Nurses and physicians' viewpoints about decision making of do not attempt resuscitation (DNAR)

Fallahi, M. and Mahdavikian, S. and Abdi, A. and Borhani, F. and Taghizadeh, P. and Hematpoor, B. (2018) Nurses and physicians' viewpoints about decision making of do not attempt resuscitation (DNAR). Multidisciplinary Respiratory Medicine, 13 (1).

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Abstract

Background: Despite advances with regard to "do not attempt resuscitation order", physicians are still reluctant to implement it. In fact, while the nurses could be of great help in making decision about "do not attempt resuscitation order," they are mostly neglected in this process. The current study was conducted to determine the nurses and physicians' viewpoints about decision making process of "do not attempt resuscitation order". Methods: A descriptive analytical study was carried out with participation of 152 physicians and 152 nurses. The participants were selected through stratified quota sampling from three educational hospitals affiliated with Kermanshah University of Medical Sciences. Data gathering tools were a demographics checklist and a researcher-designed questionnaire with 20 statements for measuring the attitudes of the respondents about the decision-making process and implementation of "do not attempt resuscitation order" of incurable patients. Results: Totally, 304 respondents (152 nurses and 152 physicians) participated in the study. The nurses' attitude score about the consent of the competent patients to "do not attempt resuscitation" was significantly lower in comparison with the physicians, (p < 0.001). However, the nurses' attitude was more positive than the physicians attitude about the belief that "taking the patient's consent is the physician's responsibility" (p < 0.001). Moreover, the nurses' attitude was more negative compared with the physicians' attitude about the idea that "obtaining the patient's consent is the nurse's responsibility" (p < 0.001). Both groups believed that the nurses cannot recommend "do not attempt resuscitation order" (p < 0.770). Both groups of the respondents believed that the nurses were not qualified to issue the "do not attempt resuscitation order" (physicians' mean score = 2.85, nurses' mean score = 2.89). The physicians' believe in "necessity to negotiate with the nurses about the order" was less deep than that of the nurses (p = 0.035). Conclusions: Given the different attitudes of the nurses and the physicians about the decision-making process of "do not attempt resuscitation," it is necessary to codify a medical guideline and clarify the decision making and implementation process. The guideline needs to clearly state physician's, nurse's, patient's, and other medical team members' responsibilities and roles, respectively. © 2018 The Author(s).

Item Type: Article
Additional Information: Export Date: 16 February 2020 Correspondence Address: Abdi, A.; Nursing and Midwifery School, Kermanshah University of Medical SciencesIran; email: Aabdi61@yahoo.com
Uncontrolled Keywords: Cardiopulmonary resuscitation Nurse Physician adult checklist controlled study decision making doctor nurse relation female human human tissue major clinical study male multicenter study practice guideline questionnaire responsibility resuscitation review sampling scientist
Subjects: WB Practice of Medicine
WG Cardiovascular System
WY Nursing
Divisions: Mashhad University of Medical Sciences
Depositing User: lib2 lib2 lib2
Date Deposited: 20 May 2020 06:55
Last Modified: 20 May 2020 06:55
URI: http://eprints.mums.ac.ir/id/eprint/17273

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