ABSTRACT
PURPOSE: The purpose of this study is to identify the changes to nursing activities of nurses on patients with DNR (Do-Not-Resuscitate) order and factors associated to the changes. METHODS: Data were collected using a structured questionnaire for 173 nurses at general hospitals. Logistic regression analysis was performed on the data using SAS 9.4. RESULTS: With 39 nursing activities, an average of 60.4 (34.9%) nurses reported an increase in the activities, 102.4 (59.2%) no change and 10.1 (5.9%) a drop. The activity increase was the greatest in the social area, and the physical area was where the activities decreased the most. The activity increase was associated knowledge competency (9 items), attitudes (2 items), practical competency (4 items) and work load (14 items were). CONCLUSION: To offer systematical care for DNR patients, it is necessary to expand nurses' knowledge through end-of-life education and adjust their workload and provide a support system at the department level.
Subject(s)
Humans , Education , Hospitals, General , Logistic Models , Nursing Care , Nursing , Resuscitation Orders , Terminal CareABSTRACT
PURPOSE: The purpose of this study is to describe and understand the meaning and the structure of subjective experiences of intensive care nurses with death of patients with do-not-resuscitate (DNR) orders. METHODS: Data were collected from eight intensive care nurses at general hospitals using individual in-depth interviews and analyzed by phenomenological research method. RESULTS: The nurses' experiences were grouped into four theme clusters: 1) ambiguity of death without correct answer, 2) a dilemma experienced at the border between death and work, 3) the weight of death that is difficult to carry and 4) death-triggered reflection of life. CONCLUSION: It is necessary to develop accurate judgment criteria for DNR, detailed regulations on the DNR decision process, guidelines and education on DNR patient care for nurses. It is also needed to develop an intervention program for DNR patients' families.