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At least 19 recordsLinked to original sources
PubMedDate not supplied

Perspectives on CPR: resuscitation or resurrection?

The use of cardiopulmonary resuscitation (CPR) is controversial. Recently allegations of age discrimination have been made. Revised guidance from the British Medical Association, Royal College of Nursing and the Resuscitation Council (UK) provides valuable help, including implications of the Human Rights Act 1998 and the Adults with Incapacity (Scotland) Act 2000. Patients do not have rights to useless treatments and CPR should not be used if there is no reasonable prospect of success. Current evidence suggests that legislation would not be helpful.

Age Factors↗
PubMedDate not supplied

Euthanasia. The issue of resuscitation.

Euthanasia in this country is illegal, but issues surrounding 'do not resuscitate' guidelines raise the questions on the right to a death with dignity for many nurses. In this paper the author discusses the statement by the British Medical Association and the Royal College of Nursing on cardiopulmonary resuscitation and advises health practitioners to use this statement as a guideline for their own policy and framework in hospitals and not to accept this framework as implicit.

Ethics, Medical↗
PubMedDate not supplied

Extended nurse prescribing: improving care for older people.

This article examines the benefits to older patients in a hospital setting, including assessment, diagnosis and treatment by a nurse who is competent in the field and has in-depth personal and professional knowledge of that person. It explores how this approach promotes individual high quality care through a patient-centred focus and empowerment while supporting the Department of Health and Scottish Executive Health Department's agenda for service redesign. It also explores how expansion of the extended independent nurse prescriber's formulary will not compromise patient safety. It recommends that nurses practicing in non-acute care areas consider developing as extended independent nurse prescribers to raise standards of patient-centred care delivered to older people in hospital. The Nurse Prescribers' Extended Formulary (British Medical Association and Royal Pharmaceutical Society of Great Britain in association with Community Practitioners, Health Visitors' Association and Royal College of Nursing, 2003) is referred to throughout this paper as the nurses' formulary, nurse prescribers' formulary or nurse prescribers' extended formulary.

Aged↗
PubMedDate not supplied

Do not attempt resuscitation decisions: the nursing role.

This exploratory study examines the roles of practice nurses with regard to do not attempt resuscitation (DNAR) decisions. The British Medical Association (BMA) and the Royal College of Nursing (RCN) have published joint DNAR guidelines. One NHS trust responded by developing a local DNAR policy written for use in hospital and general practice. The study focuses on aspects of compliance with the policy and hence DNAR decision-making, in particular, the nurse's involvement in the decision-making process. The response rate to self-administered questionnaires to practice nurses was 52% (n = 45). Hospital nurses (n = 49) were selected for interview using a quota-sampling technique. Comparisons were made of the views of acute and community staff in their use of the DNAR policy. A clear finding is that hospital nurses wish for more autonomy in DNAR decision-making and improved methods of communicating with medical colleagues when decisions are made. Practice nurses are currently not involved in DNAR decisions. The appropriateness of developing policies for such complex issues as DNAR, when compliance remains low, questions their validity. This study raises awareness, and adds to the discussion for the need for a multidisciplinary approach to DNAR policy.

Clinical Nursing Research↗
PubMed2001

The extended role of the nurse--opportunity or threat?

Nursing practice is undergoing changes that are both exciting and controversial. The UKCC Scope of Professional Practice has encouraged nurses to re-evaluate their practice and, as a result, nurses from various fields have expanded their roles to meet the changing needs of patients and the profession. Published evidence shows that nurses can be as effective as doctors within these expanded roles, but that there is a danger that gender issues will cloud the debate because of the assumption that all nurses are female and all doctors are male. This problem is especially evident when female nurses perform an extended role involving male patients, although female doctors are in a similar position and work with the same patients without undue comment. The roles of doctors and nurses should complement each other, and all practitioners should work for the benefit of patients in their care, rather than defending traditional roles and hierarchy. There is confusion surrounding accountability of nurses who work in an extended role between the medical and the nursing profession, and both the Royal College of Nursing and the British Medical Association need to clarify the situation. This article looks at the arguments for and against the extended role of the nurse specialist and discusses current opinions within the nursing and medical fields. The article also describes how nurses at Midland Fertility Services have successfully extended their role to encompass ultra-sound-guided oocyte retrieval and surgical sperm recovery.

Education, Nursing↗
PubMedDate not supplied

Discussing cardiopulmonary resuscitation with patients.

