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护理人员参与养老院临终营养和水份补充的决策:定性研究
Author(s) -
Firnhaber Gina C.,
Roberson Donna W.,
Kolasa Kathryn M.
Publication year - 2020
Publication title -
journal of advanced nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.948
H-Index - 155
eISSN - 1365-2648
pISSN - 0309-2402
DOI - 10.1111/jan.14491
Subject(s) - nursing , nursing assistant , qualitative research , focus group , nurse education , participant observation , medicine , psychology , nursing homes , sociology , social science , anthropology
Aim To better understand the participation of nursing staff in end‐of‐life nutrition and hydration decision‐making in an American nursing home. Design A qualitative exploration with ethnographic focus. Methods In April 2017, in‐person, semi‐structured interviews were performed with 19 nursing staff members in a nursing home located in the south‐eastern United States. Additional information was gathered through participant observation during interviews and review of organizational and regulatory policies. Transcripts were coded and analysed using qualitative methods described by Roper and Shapira (2000). Results Three primary themes relating to nursing staff participation in end‐of‐life nutrition and hydration decision‐making were identified: (a) Formal decision‐making: decisions made and implemented by persons with the authority to make legal and binding care decisions in the nursing home setting; (b) Informal decision‐making: decisions not requiring medical orders; and (c) Influential factors: factors that influence actions of nursing staff. Conclusion A variety of factors have an impact on nursing staff participation in end‐of‐life nutrition and hydration decision‐making. Participation is closely aligned with the type of decision, whether formal or informal, and role, whether Certified Nursing Assistant/Aide, Licensed Practical/Vocational Nurse, or Registered Nurse. Impact End‐of‐life nutrition and hydration decision‐making in nursing homes differs from decision‐making in other care settings and presents a challenge globally. Interventions that support the participation of nursing staff in end‐of‐life nutrition and hydration decision‐making have the potential to positively impact the experiences of residents and family members faced with these issues in the nursing home setting.