不要尝试心肺复苏决策过程:范围审查审查
Owen Doody1, Hope Davidson2, John Lombard2
1Nursing and Midwifery, University of Limerick, Limerick, Ireland owen.doody@ul.ie.
BMJ supportive & palliative care
|March 22, 2024
概括
了解不要尝试心肺复苏 (DNACPR) 决策是复杂的. 关键障碍包括沟通和时机不佳,而促进者涉及持续的讨论和明确的政策,强调需要改进实践.
科学领域:
- 医学伦理 医学伦理
- 医疗保健政策 医疗保健政策
- 临床决策 - 临床决策
背景情况:
- 不要尝试心肺复苏 (DNACPR) 决策至关重要但复杂.
- 关于DNACPR决策过程的证据需要合成.
研究的目的:
- 对DNACPR决策过程的证据进行范围审查.
- 确定影响DNACPR决策的障碍和促进者.
主要方法:
- 在八个数据库中进行系统搜索 (2013年1月 - 2023年4月).
- 选了66207个搜索结果,其中包括58篇论文.
- 内容分析映射到一个概念框架.
主要成果:
- 确定因素:时间,患者/家庭参与,讨论,记录,沟通和遵守.
- 障碍:时间不足,投入有限,沟通问题,道德不确定性.
- 促进者:持续的对话,充足的时间,文件,明确的政策,良好的沟通.
结论:
- DNACPR决策是复杂的,受法律,政策,资源,专业人员和患者的影响.
- 需要实质性的变化来支持和促进DNACPR实施的良好实践.
- 解决障碍和加强促进者对于有效的DNACPR流程至关重要.
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