Universal Journal of Public Health Vol. 4(2), pp. 55 - 59
DOI: 10.13189/ujph.2016.040202
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A Vital Decision about Life – Doctors' and Nurses' Attitudes to Current Procedures for DNR-orders at Swedish University Hospital

Adrian D. Meehan ^1,*, Linn Brosché ^2
1 Department of Geriatrics, Faculty of Medicine and Health, Orebro University, Sweden
² Faculty of Medicine and Health, Orebro University, Sweden

ABSTRACT

Objective: Hospital physicians in Sweden most often decide do-not-resuscitate orders (DNR) without collaboration. Systematic pre-arrest indicators of cardiopulmonary resuscitation (CPR) do not exist. Therefore, new, and for the first time, national ethical guidelines on CPR have recently been published in Sweden. We aimed primarily to investigate if doctors and nurses knew about the guidelines and thereafter to gauge their attitudes concerning DNR. Methods: An anonymous questionnaire was conducted of 48 doctors and 45 nurses (n=93) at surgical, medical and geriatric clinics at Örebro University Hospital, Sweden. A response rate of 62% was achieved. The questionnaire contained 17 questions; four about background information and 13 questions about procedures concerning DNR-orders where responses "yes, always", "normally", "seldom", "no, never" and "don't know" were most often available. Respondents were also invited to leave explanatory remarks. Results: Eighty percent of doctors knew about the new ethical guidelines, in contrast to 42% of nurses. Twenty-seven percent of doctors discussed with patients DNR-orders "normally", though 31% did it "seldom". Whereas nurses did this either "seldom" (40%) or "never" (58%). Ninety-one percent of nurses were in favour of patient involvement in decision-making concerning DNR-orders. Conclusion: While a moderate level of knowledge of the ethical guidelines existed, especially in doctors, the present study highlights a possible discrepancy between the awareness of the guidelines with the prevailing hospital praxis and the general attitudes of respondents. The study questions to what extent the guidelines are in fact implemented. Greater involvement of nurses, other paramedic staff and patients may lead to improve in-hospital patient care. Further descriptive and qualitative studies would be useful to explore these issues.

KEYWORDS
Do Not Resuscitate Order (DNR), DNR Guidelines, Ethics, Physicians, Nurses

Cite This Paper in IEEE or APA Citation Styles
(a). IEEE Format:
[1] Adrian D. Meehan , Linn Brosché , "A Vital Decision about Life – Doctors' and Nurses' Attitudes to Current Procedures for DNR-orders at Swedish University Hospital," Universal Journal of Public Health, Vol. 4, No. 2, pp. 55 - 59, 2016. DOI: 10.13189/ujph.2016.040202.

(b). APA Format:
Adrian D. Meehan , Linn Brosché (2016). A Vital Decision about Life – Doctors' and Nurses' Attitudes to Current Procedures for DNR-orders at Swedish University Hospital. Universal Journal of Public Health, 4(2), 55 - 59. DOI: 10.13189/ujph.2016.040202.