Hui Heidi Hoi Ying, Cordina Joanne, Teus Judeil Krlan, Maitland Susan, Watts Michael, Zanotti Sahn, Sheppard-Law Suzanne, Merrick Eamon, Skowronski George, Bowdler Suzanne, Light Edwina, Montgomery Amy, Preisz Anne, Sheahan Linda, Stewart Cameron, Kerridge Ian, McErlean Gemma
St George Hospital, Kogarah, NSW, Australia.
University of Wollongong, Loftus, NSW, Australia.
Aust Crit Care. 2025 Jul;38(4):101254. doi: 10.1016/j.aucc.2025.101254. Epub 2025 May 23.
Current Australian resuscitation training focusses on the practical application of cardiopulmonary resuscitation but lacks clarity on when it is inappropriate. Nurses are often first responders to inpatient emergencies and may take different approaches to cardiopulmonary resuscitation due to their views about its benefit. There is a lack of literature on how the absence of Do Not Resuscitate orders affect nurses' decisions regarding resuscitation in hospital settings.
The aim of this study was to explore nurse's views of initiating cardiopulmonary resuscitation on inpatients with unequivocal signs of death without a Do Not Resuscitate order, using hypothetical scenarios.
The cross-sectional survey recruited nurses across five Australian hospitals between October 2023 and April 2024. Participants were provided two hypothetical clinical scenarios (scenario 1: Mr D, an 84-year-old man; scenario 2: Mr G, a 35-year-old man). In both scenarios, the patients had unequivocal signs of death and absent Do Not Resuscitate orders. Respondents were asked to indicate their actions. Responses from participants working in the intensive care unit, emergency department, or critical care are reported here. Results were analysed using descriptive statistics.
Eighty participants working in the intensive care unit, emergency department, or critical care completed the survey. Most nurses indicated they would call a Code Blue and initiate full resuscitation in both scenarios (scenario 1: 51.3% [n = 41] vs scenario 2: 92.5% [n = 74]). Fear and a misunderstanding of the law was a recurring reason for initiating resuscitation in both scenarios. Ethical judgement and family's expectations were predominant reasons for initiating resuscitation for the younger patient (scenario 2).
Most nurses working in the intensive care unit, emergency department, or critical care areas chose to call a Code Blue and initiate full resuscitation in both scenarios where patients showed unequivocal signs of death and an absent Do Not Resuscitate order. Nurses' decisions were influenced by multiple factors, including patient's age and misconception of the law.
当前澳大利亚的复苏培训侧重于心肺复苏的实际应用，但对于何时不适合进行心肺复苏缺乏明确说明。护士通常是住院患者紧急情况的第一响应者，由于他们对心肺复苏益处的看法不同，可能会采取不同的心肺复苏方法。关于无“不要复苏”医嘱如何影响护士在医院环境中关于复苏的决策，目前缺乏相关文献。
本研究的目的是使用假设情景，探讨护士对在没有“不要复苏”医嘱且有明确死亡迹象的住院患者启动心肺复苏的看法。
这项横断面调查于2023年10月至2024年4月在澳大利亚的五家医院招募护士。为参与者提供了两个假设临床情景（情景1：84岁男性D先生；情景2：35岁男性G先生）。在这两个情景中，患者均有明确的死亡迹象且无“不要复苏”医嘱。要求受访者表明他们会采取的行动。这里报告了在重症监护病房、急诊科或重症护理部门工作的参与者的回复。使用描述性统计分析结果。
80名在重症监护病房、急诊科或重症护理部门工作的参与者完成了调查。大多数护士表示，在两种情景下他们都会呼叫“蓝色急救”并启动全面复苏（情景1：51.3% [n = 41] 对情景2：92.5% [n = 74]）。恐惧和对法律的误解是在两种情景下启动复苏的常见原因。道德判断和家属期望是对年轻患者（情景2）启动复苏的主要原因。
大多数在重症监护病房、急诊科或重症护理领域工作的护士在患者有明确死亡迹象且无“不要复苏”医嘱的两种情景下，都选择呼叫“蓝色急救”并启动全面复苏。护士的决策受到多种因素影响，包括患者年龄和对法律的误解。
