Objective: According to literature DNR-policies seems to improve communication between physicians, other health-caregivers, patients and their next of kin. Therefore we wanted to investigate the incidence of DNR-policies in Flemish hospitals and on acute geriatric units, and to what extent the different actors were informed about the existence of such policy.
Method: Structured mail questionnaires were sent to the President of the Medical Council and the Head of the geriatric unit of all 64 hospitals with a geriatric unit in Flanders, the Dutch speaking part of Belgium, with 60% of all inhabitants.
Results: 72% of the Presidents of the Medical Councils and 75% of the Heads of the geriatric units returned the questionnaire. A DNR-policy was reported in 60.9% of the hospitals and on 83.3% of the geriatric units. The policy of the hospital was announced to all physicians, to 88.9% of the nurses and to 48.1% of the social workers. Geriatric units informed 85.3% of the physicians, 91.2% of the nurses, 29.4% of the social workers and 23.5% of the other paramedics. However both levels of the hospital notified less than 12% of the general practitioners. 8.7% of the hospitals and 26.5% of the geriatric units never informed the patient him/herself about the possibility not to be reanimated, but in most cases the next of kin of the patients were informed. Conclusions: At present, not all hospitals in Flanders have developed a DNR-policy. Physicians and nurses are mostly informed about the existing DNR-policy, but other health-caregivers and especially general practitioners often are not. The option of DNR provisions is frequently shared with the family of patients but rarely with the patients. Further studies should investigate whether non-information of patients is restricted to incompetent patients or not.