Please use this identifier to cite or link to this item:
https://doi.org/10.21256/zhaw-2743
Publication type: | Article in scientific journal |
Type of review: | Peer review (publication) |
Title: | Do not attempt resuscitation : the importance of consensual decisions |
Authors: | Imhof, Lorenz Mahrer Imhof, Romy Janisch, C. Kesselring, A. Zürcher-Zenklusen, R. |
DOI: | 10.21256/zhaw-2743 10.4414/smw.2011.13157 |
Published in: | Swiss Medical Weekly |
Volume(Issue): | 141 |
Issue: | w13157 |
Issue Date: | 3-Feb-2011 |
Publisher / Ed. Institution: | EMH Schweizerischer Ärzteverlag |
ISSN: | 1424-7860 1424-3997 0036-7672 |
Language: | English |
Subject (DDC): | 610: Medicine and health |
Abstract: | 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in favour of cpr predominated at the beginning of hospitalisation; depending on the context, they were relieved/superseded by explicit dnar decisions.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 |
Fulltext version: | Published version |
License (according to publishing contract): | CC BY-NC-ND 4.0: Attribution - Non commercial - No derivatives 4.0 International |
Departement: | School of Health Sciences |
Organisational Unit: | Institute of Nursing (IPF) |
Appears in collections: | Publikationen Gesundheit |
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2011_Imhof_Do not attempt resuscitation_SMW.pdf | 389.75 kB | Adobe PDF | View/Open |
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Imhof, L., Mahrer Imhof, R., Janisch, C., Kesselring, A., & Zürcher-Zenklusen, R. (2011). Do not attempt resuscitation : the importance of consensual decisions. Swiss Medical Weekly, 141(w13157). https://doi.org/10.21256/zhaw-2743
Imhof, L. et al. (2011) ‘Do not attempt resuscitation : the importance of consensual decisions’, Swiss Medical Weekly, 141(w13157). Available at: https://doi.org/10.21256/zhaw-2743.
L. Imhof, R. Mahrer Imhof, C. Janisch, A. Kesselring, and R. Zürcher-Zenklusen, “Do not attempt resuscitation : the importance of consensual decisions,” Swiss Medical Weekly, vol. 141, no. w13157, Feb. 2011, doi: 10.21256/zhaw-2743.
IMHOF, Lorenz, Romy MAHRER IMHOF, C. JANISCH, A. KESSELRING und R. ZÜRCHER-ZENKLUSEN, 2011. Do not attempt resuscitation : the importance of consensual decisions. Swiss Medical Weekly. 3 Februar 2011. Bd. 141, Nr. w13157. DOI 10.21256/zhaw-2743
Imhof, Lorenz, Romy Mahrer Imhof, C. Janisch, A. Kesselring, and R. Zürcher-Zenklusen. 2011. “Do Not Attempt Resuscitation : The Importance of Consensual Decisions.” Swiss Medical Weekly 141 (w13157). https://doi.org/10.21256/zhaw-2743.
Imhof, Lorenz, et al. “Do Not Attempt Resuscitation : The Importance of Consensual Decisions.” Swiss Medical Weekly, vol. 141, no. w13157, Feb. 2011, https://doi.org/10.21256/zhaw-2743.
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