International journal of palliative nursing
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Multicenter Study
Jordanian critical care nurses' attitudes toward and experiences of do not resuscitate orders.
Do not resuscitate (DNR) decisions are an issue of considerable sensitivity for patients and their relatives, as well as health professionals. ⋯ This study demonstrates that Jordanian critical care nurses are willing to participate in DNR discussions and decision-making processes. Each hospital in the country should have a written DNR policy to guide and discipline health-care providers' practice.
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Nurses have a vital role in providing end-of-life care to patients and their families, and it is important that nursing students are adequately prepared for this role. ⋯ The need for more education on end-of-life care has implications for curriculum development in undergraduate nursing programmes, which need to provide graduating nurses with the necessary knowledge and skills to deliver quality care to patients who are dying and their families.
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Do not attempt cardiopulmonary resuscitation (DNACPR) decisions aim to prevent unwanted and/or clinically inappropriate CPR attempts. As the NHS Scotland DNACPR policy has become embedded into clinical practice there has been greater awareness of the need to discuss DNACPR decisions with patients who would not benefit from CPR; however, little is known about how nursing and medical staff experience these discussions. ⋯ The clinicians reported finding DNACPR discussions worthwhile and that they continue to discuss DNACPR decisions with patients despite the challenges. Recommendations for discussing DNACPR with patients are outlined.
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People with intellectual disabilities are often marginalised from mainstream health-care services because of the complexities of their disability. They are under-referred to specialist palliative care owing to a limited understanding of its role and little collaborative working. Furthermore, professionals caring for people with intellectual disabilities and palliative care services often lack knowledge about and confidence in their ability to meet the needs of people with an intellectual disability who require palliative care. ⋯ It highlights that training requirements need to be effectively identified, referrals between professional groups made, and the perspectives of patients understood to overcome the marginalisation of people with intellectual disability. There is a need for ongoing staff development focusing on staff confidence, collaborative working between professionals, and the empowerment of people with intellectual disability to be involved in decisions about their end-of-life care. Further research is needed to examine the most effective way of capturing the perspectives of those with intellectual disability and of enabling people with intellectual disability to access and engage with health surveillance, cancer screening, and palliative care services.