A survey of Australian and New Zealand anaesthetists' attitudes towards resuscitation orders in the perioperative setting
A survey of Australian and New Zealand anaesthetists' attitudes towards resuscitation orders in the perioperative setting
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DOI：
10.1177/0310057x1704500316
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发表时间：
2017-05-01
影响因子：
1.5
通讯作者：
Story, D. A.
中科院分区：
文献类型：
--
作者：
Keon-Cohen, Z.;Myles, P. S.;Story, D. A.
非复苏（NFR）命令通常在麻醉期间暂停，因为围手术期护理被认为固有地涉及复苏的需要，包括通气支持。最近在澳大利亚，新西兰和英国的立法变化制定了具有约束力的性质的预先护理指令（ACD）在医疗保健。关于实施预先护理计划的实践守则和政府战略计划的国家指导方针加强了预先护理计划在现代医疗保健中的作用。我们调查了随机选择的澳大利亚和新西兰的顾问和实习麻醉师，以评估他们对围手术期NFR订单和ACD的态度。我们收到了790份分布式调查中的290份（回复率为37%）。大多数（75%）受访者报告他们的知识为非常低、低或中等; 37%从未或很少治疗ACD患者。超过90%的患者报告称，患者的意愿和对ACD的理解很重要，89%的患者同意或强烈同意提前护理计划应成为高风险患者入院的常规部分。尽管如此，只有45%的受访者会一直遵循ACD。尽管本次调查的大多数受访者支持其在围手术期环境中使用，但需要澄清ACD对麻醉的具体适用性及其约束性质。
Not for resuscitation (NFR) orders are often suspended during anaesthesia, as perioperative care is believed to inherently involve the need for resuscitation including ventilation support. Recent legislative changes in Australia, New Zealand and the UK have enacted the binding nature of advance care directives (ACDs) in healthcare. National guidelines regarding codes of practice and government strategic plans for implementing advance care planning have reinforced the role for advance care planning in modern healthcare. We surveyed a random selection of Australian and New Zealand consultant and trainee anaesthetists to assess their attitudes towards NFR orders and ACDs in the perioperative setting. We received 290 of 790 distributed surveys (37% response rate). The majority (75%) of respondents reported their knowledge as very low, low, or moderate; 37% never or rarely were treating a patient who had an ACD. Over 90% reported that patient's wishes and understanding of ACDs is important and 89% agreed or strongly agreed that advance care planning should be a routine part of hospital admission for high risk patients. Despite this, only 45% of the respondents would always follow an ACD. Although the majority of respondents to this survey support their use in the perioperative setting, clarification of the specific applicability of ACDs to anaesthesia and their binding nature is required.