scholarly journals ANZICS guiding principles for complex decision making during the COVID-19 pandemic

2020 ◽  
Vol 22 (2) ◽  
pp. 98-102
Author(s):  
Stephen Warrillow ◽  
◽  
Danielle Austin ◽  
Winston Cheung ◽  
Eliana Close ◽  
...  
Keyword(s):  
Decision Making ◽  
Intensive Care ◽  
Ethical Decision ◽  
Clinical Decision Making ◽  
Ethical Decision Making ◽  
Clinical Decision ◽  
Intensive Care Society ◽  
Admission Policies ◽  
Complex Decision Making ◽  
Complex Decision

The global 2019 coronavirus disease (COVID-19) pandemic has led to major challenges in clinical decision making when the demand for intensive care exceeds local capacity. In order to promote consistent, transparent, objective and ethical decision making, the Australian and New Zealand Intensive Care Society (ANZICS) formed a committee to urgently develop guidelines outlining key principles that should be utilised during the pandemic. This guidance is intended to support the practice of intensive care specialists during the COVID-19 pandemic and to promote the development of local admission policies that should be endorsed by health care organisations and relevant local authorities.

Ethical Issues for Neonatal Nurses

1998 ◽  
Vol 5 (3) ◽  
pp. 206-217 ◽  
Author(s):  
Kaye Spence
Keyword(s):  
Decision Making ◽  
Intensive Care ◽  
Ethical Decision ◽  
Clinical Decision Making ◽  
Ethical Decision Making ◽  
Ethical Issues ◽  
Response Rate ◽  
Clinical Decision ◽  
Neonatal Nurses ◽  
Ethical Decisions

This article examines the involvement of neonatal nurses in ethical issues, achieved through a survey of Australian neonatal nurses. The aim was to discover if nurses were involved in ethical decisions, to examine various categories of neonates and the concerns that nurses felt about them, and to determine the extent to which nurses saw themselves as advocates. A response rate of 65% was achieved from nurses in two states who worked in intensive care and special care nurseries. The findings show that nurses were more likely to be involved in clinical decision making than in ethical decision making, showed the greatest concern for infants who had an uncertain prognosis, and saw themselves as advocates for their patients. The issues surrounding these findings are examined.

Factors that impact on emergency nurses’ ethical decision-making ability

2016 ◽  
Vol 25 (7) ◽  
pp. 855-866 ◽  
Author(s):  
Barbara Alba
Keyword(s):  
Decision Making ◽  
Research Design ◽  
Ethical Decision ◽  
Clinical Decision Making ◽  
Ethical Decision Making ◽  
Clinical Decision ◽  
Significant Finding ◽  
Emergency Nurses ◽  
Nursing Experience ◽  
Rational Thought

Background: Reliance on moral principles and professional codes has given nurses direction for ethical decision-making. However, rational models do not capture the emotion and reality of human choice. Intuitive response must be considered. Research purpose: Supporting intuition as an important ethical decision-making tool for nurses, the aim of this study was to determine relationships between intuition, years of worked nursing experience, and perceived ethical decision-making ability. A secondary aim explored the relationships between rational thought to years of worked nursing experience and perceived ethical decision-making ability. Research design and context: A non-experimental, correlational research design was used. The Rational Experiential Inventory measured intuition and rational thought. The Clinical Decision Making in Nursing Scale measured perceived ethical decision-making ability. Pearson’s r was the statistical method used to analyze three primary and two secondary research questions. Participants: A sample of 182 emergency nurses was recruited electronically through the Emergency Nurses Association. Participants were self-selected. Ethical considerations: Approval to conduct this study was obtained by the Adelphi University Institutional Review Board. Findings: A relationship between intuition and perceived ethical decision-making ability ( r = .252, p = .001) was a significant finding in this study. Discussion: This study is one of the first of this nature to make a connection between intuition and nurses’ ethical decision-making ability. Conclusion: This investigation contributes to a broader understanding of the different thought processes used by emergency nurses to make ethical decisions.

scholarly journals Understanding the Lived Experiences of Patients: Application of a Phenomenological Approach to Ethics

2010 ◽  
Vol 90 (8) ◽  
pp. 1185-1197 ◽  
Author(s):  
Bruce H. Greenfield ◽  
Gail M. Jensen
Keyword(s):  
Decision Making ◽  
Ethical Decision ◽  
Clinical Decision Making ◽  
Ethical Decision Making ◽  
Clinical Decision ◽  
Phenomenological Approach ◽  
Phenomenological Inquiry ◽  
Ethical Decisions ◽  
Moral Context ◽  
The Everyday

