Does the presence of a DNR order influence resource use or nursing care?
There are not enough quality data to provide an evidence-based recommendation about the use of DNR orders to influence resource use or nursing care. Further study might address whether earlier use of DNR orders would result in decreased resource consumption and level of nursing care. It has been the assumption that patients with a DNR order will consume fewer resources and require less intensive nursing care. This assumption is supported by several studies (level V). Other studies do not support this contention, and find that patients with DNR orders consume an equivalent or a greater number of resources, and require either the same or increased level of nursing care (level II-IV). This apparent conflict may be due to a heterogeneous population of patients with DNR orders written both early and late in their ICU course. Once patients have a DNR order, resource consumption as measured by length of stay or the therapeutic intervention scoring system (TISS) may decrease (level III), altho
