GH GHNHSFTeLearning Portal

A guide to the do not attempt cardiopulmonary resuscitation eLearning module

The do not attempt cardiopulmonary resuscitation eLearning module helps NHS staff and learners understand how resuscitation decisions are made, communicated and recorded. It is relevant to clinical practice, patient dignity, professional accountability and the responsibilities of the wider multidisciplinary team.

This guide is written for Australian readers using the Gloucestershire Hospitals NHS Foundation Trust eLearning portal. The module reflects NHS practice in England, so some legal terms and procedures will differ from those used in Australia. The core skills—clear communication, careful documentation, respect for capacity and appropriate escalation—remain widely applicable.

What the module is designed to teach

A DNACPR decision means that cardiopulmonary resuscitation should not be attempted if a person’s heart or breathing stops. It does not mean that other treatment stops. A patient should continue to receive appropriate nursing care, symptom relief, clinical review and treatment that is consistent with their goals and condition.

The learning usually focuses on the reasoning behind a decision, the people who may be involved and the importance of recording the outcome correctly. It also helps learners distinguish a DNACPR decision from wider treatment-escalation plans, advance care planning, or a decision to withhold a particular intervention.

The module is therefore more than a definition exercise. It asks staff to consider clinical benefit, likely outcomes, patient preferences, capacity, legal authority and the effect of poor communication during an emergency.

Why communication is central

Resuscitation decisions can be emotionally difficult for patients, relatives and staff. A calm explanation should make clear what the decision covers, why it has been considered and what care will continue. Avoiding vague phrases can prevent relatives from believing that a DNACPR order means abandonment or the withdrawal of all treatment.

The patient’s wishes should be taken seriously whenever they can be established. Where a patient lacks capacity, the clinical team must follow the relevant decision-making framework and involve an appropriate representative or substitute decision-maker where required. Staff should not assume that the loudest or most available family member automatically has authority to decide.

Good communication also supports openness when care has not gone as planned. The portal’s duty of candour module is a useful companion resource because it addresses honest, timely communication after a patient-safety incident.

Preparing before you begin

Set aside enough uninterrupted time to read the scenarios carefully rather than treating the module as a quick compliance task. Have your local policy resources available, especially guidance on resuscitation decisions, capacity, documentation, escalation and incident reporting.

Australian users should remember that the portal is connected with Gloucestershire Hospitals NHS Foundation Trust, not an Australian health service. A nurse working in Melbourne, Brisbane or Perth may use different forms, terminology and escalation pathways in their own workplace. The module can still develop transferable reasoning, but local policy always governs actual practice.

Useful checks before starting:

If access fails, content does not load or completion is not recorded, use the eLearning Helpdesk contact details provided by the Gloucestershire Hospitals NHS Foundation Trust portal. Keep a note of the module name, your username or staff identifier, the time of the problem and any error message.

Working through clinical scenarios

Scenario questions often test judgement rather than memory. Read the facts in sequence, identify who has decision-making capacity and separate the patient’s preferences from the views of relatives or staff. Consider whether the scenario describes an immediate emergency, a planned review or a change in the person’s clinical condition.

Pay close attention to wording about reversibility and benefit. CPR may be clinically inappropriate when it is very unlikely to work or would cause significant harm, but that conclusion must be reached through an appropriate clinical process. A DNACPR decision should never be used as a shortcut for rationing care based on age, disability, social circumstances or a diagnosis alone.

When an answer seems plausible, ask which option best protects the patient’s rights and provides a clear, defensible record. The strongest response will usually involve timely senior review, sensitive discussion, accurate documentation and communication with the relevant team.

Recording and sharing the decision

A decision that is discussed but not recorded may be difficult to follow during an out-of-hours event. Documentation should be clear enough for the clinical team to understand what was decided, who was involved, when it was reviewed and whether any limits or conditions apply.

The decision should be visible to the people who may need it in an emergency, subject to privacy and information-governance rules. Handover, electronic records, care plans and transfer documents must give consistent information. Conflicting records create risk for patients and staff.

Language that supports clear conversations:

A DNACPR decision should be reviewed when the patient’s condition, treatment goals or preferences change. It may also need checking when a person moves between services, such as from an acute hospital to residential care or community nursing.

Australian context and local differences

Australian health services may use terms such as “not for resuscitation”, “no-CPR order” or an advance care directive rather than the NHS wording. The legal framework varies between states and territories. For example, Victoria uses advance care directives within its own statutory framework, while New South Wales and Queensland have different rules and forms for substitute decision-making and treatment planning.

The module’s UK context also matters because England’s Mental Capacity Act and NHS documentation processes do not automatically apply in Australia. Staff in Sydney, Adelaide or regional Tasmania should check their state or territory legislation, employer policy and approved forms before applying any learning to a real patient.

Everyday practice can also affect how plans are communicated. A patient transferred from a hospital to a residential aged-care facility, or from a metropolitan service to a rural hospital, may encounter several records and teams. A clear handover is especially important when a paper form, electronic record and family understanding do not match.

Australian clinicians should translate the principle rather than copy the paperwork. The practical focus remains the same: establish the person’s wishes where possible, assess capacity, involve the right decision-makers, document the plan and ensure it is available during an emergency.

Completing the learning responsibly

After each knowledge check, review why an answer is correct instead of simply recording the result. This approach helps connect the module with real responsibilities, including escalation to a senior clinician, respectful conversations with families and accurate updates to the patient record.

Completion records may be required for local training compliance, but the certificate is not a substitute for supervised practice or workplace policy. If a scenario raises a concern about current care, follow the clinical escalation pathway immediately rather than waiting until the module is finished.

Keep a short personal note of the points that need local clarification, such as the approved form, review requirements, out-of-hours process and who can authorise or communicate the decision. The practical takeaway is simple: understand the patient’s wishes, follow the applicable legal and organisational framework, document the decision clearly, and make sure the right team can find it when it matters.