Jia Wang, Yutong Xu, Wanting Zhang, Zihan Guo, Wei Zhang, Yuying Zhang, Weiguang Ma
Transition status and influencing factors of newly graduated nurses: A descriptive survey design
Nurse education in practice
decisions whether refer admit patient intensive care unit icu clinically organizationally ethically challenging many explicit implicit factors influence decisions substantial variability made leading concerns access appropriate treatment critically ill patients currently guidance support doctors making decisions developed intervention aim supporting doctors make transparent consistent patientcentred ethically justified decisions paper reports implementation intervention three nhs hospitals england evaluates feasibility terms usage acceptability perceived impact decision making mixed method study including quantitative assessment usage qualitative interviews moderate uptake framework 282 referrals icu across sites 3month study period organizational structure culture affected implementation concerns increased workload context limited resources obstacles use doctors used reported positive impact decision making better articulation communication reasons decisions greater attention patient wishes intervention made explicit uncertainty inherent decisions sometimes challenging patient family information leaflets used feasible implement intervention improve decision making around referral admission icu embedding intervention existing organizational culture practice would likely increase adoption doctorfacing elements intervention generally acceptable perceived making icu decision making transparent patientcentred remained difficulties articulating clinical reasoning behind decisions intervention offers important step towards establishing clinically ethically sound approach icu admission