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Policy Statement Addresses DNAR Requests in Schools

Authors suggest collaboration is crucial in honoring do-not-attempt-resuscitation requests

MONDAY, April 26 (HealthDay News) -- Pediatricians have a critical role to play in working with school nurses and officials to ensure the do-not-attempt-resuscitation (DNAR) requests of the families of children and adolescents with complex chronic conditions are honored, according to a policy statement published online April 26 in Pediatrics.

Robert D. Murray, M.D., and colleagues on the Council on School Health Executive Committee, 2008 to 2009, write that there is a need for understanding and collaboration among pediatricians, school nurses, families, professional organizations, and other parties involved in the care of children and adolescents with complex chronic conditions in the school environment.

The authors note that DNAR requests in schools are becoming more accepted, but they cite a study that found, as of 2005, 80 percent of the 50 largest school districts in the United States and districts in 31 additional state capitals did not have a policy, protocol or regulation supporting a student's DNAR order. It is important that the individuals involved in a student's care develop an individualized health care plan that includes both communication and comfort-care plans, they write.

"Pediatricians who work directly with schools can also help implement policies, and professional organizations can advocate for regulations and legislation that enable students and their families to effectuate their preferences," the authors conclude.

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Physician's Briefing