Abstract Rationale Goal-concordant care in the medical ICU (MICU) requires that patients and health-care proxies (HCPs) accurately understand Do Not Resuscitate (DNR) and Do Not Intubate (DNI) orders. In the ICU—where decompensation is common and decisions (e.g., defibrillation, intubation, emergent procedures) must be made within minutes—imprecise understanding can drive unwanted care, code-status reversals, moral distress, and discordance between documented orders and actual preferences. Clinicians frequently encounter confusion equating DNR/DNI with forgoing all treatment. We sought to quantify specific misconceptions and test whether a brief true/false instrument efficiently surfaces actionable knowledge gaps that can trigger targeted bedside education. Methods We conducted an ongoing cross-sectional survey in a tertiary MICU. Adults (≥18 years) admitted ≥2 days with a documented advance-care planning discussion, or their HCPs, were eligible. An anonymous 11-item true/false questionnaire probed beliefs about what DNR/DNI does and does not entail. Surveying began May 2025. This interim analysis uses descriptive statistics. Results To date, 57 surveys were collected (patients and HCPs combined). Over half (51%) incorrectly endorsed that DNR/DNI means no medical treatment will be provided. More than one in five (21%) believed “full code” guarantees survival. Nearly one fifth (18%) thought a DNR order precludes ICU admission. Most respondents (91%) correctly recognized that comfort-focused care is always provided. Moreover, 95% of respondents felt it was the providing teams’ obligation to ensure accurate comprehension of a DNR/DNI status. Item-level patterns showed frequent conflation of DNR/DNI with withdrawal of non-resuscitative therapies (e.g., antibiotics, vasopressors, non-invasive ventilation). Across items, the average correct score was 69.5%.The true/false format rapidly distinguished accurate beliefs from correctable misconceptions at the point of care. Conclusion Substantial, patterned misunderstandings of DNR/DNI persist in the MICU, chiefly the belief that DNR/DNI equals “do not treat.” A brief true/false screen efficiently unmasks these gaps, normalizes clinician-led clarification, and can be paired with teach-back and concise decision aids to demystify code status. Making practitioners aware of the specific, prevalent misconceptions may prompt more substantive discussions that emphasize what care continues under DNR/DNI (e.g., antibiotics, vasopressors, non-invasive support, ICU-level monitoring) and what interventions are limited (chest compressions, defibrillation, intubation). Patients overwhelmingly felt that providers are obligated to ensure comprehension of the decision’s implications. Future analyses will assess knowledge gain, decisional conflict, and concordance between documented orders and stated preferences. Systematically checking and correcting discrete false beliefs can improve code-status communication, align orders with values, and potentially reduce later reversals or discordance. This abstract is funded by: None
Yoon et al. (Fri,) studied this question.