Limiting life-sustaining treatment in German intensive care units: a multiprofessional survey.
Details
Serval ID
serval:BIB_3C4E70211D11
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Limiting life-sustaining treatment in German intensive care units: a multiprofessional survey.
Journal
Journal of Critical Care
ISSN
1557-8615 (Electronic)
ISSN-L
0883-9441
Publication state
Published
Issued date
2010
Volume
25
Number
3
Pages
413-419
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Abstract
PURPOSE: Deciding about the limitation of life-sustaining treatment (LST) is a major challenge for intensive care medicine. The aim of the study was to investigate the practices and perspectives of German intensive care nurses and physicians on limiting LST.
METHODS: We conducted an anonymous, self-administered questionnaire survey among the 268 nurses and 95 physicians on all 10 intensive care units of the Munich University Hospital, Germany.
RESULTS: The response rate was 53%. Of all respondents, 91% reported being confronted with the topic at least once a month. Although all reported limiting cardiopulmonary resuscitation, almost no one reported limiting artificial hydration. Half of nurses and junior physicians felt uncertain about the decision-making process. Junior physicians were most dissatisfied with their training for this task and expressed the highest fear of litigation. Nurses were less satisfied than physicians with the communication process. Both nurses and relatives were not routinely involved in decision making. There is no standardized documentation practice, and many notes are not readily accessible to nurses.
CONCLUSIONS: Limiting LST is common in German intensive care units. The major shortcomings are team communication, communication with the patient's family, and documentation of the decision-making process.
METHODS: We conducted an anonymous, self-administered questionnaire survey among the 268 nurses and 95 physicians on all 10 intensive care units of the Munich University Hospital, Germany.
RESULTS: The response rate was 53%. Of all respondents, 91% reported being confronted with the topic at least once a month. Although all reported limiting cardiopulmonary resuscitation, almost no one reported limiting artificial hydration. Half of nurses and junior physicians felt uncertain about the decision-making process. Junior physicians were most dissatisfied with their training for this task and expressed the highest fear of litigation. Nurses were less satisfied than physicians with the communication process. Both nurses and relatives were not routinely involved in decision making. There is no standardized documentation practice, and many notes are not readily accessible to nurses.
CONCLUSIONS: Limiting LST is common in German intensive care units. The major shortcomings are team communication, communication with the patient's family, and documentation of the decision-making process.
Keywords
Attitude of Health Personnel, Cardiopulmonary Resuscitation/psychology, Decision Making, Documentation, Female, Fluid Therapy/psychology, Germany, Hospitals, University, Humans, Intensive Care Units/organization & administration, Interprofessional Relations, Life Support Care/psychology, Male, Medical Staff, Hospital/psychology, Nurse's Practice Patterns, Nursing Staff, Hospital/psychology, Organizational Culture, Physician's Practice Patterns, Professional-Family Relations, Questionnaires, Social Dominance, Withholding Treatment
Pubmed
Web of science
Create date
14/01/2014 10:22
Last modification date
20/08/2019 13:32
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