Code status
Formal Definition
A patient's documented preferences regarding cardiopulmonary resuscitation (CPR) and other life-sustaining interventions; specified as Full Code (all resuscitative measures attempted), DNR/DNI (Do Not Resuscitate/Do Not Intubate), DNR only, or Allow Natural Death (AND); based on informed consent and must be re-clarified at each hospitalization.
How It's Used on the Ward
"What is the code status?" — one of the first things asked on any admission, and the most important communication to verify is current and documented.
Example
""Before transferring this patient to the floor, confirm code status: his last hospitalization 6 months ago he was full code, but he has had a significant decline. This is a conversation we need to have with him and his family before he leaves the ICU.""
Clinical Context
Code status is NOT a binary full code vs DNR decision — it can be nuanced (intubate but no compressions, chemical code only). Code status must reflect current informed consent: a code status from a prior admission is not automatically valid — re-clarify, especially after new diagnoses or functional decline. POLST/MOLST: portable, immediately actionable medical order for out-of-hospital and cross-setting care (different from an advance directive, which is a legal document expressing wishes). Default: if no documented code status and patient cannot consent, Full Code is the default while surrogate is identified. Changing code status: requires physician-patient/family conversation, never "order" it without the conversation. Documentation in chart and on POLST is equally important.
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