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Inicio Enfermería Intensiva (English Edition) Suitability of therapeutic effort in paediatric intensive care units: Opinion an...
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Vol. 31. Issue 4.
Pages 184-191 (October - December 2020)
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Vol. 31. Issue 4.
Pages 184-191 (October - December 2020)
Original article
DOI: 10.1016/j.enfie.2020.02.002
Suitability of therapeutic effort in paediatric intensive care units: Opinion and attitude of professionals
Adecuación del esfuerzo terapéutico en unidades de cuidados intensivos pediátricos: opinión y actitud de los profesionales
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R. López-Sáncheza,
Corresponding author
raquelosan@hotmail.com

Corresponding author.
, E. Jiménez-Garcíab, S. Osorio-Álvarezc, M.R. Riestra-Rodríguezc, E. Oltra-Rodríguezc, A.M. García-Pozod
a Facultad de Enfermería de Gijón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Gijón, Asturias, Spain
b Facultad de Enfermería Salus Infirmorum, Madrid, Spain
c Facultad de Enfermería de Gijón, Gijón, Asturias, Spain
d Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
Article information
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Figures (2)
Tables (3)
Table 1. Variables studied in the questionnaire given to the professionals taking part in the study.
Table 2. Opinion of the doctors and nurses on who should take the decision of the STE in the PICU.
Table 3. Perception of doctors and nurses on the degree of integration in decision-making on the STE of patients under their care.
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Abstract
Objective

To determine the opinion and describe the attitude of different health professionals on suitability of therapeutic effort.

Method

Multi-centre, cross-sectional observational study carried out with nurses and doctors who work in the paediatric intensive care units of four hospitals in the Madrid region. A self-administered questionnaire, previously piloted to assess its viability, was used and a sealed box was set up at the nursing station to hand it in. The analysis was performed using SPSS 21.0 software.

Results

98.9% of the respondents were in favour of suitability of therapeutic effort. Doctors consider that the decision is made with the agreement of the multidisciplinary staff and the child’s parents (48.8%). Of the nurses, 51.1% believe that the decision is made by agreement with the doctors and parents. Of the nurses, 65.5% state that they are never asked about decision-making for their patients. Of the doctors, 75% are always or almost always asked. Fifty-seven percent of the nurses and 83% of the doctors feel capable of making decisions about suitability of therapeutic effort. Of the professionals, 77.2% believe that suitability is used less often than required.

Conclusions

There are differences between doctors and nurses both in the perception of the decision-making model and in the way to proceed. Professionals seem not to follow any protocols or circuits in the decision-making process.

Keywords:
Critical care
Decision-making
Bioethics
Paediatrics
Nursing
Resumen
Objetivos

Conocer la opinión y describir la actitud ante la adecuación del esfuerzo terapéutico de diferentes profesionales sanitarios.

Método

Estudio multicéntrico, observacional y transversal realizado con enfermeras y médicos que desarrollan su labor asistencial en las unidades de cuidados intensivos pediátricos de cuatro hospitales de la Comunidad de Madrid.

Se utilizó un cuestionario de elaboración propia pilotado para valorar su viabilidad y se habilitó una urna clausurada en el control de enfermería para que fuera depositado. El análisis se realizó con el programa SPPS 21.0.

Resultados

El 98,9% de los encuestados declaró estar a favor de la adecuación del esfuerzo terapéutico. Los médicos consideran que la decisión se toma por consenso del equipo multidisciplinar más los padres del niño (48,8%). El 51,1% de las enfermeras opinan que se realiza por consenso de los médicos más los padres y el 65,5% afirma que nunca les consultan en la toma de decisiones de pacientes a su cargo. Al 75% de los médicos siempre o casi siempre les consultan. El 57% de las enfermeras y el 83% de los médicos se sienten capacitados para la toma de decisiones sobre AET. El 77,2% de los profesionales cree que la adecuación se aplica en menos ocasiones de las necesarias.

Conclusiones

Existen diferencias entre médicos y enfermeras tanto en la percepción del modelo de toma de decisiones como en el modo de actuación. Los profesionales no siguen ningún protocolo ni circuito de toma de decisiones consensuado.

Palabras clave:
Cuidados críticos
Toma de decisiones
Bioética
Pediatría
Enfermería

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