The Views of Neonatal Nurse Practitioners Regarding Life-Sustaining Treatments for Critical Infants

2.50
Hdl Handle:
http://hdl.handle.net/10755/151792
Type:
Presentation
Title:
The Views of Neonatal Nurse Practitioners Regarding Life-Sustaining Treatments for Critical Infants
Abstract:
The Views of Neonatal Nurse Practitioners Regarding Life-Sustaining Treatments for Critical Infants
Conference Sponsor:Sigma Theta Tau International
Conference Year:2001
Conference Date:June, 2001
Author:Currier, Sarah, PhD
P.I. Institution Name:Creighton University
Title:Assistant Professor
Objective: The purpose of this study was to identify the views of Neonatal Nurse Practitioners (NNPs) toward life-sustaining treatments (LSTs) for critically ill infants. Design: A descriptive survey design was used. Population, Sample, Setting, Years: The original study population included all 2,484 certified NNPs in the United States (USA). This sample consists of the first 900 completed surveys from 1,321 respondents (response rate = 54%). The study was conducted in 1999-2000. Concept or Variables Studied Together or Intervention and Outcome Variables: Attitudes and behaviors of NNPs regarding LSTs for critically ill infants. Methods: A European survey tool (Cuttini, et al., 1997) was modified, tested for content validity, and pretested. Two mailings, consisting of a cover letter, the questionnaire, and a self-addressed stamped return envelope, were sent to every certified NNP in the USA. Data analysis was performed using SPSS 9.0 for Windows 95/98. Descriptive statistics were used to answer the research question. Findings: The typical respondent was a Caucasian (93%), female (97%), currently working as a NNP (88%). Most had a graduate degree (62.5%) and 78% reported receiving ethics content during their NNP program. Thirty seven percent were Catholic and 47% were Protestant. Every geographic region in the USA was represented. Over 80% of the NNPs indicated it is sometimes justifiable to limit LSTs. They were more likely to limit treatments for the extremely low birth weight (ELBW) infant than for the Asphyxia or Anomaly infants. Withholding emergency interventions, resuscitation at birth, surgery and ventilators were acceptable ways to limit LSTs, as were continuing current treatments without adding others, or administering sedatives/analgesics with the potential for death. Withholding tube feedings or administering drugs to cause death were unacceptable. When infants needed resuscitation, most NNPs (84-97%) reported they would initiate LSTs. NNPs were more likely to recommend limitation or withdrawal of LSTs for the Asphyxia (55%) and ELBW (40%) infants than for the Anomaly infant (6%). One third would accept the parents request regarding LSTs. Of those who would not, if the parents were strongly opposed to the NNP’s recommendation, NNPs were more likely to change their recommendation for the ELBW and Asphyxia infants (27-31%) than for the Anomaly infant (14%). Fifteen percent who objected to the withdrawal of mechanical ventilation for the Anomaly infant would participate anyway if parents wanted mechanical ventilation withdrawn. One third would continue LSTs against parental wishes. A few indicated they would administer drugs to end the baby’s life. Conclusions: The typical response when an infant needed LSTs was to resuscitate. NNPs were less willing to limit LSTs for the Anomaly infant than for the ELBW and Asphyxia infants. Implications: NNPs need to be prepared for involvement in LST decisions. Student NNPs should be aware of the prevailing attitudes and behaviors of practicing NNPs as they prepare to join this group of advanced practice nurses. Ethical and emotional conflicts are areas where educational programs should be targeted. NNPs need to be aware of policies and procedures as well as state regulations regarding their scope of practice. The survey tool should be reevaluated prior to further use.
Repository Posting Date:
26-Oct-2011
Date of Publication:
Jun-2001
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleThe Views of Neonatal Nurse Practitioners Regarding Life-Sustaining Treatments for Critical Infantsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/151792-
dc.description.abstract<table><tr><td colspan="2" class="item-title">The Views of Neonatal Nurse Practitioners Regarding Life-Sustaining Treatments for Critical Infants</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2001</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">June, 2001</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Currier, Sarah, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Creighton University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">scurrier@creighton.edu</td></tr><tr><td colspan="2" class="item-abstract">Objective: The purpose of this study was to identify the views of Neonatal Nurse Practitioners (NNPs) toward life-sustaining treatments (LSTs) for critically ill infants. Design: A descriptive survey design was used. Population, Sample, Setting, Years: The original study population included all 2,484 certified NNPs in the United States (USA). This sample consists of the first 900 completed surveys from 1,321 respondents (response rate = 54%). The study was conducted in 1999-2000. Concept or Variables Studied Together or Intervention and Outcome Variables: Attitudes and behaviors of NNPs regarding LSTs for critically ill infants. Methods: A European survey tool (Cuttini, et al., 1997) was modified, tested for content validity, and pretested. Two mailings, consisting of a cover letter, the questionnaire, and a self-addressed stamped return envelope, were sent to every certified NNP in the USA. Data analysis was performed using SPSS 9.0 for Windows 95/98. Descriptive statistics were used to answer the research question. Findings: The typical respondent was a Caucasian (93%), female (97%), currently working as a NNP (88%). Most had a graduate degree (62.5%) and 78% reported receiving ethics content during their NNP program. Thirty seven percent were Catholic and 47% were Protestant. Every geographic region in the USA was represented. Over 80% of the NNPs indicated it is sometimes justifiable to limit LSTs. They were more likely to limit treatments for the extremely low birth weight (ELBW) infant than for the Asphyxia or Anomaly infants. Withholding emergency interventions, resuscitation at birth, surgery and ventilators were acceptable ways to limit LSTs, as were continuing current treatments without adding others, or administering sedatives/analgesics with the potential for death. Withholding tube feedings or administering drugs to cause death were unacceptable. When infants needed resuscitation, most NNPs (84-97%) reported they would initiate LSTs. NNPs were more likely to recommend limitation or withdrawal of LSTs for the Asphyxia (55%) and ELBW (40%) infants than for the Anomaly infant (6%). One third would accept the parents request regarding LSTs. Of those who would not, if the parents were strongly opposed to the NNP&rsquo;s recommendation, NNPs were more likely to change their recommendation for the ELBW and Asphyxia infants (27-31%) than for the Anomaly infant (14%). Fifteen percent who objected to the withdrawal of mechanical ventilation for the Anomaly infant would participate anyway if parents wanted mechanical ventilation withdrawn. One third would continue LSTs against parental wishes. A few indicated they would administer drugs to end the baby&rsquo;s life. Conclusions: The typical response when an infant needed LSTs was to resuscitate. NNPs were less willing to limit LSTs for the Anomaly infant than for the ELBW and Asphyxia infants. Implications: NNPs need to be prepared for involvement in LST decisions. Student NNPs should be aware of the prevailing attitudes and behaviors of practicing NNPs as they prepare to join this group of advanced practice nurses. Ethical and emotional conflicts are areas where educational programs should be targeted. NNPs need to be aware of policies and procedures as well as state regulations regarding their scope of practice. The survey tool should be reevaluated prior to further use.</td></tr></table>en_GB
dc.date.available2011-10-26T11:13:50Z-
dc.date.issued2001-06en_GB
dc.date.accessioned2011-10-26T11:13:50Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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