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Sjuksköterskors delaktighet och upplevelser vid beslutsfattande om ingen åtgärd vid hjärtstopp: en litteraturstudie
University of Gävle, Faculty of Health and Occupational Studies.
University of Gävle, Faculty of Health and Occupational Studies.
2010 (Swedish)Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
Abstract [sv]

Sammanfattning

Sedan introduktionen av HLR för 50 år sedan har förutsättningarna för att rädda liv förändrads avsevärt. Många av patienterna som vårdades på sjukhus var äldre och hade svåra kroniska sjukdomar och deras utsikter för en lyckad HLR utan följdkomplikationer var ofta minimala. Beslut om ej-HLR ska fattas av läkaren men bör föregås av samtal med övrig vårdpersonal. Syftet med studien var att identifiera sjuksköterskors delaktighet och upplevelser i beslutsprocessen när ej-HLR fattades. Studien utfördes som en deskriptiv litteraturstudie och 12 vetenskapliga artiklar kvalitets granskades. De utvalda artiklarna höll alla medel eller hög vetenskaplig kvalitet. Resultatet visade att sjuksköterskors delaktighet varierade och att delaktigheten kunde yttra sig på olika sätt. Sjuksköterskor initierade ofta beslutet om ej-HLR och upplevde moralisk stress när de stod mellan patienten och läkaren. Sjuksköteskor upplevde också en känsla av lättnad över att inte ha det yttersta ansvaret samt hade lättare att acceptera palliativ vård än vad läkaren hade. Konklusion: Tydligare riktlinjer om sjuksköterskors delaktighet skulle underlätta och minska risken för osäkerhet och passivitet hos sjuksköterskor. Det behövs ytterligare forskning om sjuksköterskors egna åsikter hur de vill ingå i beslutsfattandet om ej-HLR samt vad deras involvering ska innefatta i klinisk praxis.

Abstract [en]

Abstract

Since the introduction of CPR 50 years ago has the potential to save lives changed significantly. Many of the patients who were treated in hospitals were older and had chronic diseases and their prospects for successful CPR without following complications were often minimal. Decisions on DNR shall be taken by the physician but should be preceded by discussions with other health professionals. The aim of this study was to identify nurses' involvement and experiences in DNR decision-making. The study was conducted as a descriptive literature review and 12 scientific articles was quality examined. The selected articles were all of medium or high scientific quality. The results showed that nurses' participation varied and that participation could be heard in different ways. Nurses often initiate the order for DNR. Nurses experienced moral distress when they were between patient and doctor. Nursing also experienced a sense of relief of not having the ultimate responsibility. Nurses found it easier to accept palliative care than the doctor had.

Conclusion: Clearer guidelines on nurses' participation would facilitate and reduce the risk of uncertainty and passivity of nurses. Further research on nurses' own views of how they want to be included in decision-making on DNR is needed and what their involvement should include in clinical practice.

Place, publisher, year, edition, pages
2010. , 24 p.
Keyword [en]
CPR, DNR, nurses´participation, nursrs´experiences
Keyword [sv]
HLR, ej-HLR, sjuksköterskors delaktighet, sjuksköterskors upplevelser
National Category
Nursing
Identifiers
URN: urn:nbn:se:hig:diva-7908Archive number: SSKVk08/ht10nr3OAI: oai:DiVA.org:hig-7908DiVA: diva2:360691
Uppsok
Social and Behavioural Science, Law
Supervisors
Examiners
Available from: 2010-12-03 Created: 2010-11-04 Last updated: 2010-12-03Bibliographically approved

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CiteExportLink to record
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Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
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More styles
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  • sv-SE
  • Other locale
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