ABSTRACT
The purpose of this survey of Nebraska hospitals (N = 79) was to describe the planning, implementation, and evaluation of the Patient Self-Determination Act (PSDA) and to explore the role of the nurse in these processes. Results indicate nurses were very involved in the planning phase but rarely in the implementing phase. Few evaluation strategies were utilized and only some respondents identified problematic issues related to the implementation of the PSDA. Clinical implications for issues related to the PSDA are discussed and framed within the American Nurses' Association Position Statement on the PSDA (1991). Future studies are suggested, especially related to evaluation of PSDA implementation.
Subject(s)
Legislation, Hospital , Patient Acceptance of Health Care , Patient Advocacy/legislation & jurisprudence , Treatment Refusal/legislation & jurisprudence , American Nurses' Association , Federal Government , Government Regulation , Humans , Legislation, Hospital/statistics & numerical data , Nebraska , Nursing Administration Research/statistics & numerical data , Nursing Staff, Hospital/legislation & jurisprudence , Nursing Staff, Hospital/statistics & numerical data , Patient Acceptance of Health Care/statistics & numerical data , Patient Advocacy/statistics & numerical data , Professional Role , Surveys and Questionnaires , Treatment Refusal/statistics & numerical data , United StatesABSTRACT
A case was used to examine ethical challenges in the neonatal intensive care unit from the perspective of parents and nurses. Discussion focuses on issues of treatment versus nontreatment, informed consent, and decision making. An integration of crisis intervention techniques and caring processes is presented for nurses to assist parents through the neonatal intensive care unit experience.
