J Gerontol Nurs. 2022 Nov;48(11):45-52. doi: 10.3928/00989134-20221003-04. Epub 2022 Nov 1.
Nurses and social workers are uniquely positioned to advocate for patients' wishes for do-not-hospitalize (DNH) directives. The purpose of the current study was to explore the impact of DNH education, policy, and advocacy on the use of DNH orders by nurses (RNs and licensed practical nurses [LPNs]) and social workers employed in skilled nursing facilities (SNFs). This multisite secondary analysis used cross-sectional survey data and analyzed responses of RNs, LPNs, and social workers ( = 354) from 29 urban SNFs. Mixed model regression was used to examine possible predictors of frequency of DNH orders within SNFs while adjusting for random effects. Results showed that having a DNH written policy, education on DNH orders, and having an advanced care planning advocate in the facility were strongly associated with a higher reported frequency of DNH discussions with residents and their families ( < 0.01 for each variable). [(11), 45-52.].
护士和社会工作者在倡导患者的不住院（DNH）指令方面具有独特的优势。本研究的目的是探讨 DNH 教育、政策和宣传对在熟练护理机构（SNF）工作的护士（注册护士和执业护士）和社会工作者使用 DNH 医嘱的影响。这项多地点二次分析使用了横断面调查数据，并对来自 29 个城市 SNF 的 354 名注册护士、执业护士和社会工作者的反应进行了分析。混合模型回归用于检查 SNF 内 DNH 医嘱频率的可能预测因素，同时调整随机效应。结果表明，制定 DNH 书面政策、DNH 医嘱教育以及在机构内配备高级医疗保健规划倡导者与更高的 DNH 讨论频率与居民及其家属相关（每个变量 < 0.01）。[(11), 45-52.].
