Percepción, actitud y conocimiento sobre la limitación del soporte vital y la donación en asistolia en medicina y enfermería ¿jugamos en el mismo equipo?

Identifier:  TDX:2712

Handle: https://hdl.handle.net/20.500.11797/TDX2712

Authors:  Lomero Martínez, Maria del Mar

Abstract:
Background: Limitation of life-sustaining treatment (LLST) is a common practice in critical care units, and donation after circulatory death (DCD) has come to be included as an option within this care plan. Lack of knowledge and misunderstandings can act as a barrier between healthcare providers. Aim: The aim of this study is to determine the knowledge and attitude of nurses and doctors in intensive care units before and after a multi-disciplinary training program in LLST and DCD. Methodology: A cross-sectional study was carried out, after which contingency tables, Pearson’s chi-squared test, Student’s t-test and the Mann-Whitney u-test were used to perform descriptive and bivariate statistical analyses and multivariant analysis when the bivariate analysis produced a statistical significant level. Results: A total of 143 participants completed the course, of whom 133 completed the pre-training survey and 72 the post-training questionnaire (54.1%). 44.3% of the participants felt comfortable when deciding whether to implement LLST, although physicians did so in greater number (55.7%) than nurses (32.3 %). 88.9% of nurses agreed that LLST decisions should be made jointly, a figure that reached 100% after the training. At the beginning, only 20% of nurses were able to describe the DCD process and they were less familiar with the legislation regulating DCD in comparison to the 60% recorded by physicians, a difference that disappeared after the training. Nurses feel excluded from the development of protocols and the decision-making process, whilst the perception of physicians is that they have greater knowledge of the topic and decisions are reached by consensus. Training helps healthcare providers to work together with greater coordination, benefitting patients and their next of kin by providing excellent end-of-life care.