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Publikationstyp: Beitrag in wissenschaftlicher Zeitschrift
Art der Begutachtung: Peer review (Publikation)
Titel: Do not attempt resuscitation : the importance of consensual decisions
Autor/-in: Imhof, Lorenz
Mahrer Imhof, Romy
Janisch, C.
Kesselring, A.
Zürcher-Zenklusen, R.
DOI: 10.21256/zhaw-2743
10.4414/smw.2011.13157
Erschienen in: Swiss Medical Weekly
Band(Heft): 141
Heft: w13157
Erscheinungsdatum: 3-Feb-2011
Verlag / Hrsg. Institution: EMH Schweizerischer Ärzteverlag
ISSN: 1424-7860
1424-3997
0036-7672
Sprache: Englisch
Fachgebiet (DDC): 610: Medizin und Gesundheit
Zusammenfassung: Aims: To describe the involvement and input of physicians and nurses in cardiopulmonary resuscitation (cpr / do not attempt resuscitation (dnar) decisions; to analyse decision patterns; and understand the practical implications. Design: A qualitative grounded theory study using one-time open-ended interviews with 40 volunteer physicians and 52 nurses drawn from acute care wards with mixes of heterogeneous cases in seven different hospitals in German-speaking Switzerland. Results: Establishing dnar orders in the best interests of patients was described as a challenging task requiring the leadership of senior physicians and nurses. Implicit decisions in favour of cpr predominated at the beginning of hospitalisation; depending on the context, they were relieved/superseded by explicit dnar decisions. Explicit decisions were the result of hierarchical medical expertise, of multilateral interdisciplinary expertise, of patient autonomy and/or of negotiated patient autonomy. Each type of decision, implicit or explicit, potentially represented a team consensus. Non-consensual decisions were prone to precipitate personal or team conflicts, and, occasionally, led to non-compliance. Conclusion: Establishing dnar orders is a demanding task. Reaching a consensus is of crucial importance in guaranteeing teamwork and good patient care. Communication and negotiation skills, professional and personal life experience and empathy for patients and colleagues are pivotal. Therefore, leadership by experienced senior physicians and nurses is needed and great efforts should be made with regard to multidisciplinary education.
URI: https://digitalcollection.zhaw.ch/handle/11475/12470
Volltext Version: Publizierte Version
Lizenz (gemäss Verlagsvertrag): CC BY-NC-ND 4.0: Namensnennung - Nicht kommerziell - Keine Bearbeitungen 4.0 International
Departement: Gesundheit
Organisationseinheit: Institut für Pflege (IPF)
Enthalten in den Sammlungen:Publikationen Gesundheit

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