医疗保健专业人员遇到的不尝试复苏 (DNAR) 命令的问题 - 一项定性研究
Hanna Kuusisto1,2, Tapani Keränen1, Kaija Saranto1
1University of Eastern Finland, Kuopio, Finland.
Studies in health technology and informatics
|October 23, 2023
概括
医疗保健专业人员面临的挑战是,在医疗保健方面做出改变.
科学领域:
- 医学伦理 医学伦理
- 临床决策 - 临床决策
- 医疗保健管理的管理
背景情况:
- 不要尝试复苏 (DNAR) 命令是关键的,但具有挑战性的医疗决定.
- 欧洲的指导方针已经存在,但医疗保健专业人员 (HCP) 报告DNAR命令执行方面存在困难.
- 了解这些挑战对于改善终身护理沟通至关重要.
研究的目的:
- 评估医疗保健人员在做DNAR订单时遇到的具体问题.
- 根据"太华决策支持框架"确定决策支持方面的缺陷.
- 为DNAR决策制定提供更好的支持系统的发展提供信息.
主要方法:
- 为医生和护士分发了一份基于网络的问卷,其中包含开放式问题.
- 通过使用定性方法 (Atlas.ti软件) 分析了来自648名受访者的数据.
- 响应根据太华决策支持框架进行了分类,并扩大了决策需求.
主要成果:
- 599份陈述指出了与不充分的咨询,信息,情感支持和工具性帮助有关的问题.
- 医疗保健人员在多个DNAR决策层面上缺乏支持.
- 定性分析显示,在DNAR过程中,存在重大未得到满足的需求.
结论:
- 医疗保健专业人员需要加强对DNAR订单决策的支持.
- 建议将数字决策支持集成到电子患者记录 (EPR) 中.
- 通过改进的数字工具,可以促进及时和可见的DNAR订单.
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