Paediatric Nurses' Decision-Making About CPR in Challenging Clinical Scenarios : Insights From a Cross-Sectional...

This study explored paediatric nurses' decision-making regarding resuscitation in patients with unequivocal signs of death and no Do Not Resuscitate (DNR) order. A cross-sectional survey was conducted between October 2023 and April 2024 across the paediatric wards of four Australian hospitals. Participants were asked to respond to two hypothetical clinical scenarios involving a three-year-old boy and a twelve-year-old girl, both clearly deceased-neither of whom had documented DNR orders. Participants indicated their intended resuscitation plan and reasoning for each scenario. Data were analysed descriptively. All respondents (n = 26) (100 per cent) indicated that they would initiate resuscitation for the younger child, while 84.6 per cent (n = 22) would do so for the twelve-year-old. The absence of a DNR order and perceived duty of care were key reasons for their decisions. Findings reveal ethical, legal, and clinical challenges inherent to paediatric resuscitation decisions. This highlights the need for clearer policies, education, and support to guide determination of when resuscitation is appropriate.