Paddley Brianna, Espin Sherry, Indar Alyssa, Rose Don, Bookey-Bassett Sue
Medical Surgical Intensive Care Unit, 10071St. Michael's Hospital, Toronto, Canada.
Daphne Cockwell School of Nursing, 7984Ryerson University, Toronto, Canada.
Can J Nurs Res. 2023 Jun;55(2):176-184. doi: 10.1177/08445621221099117. Epub 2022 May 11.
Interprofessional teams working in the Intensive Care Unit (ICU) care for patients requiring varying degrees of life sustaining therapy. A patient's code status can help clinicians to understand the appropriate life support measures to deliver to patients in this setting. Members of the interprofessional team, such as physicians and nurses, can experience challenges related to communication when the code status is unclear.
The purpose of this study was to explore how nurses and physicians in the ICU experience communication of code status escalations.
A qualitative case study approach was used. Participants were physicians and nurses, working in the medical-surgical ICU of a large, urban academic hospital. Data were collected using semi-structured interviews, observations of health care rounds and a chart review. Data were analyzed using qualitative content analysis.
Thematic findings include: (1) engaging in an interprofessional discussion, (2) finding consistent documentation, (3) revisiting the code status, and (4) telling the patient story. The study findings also provide contextual information about participants' experiences of code status communication during the first wave (February 2020 to May 2020) of the COVID-19 pandemic.
The results of this study could inform standard communication frameworks or practices related to dissemination of code status decisions among members of the ICU team.
在重症监护病房（ICU）工作的跨专业团队负责护理需要不同程度生命维持治疗的患者。患者的代码状态有助于临床医生了解在此环境下应向患者提供的适当生命支持措施。当代码状态不明确时，跨专业团队的成员，如医生和护士，可能会在沟通方面遇到挑战。
本研究的目的是探讨ICU中的护士和医生如何体验代码状态升级的沟通。
采用定性案例研究方法。参与者是在一家大型城市学术医院的内科-外科ICU工作的医生和护士。通过半结构化访谈、医疗查房观察和病历审查收集数据。使用定性内容分析法对数据进行分析。
主题性发现包括：（1）进行跨专业讨论，（2）找到一致的记录，（3）重新审视代码状态，以及（4）讲述患者情况。研究结果还提供了有关参与者在2019年冠状病毒病疫情第一波（2020年2月至2020年5月）期间代码状态沟通经历的背景信息。
本研究结果可为ICU团队成员之间传播代码状态决策的标准沟通框架或实践提供参考。