The British Medical Association and the Royal College of Nursing acknowledge that patients should be involved in the decision-making process regarding cardiopulmonary resuscitation (CPR) in order to gain compliance with any decision made on their behalf. In the past, it was apparent that decisions concerning the eligibility of patients for CPR were being made arbitrarily and older people were being treated unfairly in respect of their consideration for this intervention. This article reviews literature associated with patient involvement in decision-making regarding CPR and 'do not resuscitate' orders and how an assessment and rehabilitation unit promoted this activity as usual practice. In order to enhance partnership with patients and promote best possible practice in respect of CPR decision making the authors suggest a strategy that includes (1) evaluating documentation (2) development of a patient information leaflet and (3) an education programme for healthcare personnel.

Advance Directives↗
PubMedDate not supplied

Intubation training: an ethical practice?

Some hospitals allow junior doctors, nurses and paramedical staff to practise the technique of intubation on recently deceased patients. The Royal College of Nursing, in common with the British Medical Association, believes that this practice can only be justified in the most exceptional circumstances where the deceased patient has suffered severe head, neck or facial injuries. It may then be acceptable for learners already skilled in intubation techniques to extend their knowledge for the benefit of future patients with similar injuries who might, as a result, have a prospect of survival.

Cadaver↗
PubMed1996

Nurses' views of the decision not to resuscitate a patient.

The decision not to resuscitate a patient is a complex issue and there is little guidance for nurses on how such a decision is made. The aim of this study was, therefore, to explore the views and working practices of staff in relation to current guidelines and theories, using a situational analysis. Overall, the staff seemed to meet the criteria outlined in the guidelines, although there was little awareness of the guidelines. Nurses in the clinical area should be both educated in the recommendations for practice and should be consulted and involved in developing such recommendations.

Attitude of Health Personnel↗
PubMedDate not supplied

Patient involvement in resuscitation decisions.

The dilemma over whether patients should be involved in resuscitation decisions is a crucial issue as it brings into question some of the fundamental principles on which we base our practice. Nurses have a vital role to play in protecting patients' autonomy.

Advance Directives↗
PubMed1996

Some dilemmas of living wills.

The question of care of terminally ill patients is, as we all know, fraught with difficulties which become more rather than less intense with new developments in medical systems. Once, doctors were not faced with the question of whether to keep someone alive when it was scarcely in their power to intervene in nature's course. Today, with new powers to keep people alive, the question arises, with ever greater urgency, when and whether those powers should be used.

Cultural Diversity↗
PubMed2002

Professional perceptions about home safety: cross-national validation of the Home Falls and Accidents Screening Tool (HOME FAST).

The Home Falls and Accidents Screening Tool (HOME FAST) was developed to measure the risk of older people falling within their home environment. If this tool is to be effective, the underlying dimensions perceived by potential raters when using the HOME FAST need to be consistent with the purpose of the tool. The content validation process undertaken to evaluate the HOME FAST and a method to develop a home safety score are described. Experts in home safety assessment were recruited from the British Association of Occupational Therapy, the Chartered Society of Physiotherapists, and the Royal College of Nursing in the United Kingdom. Participants rated each HOME FAST item using a Thurstone technique format. Each item was weighted according to the level of perceived falls risk each expert attributed to the home safety item. Principal components factor analysis identified a two-factor structure interpreted as environment and function underlying the HOME FAST. Results indicated that no item should be deleted from the checklist. Weights were calculated for each item to generate an overall hazard score. Some differences in responses to the degree of risk associated with home safety items were noted between the professional groups. The HOME FAST has captured highly relevant home safety items considered by an expert panel and measures a domain applicable to home safety and falls risk.

Accidental Falls↗
PubMed1997

Hypoglycaemia of the newborn.

The seven points of these hypoglycaemia guidelines, together with their explanatory text, were drawn up by a group of 25 leading health professionals and breast-feeding counsellors. Midwives on the group included Catherine McCormick and Melanie Every, RCM; Dora Henschel, MBE, Sally Inch, Ann Newman. Professor Mary Renfrew and Penelope Samuel. The initiative was co-ordinated by the National Childbirth Trust, with initial funding from the Department of Health. The guidelines have been endorsed by the Royal College of Midwives, the Neonatal Nurses' Association, UNICEF UK Baby Friendly Initiative and the British Association of Perinatal Medicine, and are supported by the Department of Health. Copies are available from NCT Maternity Sales Ltd, 239 Shawbridge Street, Glasgow G43 1QN; tel: 0141 636 0600.

Blood Glucose↗