This perspective article provides a justification, with an overview, of the use of phenomenological inquiry and the interpretation into the everyday ethical concerns of patients with disabilities. Disability is explored as a transformative process that involves physical, cognitive, and moral changes. This perspective article discusses the advantages of phenomenology to supplement and enhance the principlist process of ethical decision making that guides much of contemporary medical practice, including physical therapy. A phenomenological approach provides a more contextual approach to ethical decision making through probing, uncovering, and interpreting the meanings of “stories” of patients. This approach, in turn, provides for a more coherent and genuine application of ethical principles within the “textured life-world” of patients and their evolving values as they grapple with disability to make ethical and clinical decisions. The article begins with an in-depth discussion of the current literature about the phenomenology of people with disability. This literature review is followed by a discussion of the traditional principlist approach to making ethical decisions, which, in turn, is followed by a discussion of phenomenology and its tools for use in clinical inquiry and interpretation of the experiences of patients with disabilities. A specific case is presented that illustrates specific tools of phenomenology to uncover the moral context of disability from the perspective of patients. The article concludes with a discussion of clinical, educational, and research implications of a phenomenological approach to ethics and clinical decision making.

Neonatal nurse practitioner ethics knowledge and attitudes

2018 ◽  
Vol 26 (7-8) ◽  
pp. 2247-2258
Author(s):  
Mobolaji Famuyide ◽  
Caroline Compretta ◽  
Melanie Ellis
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Nurse Practitioners ◽  
Neonatal Intensive Care ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Ethical Issues ◽  
Neonatal Nurse Practitioners

Background: Neonatal nurse practitioners have become the frontline staff exposed to a myriad of ethical issues that arise in the day-to-day environment of the neonatal intensive care unit. However, ethics competency at the time of graduation and after years of practice has not been described. Research aim: To examine the ethics knowledge base of neonatal nurse practitioners as this knowledge relates to decision making in the neonatal intensive care unit and to determine whether this knowledge is reflected in attitudes toward ethical dilemmas in the neonatal intensive care unit. Research design: This was a prospective cohort study that examined decision making at the threshold of viability, life-sustaining therapies for sick neonates, and a ranking of the five most impactful ethical issues. Participants and research context: All 47 neonatal nurse practitioners who had an active license in the State of Mississippi were contacted via e-mail. Surveys were completed online using Survey Monkey software. Ethical considerations: The study was approved by the University of Mississippi Medical Center Institutional Review Board (IRB; #2015-0189). Findings: Of the neonatal nurse practitioners who completed the survey, 87.5% stated that their religious practices affected their ethical decision making and 76% felt that decisions regarding life-sustaining treatment for a neonate should not involve consultation with the hospital’s legal team or risk management. Only 11% indicated that the consent process involved patient understanding of possible procedures. Participating in the continuation or escalation of care for infants at the threshold of viability was the top ethical issue encountered by neonatal nurse practitioners. Discussion: Our findings reflect deficiencies in the neonatal nurse practitioner knowledge base concerning ethical decision making, informed consent/permission, and the continuation/escalation of care. Conclusion: In addition to continuing education highlighting ethics concepts, exploring the influence of religion in making decisions and knowing the most prominent dilemmas faced by neonatal nurse practitioners in the neonatal intensive care unit may lead to insights into potential solutions.

scholarly journals Storytelling, Safeguarding, Treatment, and Responsibility: attributes of recovery in psychiatric intensive care units

2014 ◽  
Vol 11 (02) ◽  
pp. 105-118 ◽  
Author(s):  
Karleen Gwinner ◽  
Louise Ward
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Mental Illness ◽  
Intensive Care ◽  
Lived Experience ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Review Of Literature ◽  
Psychiatric Distress ◽  
Nurse Knowledge

AbstractBackground and aimIn recent years, policy in Australia has endorsed recovery-oriented mental health services underpinned by the needs, rights and values of people with lived experience of mental illness. This paper critically reviews the idea of recovery as understood by nurses at the frontline of services for people experiencing acute psychiatric distress.MethodData gathered from focus groups held with nurses from two hospitals were used to ascertain their use of terminology, understanding of attributes and current practices that support recovery for people experiencing acute psychiatric distress. A review of literature further examined current nurse-based evidence and nurse knowledge of recovery approaches specific to psychiatric intensive care settings.ResultsFour defining attributes of recovery based on nurses’ perspectives are shared to identify and describe strategies that may help underpin recovery specific to psychiatric intensive care settings.ConclusionThe four attributes described in this paper provide a pragmatic framework with which nurses can reinforce their clinical decision-making and negotiate the dynamic and often incongruous challenges they experience to embed recovery-oriented culture in acute psychiatric settings.

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