The Effectiveness of Video and Other Electronic Media on DNR/DNI Decisions within Advance Care Planning

Advance Care Planning is used to ensure patients’ wishes and preferences for treatment are in line with their medical situation. Its use has increased over the past years, but it has been implemented in a piece wise and unorganized fashion. Changes in provider billing capabilities and a recent consensus definition and implementation strategies of Advance Care Planning have created an opportunity to research and explore best use practices. A key feature of Advance Care Planning is creating autonomy for patients’ decisions. Autonomy is especially important for the use of cardiopulmonary resuscitation (CPR) in the event of a medical crisis. Research has shown that using videos to describe disease states or medical procedures has a positive effect on patient knowledge and has a demonstrable effect on patient care preferences. A literature review of recent studies using videos to depict and describe CPR has shown similar results. The future of using videos to aid in advance care planning will need to be incorporated with provider facilitated discussions and the use of out-of-clinic multimedia and internet based learning tools. Standardized charting and electronic medical record management will also need to be utilized to adapt to changing patient needs and ensure patient preferences are respected as patients transition from primary care to acute care settings. In addition, large scale studies using standardized video tools in diverse populations will aid in developing best practices