Pyl Nicole, Menard Prudy
The Ottawa Hospital, General Campus, 501 Smyth Road, Ottawa, ON, Canada K1H 8L6.
ISRN Nurs. 2012;2012:591541. doi: 10.5402/2012/591541. Epub 2012 Dec 5.
The decision whether to receive cardiopulmonary resuscitation (CPR) is a decision in which the personal values of the patient must be considered along with information about the risks and benefits of the treatment. A decision aid can be used to provide patient decision support to a patient who is seriously ill and needs to consider CPR options. The goal of this project was to identify the barriers and facilitators to using a CPR decision aid, through evaluating nursing perceptions on providing patient decision support. Using a needs assessment, it was determined that implementing a patient decision aid for CPR status in the Acute Monitor Area (AMA) of The Ottawa Hospital would be an excellent quality improvement project. The nurses who chose to participate were given an education session regarding patient decision support. Questionnaires were distributed to evaluate their views of patient decision support and decision aids before and after the education session and implementation of the CPR decision aid. Questionnaire results did not indicate a significant change between before or after education session and decision aid implementation. Qualitative reports did indicate that nurses generally have positive attitudes toward patient decision support and decision aids. The nurses identified specific barriers and facilitators in their commentaries. This clinically relevant data supports the idea that patient decision support should be integrated into daily nursing practice.
是否接受心肺复苏(CPR)的决定是一个必须结合患者个人价值观以及治疗风险和益处信息来考虑的决定。决策辅助工具可用于为重症且需要考虑心肺复苏选项的患者提供患者决策支持。本项目的目标是通过评估护士对提供患者决策支持的看法,确定使用心肺复苏决策辅助工具的障碍和促进因素。通过需求评估,确定在渥太华医院急性监测区(AMA)实施关于心肺复苏状态的患者决策辅助工具将是一个优秀的质量改进项目。选择参与的护士接受了关于患者决策支持的教育课程。在教育课程以及心肺复苏决策辅助工具实施前后,分发问卷以评估他们对患者决策支持和决策辅助工具的看法。问卷结果并未表明教育课程前后以及决策辅助工具实施前后有显著变化。定性报告确实表明护士对患者决策支持和决策辅助工具总体持积极态度。护士们在评论中指出了具体的障碍和促进因素。这些具有临床相关性的数据支持了应将患者决策支持纳入日常护理实践的观点。