某醫學中心住院病人簽署不施予心肺復甦術之概況探討

目的：本研究探討某醫學中心病人簽署不施行心肺復甦術的情況，了解不施予心肺復甦術簽署及跨領域團隊照護情況，供臨床醫護人員參考。方法：本研究為病歷回溯式橫斷研究設計，以住院病人簽署不施予心肺復甦術者為研究對象，由臨床病人資料庫提供去辨識檔案，排除條件後，篩選年滿20歲病人的相關資料共9,281人，使用SPSS/Windows 22.0軟體作資料統整與分析，以平均值、百分比分析病人的基本資料、簽署同意書類別、會診跨領域團隊狀況。結果：於2016至2020年間，本研究樣本9,281人，其中由最近親屬填寫「不施行心肺復甦術同意書」為73.7-79.7%，本人填寫「預立安寧緩和醫療暨維生醫療抉擇意願書」為17.0-25.4%。有48.0%會診安寧緩和醫師，33.3%會診安寧共同照護護理師。結論：醫療團隊了解病人臨終準備的時間，協助病人及家屬簽署不施行心肺復甦術的過程，盡早讓緩和療護團隊能無縫接軌提供更及時性及連續性之照顧，將會讓病人及家屬甚至照護團隊達到安心無憾的醫療品質。

關鍵字

不施予心肺復甦術；末期診斷；緩和醫療照護

並列摘要

Objectives: This study explores patients who sign DNR in a medical center, and to understand of relationship between signing the DNR and cross-disciplinary team care for reference by clinical medical staff . Methods: This study was designed as a retrospective cross-sectional study of medical records. The subjects of the study were inpatients that signed "do not to perform cardiopulmonary resuscitation" (DNR). The clinical patient database provided de-identified files of 9281 people. SPSS/Windows 22.0 software was used for data integration and analysis, analysis of basic patient data, the types of signed consent forms, and the status of the cross-disciplinary team for consultation by means of averages and percentages. Results: Between 2016 and 2020, 9,281 people in the study sample, 73.7-79.7% of whom filled out the "Consent Form for DNR" by their nearest relatives, and 17.0-25.4% who filled out the "Pre-Order Palliative Care and Life-Sustaining Care Decision Form". 48.0% consulted palliative physician, and 33.3% consulted Co-Nursing Physician. Conclusions: The medical team understands the time of the patient's end-of-life preparation, assists the patient and their family members with the process of signing the Consent Form for DNR, and enables the palliative care team to seamlessly connect to provide timely and continuous care as soon as possible, which will allow patients, their families, and even the care team, to achieve peace of mind and high-quality medical care.

並列關鍵字

DNR ； terminal diagnosis ； palliative care

參考文獻

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