Resuscitation Planning and 7 Step Pathway

7 November 2014
Resuscitation Planning and 7 Step Pathway
With the recent introduction of the new Advance Care Directives Act 2013 (SA) and changes to
the Consent to Medical Treatment and Palliative Care Act 1995 on 1 July 2014, a series of new
forms have been introduced to support clinicians and patients in planning care. These include:
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Resuscitation Alert Confirmation (MR-RESUS A)
Resuscitation Alert – 7 Step Pathway – Developing a Resuscitation Plan (MR-RESUS)
Advance Care Directive
Adult Rapid Detection and Response Chart (MR59A)
The Advance Care Directive Form and the Adult Rapid Detection and Response Chart are
currently in use. From 10 November 2014 the Resuscitation Plan 7 Step Pathway forms (MRRESUS, MR RESUS A) will progressively be released across Central Adelaide. Education in
Resuscitation Planning 7 Step Pathway occurred with the release of the Advance Care Directives
and further education sessions will be available.
What is the Resuscitation Plan 7 Step Pathway?
The Resuscitation Plan 7 Step Pathway provides a step-by-step process for developing a
resuscitation and care plan and for clinical decision-making for patients at risk of deterioration. It
describes best practice in resuscitation and end of life care planning that is patient centred and
where possible aligned to patient wishes.
The Resuscitation Plan/Alert form is used by medical staff (excluding interns) to document
decisions about resuscitation and end-of-life clinical treatment and care.
What does the Resuscitation Plan 7 Step Pathway replace?
The Resuscitation Plan/Alert replaces existing forms and the current practice of writing informal
orders and placing an alert sticker in patients’ progress notes such as:
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Not For Resuscitation/NFR
Not for Cardiopulmonary Resuscitation/Not for CPR
Do Not Resuscitate/DNR
The Resuscitation Alert Confirmation form should have an alert sticker placed on outside edge.
The form is to be filed in the Alert section at the front of the patient’s medical record. The original
Resuscitation Alert 7 Step Pathway form is filed in the medical record in the clear plastic sleeve
with an Advance Care Directive (if the patient has one) and the carbonless copy placed at the
bedside next to the RDR Chart. On discharge this copy is to be placed in a Resuscitation
Plan/Alert envelope and given to the patient by the intern. The form can be valid for the current
admission only, indefinitely or until revoked. An OWI will be released in mid-November.
The details of a Resuscitation Plan must be communicated at clinical handover.
For more information
Virginia Wilkinson
CALHN Director Safety, Quality and Risk
Ph: 8222 2630
[email protected]
© Department of Health, Government of South Australia. All rights reserved.
A description of each form is listed below:
Resuscitation Alert Confirmation (MR-RESUS A)
The Resuscitation Alert Confirmation form is to be used to confirm that
the existing Resuscitation Plan is valid. This form provides clarity for
the clinical team to know that the Resuscitation Plan (MR-RESUS) has
been assessed and is still clinically relevant for the patient.
Resuscitation Alert 7 Step Pathway – Developing a Resuscitation
Plan (MR-RESUS)
The Resuscitation Plan 7 Step Pathway is not a legal document but an
extension of the medical notes. It can also be used to develop and
document end-of-life clinical care plans for patients consistent with the
wishes contained in an Advance Care Directive/or expressed by the
patient themselves. This form can only be completed by a doctor
(above the level of an intern).
Adult Rapid Detection and Response Chart (MR59A)
The introduction of the Resuscitation Alert – Resuscitation Planning 7
Step Pathway to align with the Advance Care Directives Act 2013
requires a minor amendment to the Resuscitation section of the Adult
RDR Chart (MR59A). Documentation by the nurse or doctor is required on the MR59A to indicate:
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The presence or absence of a resuscitation plan, and if present, in the event that the
patient deteriorates, whether the patient is to receive: Cardiopulmonary Resuscitation
(CPR) and/or
a Medical Emergency Response
A video (A clear path to care) demonstrates the use of the 7 Step Pathway:
http://www.sahealth.sa.gov.au/wps/wcm/connect/Public+Content/SA+Health+Internet/Clinical+res
ources/Advance+care+directive
Further information and resources on Advance Care Directives and the 7 Step Pathway:
http://dev.health.sa.gov.au/cnahs_dev/InsideCentral/CALHNGovernance/Accreditation/NationalSa
fetyandQualityHealthServiceStandar/NSQHSSStandard9/tabid/608/Default.aspx
Peter Satterthwaite
Executive Director Medical Services
Central Adelaide Local Health Network
For more information
Virginia Wilkinson
CALHN Director Safety, Quality and Risk
Ph: 8222 2630
[email protected]
© Department of Health, Government of South Australia. All rights reserved.

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