Provider Perspectives Regarding Resuscitation Decisions for Neonates and Other Vulnerable Patients

The Journal of Pediatrics
Amélie Dupont-ThibodeauA Janvier

Abstract

To use structured surveys to assess the perspectives of pediatric residents and neonatal nurses on resuscitation decisions for vulnerable patients, including neonates. Pediatric providers were surveyed using scenarios for 6 critically ill patients of different ages with outcomes explicitly described. Providers were asked (1) whether resuscitation was in each patient's best interest; (2) whether they would accept families' wishes for comfort care (no resuscitation); and (3) to rank patients in order of priority for resuscitation. In a structured interview, each participant explained how they evaluated patient interests and when applicable, why their answers differed for neonates. Interviews were audiotaped; transcripts were analyzed using thematic analysis and mixed methods. Eighty pediatric residents and neonatal nurses participated (response rate 74%). When making life and death decisions, participants considered (1) patient characteristics (96%), (2) personal experience/biases (85%), (3) family's wishes and desires (81%), (4) disease characteristics (74%), and (5) societal perspectives (36%). These factors were not in favor of sick neonates: of the participants, 85% reported having negative biases toward neonates and 60% did ...Continue Reading

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Citations

Mar 24, 2018·Acta Paediatrica·Thor Willy Ruud HansenReidun Førde
May 14, 2020·The American Journal of Bioethics : AJOB·Marlyse F HawardJohn Lantos
Jun 23, 2018·Pediatrics·Jason HigginsonJohn D Lantos

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