Ethical Issues for Emergency Nurses during Resuscitation of Injured Patients

急诊护士在受伤患者复苏过程中的道德问题

• 批准号: 7329214
• 负责人: Mindy B Zeitzer
• 金额: $ 3.46万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-08-01 至 2009-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7329214
• 关键词: Accident and Emergency department; Address; Affect; Age; Belief; Bioethics; Cardiopulmonary Resuscitation; Care given by nurses; Caring; Complex; Conflict (Psychology); Data; Decision Making; Depth; Discipline of Nursing; Distress; Emergency Nursing; Environment; Ethical Issues; Ethics; Face; Family member; Frequencies; Future; Goals; Health; Health Personnel; Health Status; Hospitals; Injury; Intervention; Interview; Knowledge; Lead; Legal; Life; Medical; Methods; Mission; Morals; Names; Nature; Nurse' s Role; Nurses; Nursing Specialties; Occupations; Outcome; Patient Care; Patients; Perception; Physiological; Play; Process; Provider; Public Health; Purpose; Quality of Care; Research; Resource Allocation; Resuscitation; Resuscitation Decision; Societies; Stress; Structure; Technology; Translating; Trauma; Trauma Nursing; Work; Workplace; coping; cost; design; end of life; expectation; experience; improved; injured; member; trauma centers

DESCRIPTION (provided by applicant): Nurses working in emergency departments ED of trauma centers participate as members of the trauma team in the initial resuscitation of severely injured patients. Decisions regarding these resuscitations are made in high stress environments and are inevitably rife with ethical issues due to the high frequency of injury and its exorbitant costs to society. These decisions are made with little background knowledge about the patients during a complex process of rapid assessment of physiological status overlaid by ethical principles, societal norms and expectations, and legal mandates. Research shows that nurses are confronted with various ethical issues throughout many nursing specialties, leading to consequences such as job dissatisfaction and moral distress which can decrease quality of care. However, the specific ethical issues ED nurses experience during the resuscitation of severely injured patients, the factors contributing to the ethical decisions made during the these situations, and how nurses are involved in these decisions remain largely unknown. The purpose of this study is to explicate ED nurses' perceptions of ethical issues and decisions during resuscitation of severely injured patients. A qualitative descriptive design using semi- structured face-to-face interviews of ED nurses participating in the initial resuscitation of severely injured patients will be used to answer the following four research questions: 1.) What ethical issues arise during the initial resuscitation of severely injured patients?, 2.) How are ED nurses affected by the ethical issues that arise during initial resuscitation of severely injured patients?, 3.) What factors contribute to the ethical decisions made during the initial resuscitation of severely injured patients?, and 4.) How are nurses involved in making decisions during resuscitation of severely injured patients? This study will initiate a trajectory of empirical bioethics research examining the ethics involved in trauma and the effects they have on health care providers. This will ultimately lead to methods of improving health care provider ethical decision making in regards to trauma patients and situations thereby improving the care trauma patients receive. The negative effects of ethical issues can lead to decreased quality of care and poor patient outcomes. With the high occurrence of injury, decreased quality of care and poor patient outcomes can have devastating effects on public health. Addressing the ethical issues encountered by the ED nurses can lead to strategies and interventions to assist in coping with these issues and decisions. This will not only improve public health, but also address NINR's mission statement and strategic goals improving the nursing work environment, quality of care, and possibly retention of nurses.

描述（由申请人提供）：在创伤中心急诊科工作的护士作为创伤团队的成员参与重伤患者的初步复苏。有关这些复苏的决定是在高压环境下做出的，并且由于受伤频率高及其对社会造成的高昂成本，不可避免地充满道德问题。这些决定是在对患者生理状态进行快速评估的复杂过程中做出的，对患者的背景知识知之甚少，并受到伦理原则、社会规范和期望以及法律要求的影响。研究表明，许多护理专业的护士都面临着各种道德问题，导致工作不满和道德困扰等后果，从而降低护理质量。然而，急诊室护士在重伤患者复苏过程中遇到的具体道德问题、在这些情况下做出道德决策的因素以及护士如何参与这些决策仍然很大程度上未知。本研究的目的是阐明急诊室护士对重伤患者复苏过程中道德问题和决策的看法。对参与重伤患者初始复苏的急诊科护士进行半结构化面对面访谈的定性描述性设计将用于回答以下四个研究问题：1.）在重伤患者初始复苏过程中出现哪些道德问题？，2.）急诊科护士如何受到重伤患者初始复苏过程中出现的道德问题的影响？，3.）哪些因素影响在重伤患者初始复苏过程中做出的道德决策？ 重伤患者的初步复苏？以及 4.) 护士如何参与重伤患者复苏过程中的决策？这项研究将启动实证生物伦理学研究的轨迹，研究创伤所涉及的伦理及其对医疗保健提供者的影响。这最终将导致改善医疗保健提供者对创伤患者和情况的道德决策的方法，从而改善创伤患者接受的护理。道德问题的负面影响可能导致护理质量下降和患者预后不佳。由于伤害发生率高，护理质量下降和患者预后不佳可能对公共健康产生破坏性影响。解决急诊护士遇到的道德问题可以制定策略和干预措施来协助应对这些问题和决策。这不仅将改善公众健康，还将实现 NINR 的使命宣言和战略目标，改善护理工作环境、护理质量，并可能保留护士。