used the workflow for 32 inpatients to temporarily rescind DNR orders for cardiology procedures. Average patient age was 76.6\u00a0years. Code status discussion was documented preprocedurally for 78% of patients; however, the documenting clinician varied. Over one third (37.5%) of cases were done with the primary goal of extending the patient\u2019s life. Four patients died during the same hospitalization as the procedure. The workflow was well received by stakeholders who appreciated the efficiency and clarity of the process. Interdisciplinary collaboration with key stakeholders and IT support were integral to the success of this intervention.<\/jats:p>","DOI":"10.1177\/00031348251363547","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T11:35:43Z","timestamp":1755171343000},"page":"293-298","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Structured Workflow to Manage Periprocedural Code Status for Patients With Do-Not-Resuscitate Orders"],"prefix":"10.1177","volume":"92","author":[{"given":"Carrie","family":"Fisher","sequence":"first","affiliation":[{"name":"Virginia Commonwealth University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle","family":"Noreika","sequence":"additional","affiliation":[{"name":"Virginia Commonwealth University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9790-8637","authenticated-orcid":false,"given":"Kyeong Ri","family":"Yu","sequence":"additional","affiliation":[{"name":"Virginia Commonwealth University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teri","family":"Dulong Rae","sequence":"additional","affiliation":[{"name":"Virginia Commonwealth University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jules","family":"Thomas-Highfield","sequence":"additional","affiliation":[{"name":"Virginia Commonwealth University Health System"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria","family":"Green","sequence":"additional","affiliation":[{"name":"Virginia Commonwealth University Health System"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leopoldo G.","family":"Ang","sequence":"additional","affiliation":[{"name":"Virginia Commonwealth University Health System"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth","family":"Ellenbogen","sequence":"additional","affiliation":[{"name":"Virginia Commonwealth University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zachary M.","family":"Gertz","sequence":"additional","affiliation":[{"name":"Virginia Commonwealth University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5739-9591","authenticated-orcid":false,"given":"Emily B.","family":"Rivet","sequence":"additional","affiliation":[{"name":"Virginia Commonwealth University"},{"name":"Virginia Commonwealth University"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,8,14]]},"reference":[{"key":"e_1_3_4_2_2","unstructured":"American Society of Anesthesiologists (ASA). Statement on ethical guidelines for the anesthesia care of patients with do-not-resuscitate orders. https:\/\/www.asahq.org\/standards-and-practice-parameters\/statement-on-ethical-guidelines-for-the-anesthesia-care-of-patients-with-do-not-resuscitate-orders. October 17 2018. Accessed October 13 2023."},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2017.0601"},{"issue":"2","key":"e_1_3_4_4_2","first-page":"80","article-title":"Management of do not resuscitate orders before invasive procedures","volume":"38","author":"Wong J","year":"2021","unstructured":"Wong J, Gravely A, Duane PG. Management of do not resuscitate orders before invasive procedures. Fed Pract. 2021;38(2):80-83.","journal-title":"Fed Pract"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17980"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2023.3340"},{"key":"e_1_3_4_7_2","unstructured":"American College of Surgeons Committee on Ethics. American College of Surgeons Committee on ethics statement on advance directives by patients: \u201cDo Not Resuscitate\u201d in the operating room. https:\/\/www.facs.org\/about-acs\/statements\/19-advance-directives. January 3 2014. Accessed March 7 2024."}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348251363547","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348251363547","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348251363547","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:38:17Z","timestamp":1777379897000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348251363547"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,14]]},"references-count":6,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1177\/00031348251363547"],"URL":"https:\/\/doi.org\/10.1177\/00031348251363547","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,14]]}}}