Nurses and guideline for interrupting or not initiating CPR: An exploratory survey

C. Agnoletto, F. Gastaldo, Simonetta Padrin
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Abstract

Objective: An area that still causes difficulties and a sense of inadequacy in healthcare providers is related to Do Not Attempt Resuscitation decision (DNAR). The aim of the study is to investigate knowledge, opinions and behaviors of nurses about DNAR in order to plan appropriate improvement interventions.Methods: An anonymous questionnaire was administered to 207 nurses belonging to four Medicine Departments and to four Intensive Care areas. The questionnaire, which consists of 29 items, collects some information related to work experience and investigates opinions and behaviors of nurses about DNAR decision.Results: 55% of the nurses in the sample say they do not know the meaning of the acronym DNAR. It was noted a statistically significant association both between training and knowledge of DNAR (p-value = .038) and between years of work and knowledge of the acronym (p-value = .004). There was also a statistically significant difference between knowledge of the acronym and some opinions and behaviors of nurses, including the importance of informing the patient about DNAR decision (p-value = .028).Conclusions: The study shows that the sample investigated, regardless of the work area of afference, does not know DNAR decision adequately. The lack of knowledge influences opinions and attitudes of nurses in relation to DNAR decision, constituting a barrier for an appropriate management of the patient. The need for more training on the topic and the formulation of clear protocols on DNAR decision emerges.
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护士和中断或不启动心肺复苏术的指南:一项探索性调查
目的:医疗服务提供者仍然存在困难和不足感的一个领域与“不尝试复苏决定”(DNAR)有关。本研究的目的是调查护士对DNAR的知识、意见和行为,以制定适当的改进干预措施。方法:对四个内科和四个重症监护区的207名护士进行匿名问卷调查。该问卷共29项,收集了一些与工作经验有关的信息,并调查了护士对DNAR决策的意见和行为。结果:样本中55%的护士表示他们不知道缩写DNAR的含义。研究发现,培训和DNAR知识之间(p值=0.038)以及工作年限和首字母缩写知识之间(p值=0.004)存在统计学上显著的相关性。首字母缩写的知识与护士的一些意见和行为之间也存在统计学上显着的差异,包括告知患者DNAR决定的重要性(p值=0.028)。结论:研究表明,无论影响的工作区域如何,所调查的样本都不充分了解DNAR决定。知识的缺乏影响了护士对DNAR决定的意见和态度,构成了对患者进行适当管理的障碍。需要就这一主题进行更多的培训,并制定关于DNAR决策的明确协议。
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