2.50
Hdl Handle:
http://hdl.handle.net/10755/159365
Type:
Presentation
Title:
Use of Advance Directives in the Chronically Critically Ill
Abstract:
Use of Advance Directives in the Chronically Critically Ill
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2003
Author:Kelley, Carol
Contact Address:Frances Payne Bolton School of Nursing, 10900 Euclid Avenue, Cleveland, OH, 44106, USA
Co-Authors:Barbara J. Daly; Sara Douglas
The chronically critically ill are growing population of patients who experience prolonged periods (>96 hours) of in-hospital mechanical ventilation. Many of these patients have lost cognitive ability and 50% of these patients will not live to hospital discharge, hence the use of advance directives may be important. The purpose of this study was to describe the use of advance directives in the chronically critically ill and to identify relationships between advance directives, length of time on mechanical ventilation and cause of death. This study was part of a larger prospective longitudinal descriptive study of post-hospital outcomes for long-term ventilator patients. Data were collected on 470 intensive care unit patients admitted to a university medical center, Veteran’s Administration hospital or small community hospital who required >96 hours of continuous mechanical ventilation. Thirty-seven percent (N=144) of the sample had an advance directive upon admission to the hospital. Of persons these, half were Caucasian males over age 73, married, and living at home prior to this hospitalization. The majority (51%) had been on the ventilator for 4-8 days with 64% having hospital stays between 4-20 days. Of the forty-one percent of the total sample who died while in the hospital, there were no statistically significant relationships found between those who had an advance directive on admission and the cause of death, mechanical ventilation at the time of death, and decision to withdraw mechanical ventilation. In addition there were no significant differences between patients who did and did not have a living will at the time of death in their length of stay or length of mechanical ventilation. Despite the high mortality risk in this population, advance directives do not seem to directly effect treatment patterns. This raises questions about their usefulness in complex decision-making situations. AN: MN030368
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleUse of Advance Directives in the Chronically Critically Illen_GB
dc.identifier.urihttp://hdl.handle.net/10755/159365-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Use of Advance Directives in the Chronically Critically Ill</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2003</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Kelley, Carol</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">Frances Payne Bolton School of Nursing, 10900 Euclid Avenue, Cleveland, OH, 44106, USA</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Barbara J. Daly; Sara Douglas</td></tr><tr><td colspan="2" class="item-abstract">The chronically critically ill are growing population of patients who experience prolonged periods (&gt;96 hours) of in-hospital mechanical ventilation. Many of these patients have lost cognitive ability and 50% of these patients will not live to hospital discharge, hence the use of advance directives may be important. The purpose of this study was to describe the use of advance directives in the chronically critically ill and to identify relationships between advance directives, length of time on mechanical ventilation and cause of death. This study was part of a larger prospective longitudinal descriptive study of post-hospital outcomes for long-term ventilator patients. Data were collected on 470 intensive care unit patients admitted to a university medical center, Veteran&rsquo;s Administration hospital or small community hospital who required &gt;96 hours of continuous mechanical ventilation. Thirty-seven percent (N=144) of the sample had an advance directive upon admission to the hospital. Of persons these, half were Caucasian males over age 73, married, and living at home prior to this hospitalization. The majority (51%) had been on the ventilator for 4-8 days with 64% having hospital stays between 4-20 days. Of the forty-one percent of the total sample who died while in the hospital, there were no statistically significant relationships found between those who had an advance directive on admission and the cause of death, mechanical ventilation at the time of death, and decision to withdraw mechanical ventilation. In addition there were no significant differences between patients who did and did not have a living will at the time of death in their length of stay or length of mechanical ventilation. Despite the high mortality risk in this population, advance directives do not seem to directly effect treatment patterns. This raises questions about their usefulness in complex decision-making situations. AN: MN030368 </td></tr></table>en_GB
dc.date.available2011-10-26T21:56:51Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T21:56:51Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.