Geronimo, Rachelle B. 4 0
Quality of nursing care to critically-ill patients with do-not-resuscitate consent 6 6 Geronimo, Rachelle B. - - - xii, 183 pages 280 cm. - - - - - . - . - 0 . - . - 0 .
Thesis (Graduate) Pamantasan ng Lungsod ng Maynila, 2015;A Thesis Presented to the Faculty of the Graduate School of Health Sciences in Partial Fulfillment of the requirements for the degree of Master of Arts in Nurwsing
5
ABSTRACT: This study aims to describe how a critically-ill patient with Do-Not-Resuscitate (DNR) consent is being treated and cared for by nurses in the Intensive Care Unit (ICU). Nine nurses with at least 2 years of clinical experience working in the critical care setting shared the meaning of their experiences on how they provided treatment and nursing management in caring for patients with DNR consent during a semi-structured in-depth interview via Skype. Qualitative method of research specifically the Descriptive type of Phenomenology was made use in this study. Themes were gathered from the analysis of these interviews with the aid of the combination of Data Analysis frameworks. The four themes that emerged are: 1) Poor Quality of Nursing Care: 2) Conflicts of care: DNR patients vs. Non-DNR patients vs. Non-DNR patients; 3) Multiple factors hinder quality of nursing care; 4) Nurse's complacency and suppressed emotions. Findings of the study showed that participants believe, based from their experiences of treating and caring for patients with DNR consent that nurses knowledge and behavior on DNR, inappropriate staff levels, patient and nurse ratio, families and financial constraints influence the quality of treatment and care provided to these patients in the ICU. Regardless of these constraints, some of the nurses believed that provision of equal, and quality treatment and nursing management is a must to all patients in the ICU. Hence, it will also give the family comfort in knowing and seeing that everything is being done for their loved ones. It was also revealed in the study that nurses experiences and personal perspective on DNR orders influenced and showed the quality of treatment and care provided to their patients. Thus, the ICU nurses do not prioritize treatment and nursing care of critically-ill patients with DNR orders, but basic needs and nursing care are provided. The majority of participants were in support of a policy/guideline development on DNR for they believed it will serve as a direction and will emphasize the quality treatment and nursing care needed by critically-ill patients. From their experiences, the nurses think that such policy/guideline would facilitate greater understanding and improvement in the practice of treating and caring for critically-ill patients amongst health care professionals. Qualitative findings revealed that personal, organizational and social factors influence nurses quality of care towards patients with DNR consent. The nursing staff is committed to changing their practice which can be seen in the findings of this study. As indicated, there is a call for the development of written policies and guidelines on DENR practice to meet the needs of patients, families, and staff through the provision of consistent, safe, and caring practices for all involved in the no resuscitation process. The conceptual model of quality of care among patients with DNR consent can be useful in the practice of evidence-based nursing as a guide and aid in professional development, thus, giving opportunities for nurses to further become empowered within their DNR practice.
5
2 = =
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2 --0------
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0 2 --
--20------
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----2
/ 2
/ 2
/
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Quality of nursing care to critically-ill patients with do-not-resuscitate consent 6 6 Geronimo, Rachelle B. - - - xii, 183 pages 280 cm. - - - - - . - . - 0 . - . - 0 .
Thesis (Graduate) Pamantasan ng Lungsod ng Maynila, 2015;A Thesis Presented to the Faculty of the Graduate School of Health Sciences in Partial Fulfillment of the requirements for the degree of Master of Arts in Nurwsing
5
ABSTRACT: This study aims to describe how a critically-ill patient with Do-Not-Resuscitate (DNR) consent is being treated and cared for by nurses in the Intensive Care Unit (ICU). Nine nurses with at least 2 years of clinical experience working in the critical care setting shared the meaning of their experiences on how they provided treatment and nursing management in caring for patients with DNR consent during a semi-structured in-depth interview via Skype. Qualitative method of research specifically the Descriptive type of Phenomenology was made use in this study. Themes were gathered from the analysis of these interviews with the aid of the combination of Data Analysis frameworks. The four themes that emerged are: 1) Poor Quality of Nursing Care: 2) Conflicts of care: DNR patients vs. Non-DNR patients vs. Non-DNR patients; 3) Multiple factors hinder quality of nursing care; 4) Nurse's complacency and suppressed emotions. Findings of the study showed that participants believe, based from their experiences of treating and caring for patients with DNR consent that nurses knowledge and behavior on DNR, inappropriate staff levels, patient and nurse ratio, families and financial constraints influence the quality of treatment and care provided to these patients in the ICU. Regardless of these constraints, some of the nurses believed that provision of equal, and quality treatment and nursing management is a must to all patients in the ICU. Hence, it will also give the family comfort in knowing and seeing that everything is being done for their loved ones. It was also revealed in the study that nurses experiences and personal perspective on DNR orders influenced and showed the quality of treatment and care provided to their patients. Thus, the ICU nurses do not prioritize treatment and nursing care of critically-ill patients with DNR orders, but basic needs and nursing care are provided. The majority of participants were in support of a policy/guideline development on DNR for they believed it will serve as a direction and will emphasize the quality treatment and nursing care needed by critically-ill patients. From their experiences, the nurses think that such policy/guideline would facilitate greater understanding and improvement in the practice of treating and caring for critically-ill patients amongst health care professionals. Qualitative findings revealed that personal, organizational and social factors influence nurses quality of care towards patients with DNR consent. The nursing staff is committed to changing their practice which can be seen in the findings of this study. As indicated, there is a call for the development of written policies and guidelines on DENR practice to meet the needs of patients, families, and staff through the provision of consistent, safe, and caring practices for all involved in the no resuscitation process. The conceptual model of quality of care among patients with DNR consent can be useful in the practice of evidence-based nursing as a guide and aid in professional development, thus, giving opportunities for nurses to further become empowered within their DNR practice.
5
2 = =
2
2 --0------
6 --0-- 2 --------
0 2 --
--20------
--------20--
--------20--
----2
/ 2
/ 2
/
/