ICU nurses are most frequently at the patient's bedside, providing care for both patients and family members. They perform an essential role and are involved in decision-making. Despite this, research suggests that nurses have a limited role in the end-of-life decision-making process and are occasionally not involved. Explore global ICU nurse involvement in end of life decisions based on the physician's perceptions and sub-analyses from the ETHICUS-2 study. This is a secondary analysis of a prospective multinational, observational study of the ETHICUS-2 study. End of life decision-making processes in ICU patients were studied during a 6-month period between Sept 1, 2015, and Sept 30, 2016, in 199 ICUs in 36 countries. None. The ETHICUS II study instrument contained 20 questions. This sub-analysis addressed the four questions related to nurse involvement in end-of-life decision-making: Who initiated the end-of-life discussion? Was withholding or withdrawing treatment discussed with nurses? Was a nurse involved in making the end-of-life decision? Was there agreement between physicians and nurses? These 4 questions are the basis for our analysis. Global regions were compared. Physicians completed 91.8 % of the data entry. A statistically significant difference was found between regions (p < 0.001) with Northern Europe and Australia/New Zealand having the most discussion with nurses and Latin America, Africa, Asia and North America the least. The percentages of end-of-life decisions in which nurses were involved ranged between 3 and 44 %. These differences were statistically significant. Agreement between physicians and nurses related to decisions resulted in a wide range of responses (27–86 %) (p < 0.001). There was a wide range of those who replied “not applicable” to the question of agreement between physicians and nurses on EOL decisions (0–41 %). There is large variability in nurse involvement in end-of-life decision-making in the ICU. The most concerning findings were that in some regions, according to physicians, nurses were not involved in EOL decisions and did not initiate the decision-making process. There is a need to develop the collaboration between nurses and physicians. Nurses have valuable contributions for best possible patient-centered decisions and should be respected as important parts of the interdisciplinary team. Wide global differences were found in nurse end of life decision involvement, with low involvement in North and South America and Africa and higher involvement in Europe and Australia/New Zealand.

中文翻译：

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全球重症监护病房护士参与临终实践的报告差异 (ETHICUS-2)：一项前瞻性观察研究


ICU 护士最常在患者床边为患者及其家属提供护理。他们发挥着重要作用并参与决策。尽管如此，研究表明护士在临终决策过程中的作用有限，并且有时不参与。根据医生的看法和 ETHICUS-2 研究的子分析，探索全球 ICU 护士参与临终决策的情况。这是对 ETHICUS-2 研究的前瞻性跨国观察性研究的二次分析。 2015 年 9 月 1 日至 2016 年 9 月 30 日期间的 6 个月期间，研究人员在 36 个国家的 199 个 ICU 中对 ICU 患者的临终决策过程进行了研究。没有任何。 ETHICUS II 研究工具包含 20 个问题。该子分析解决了与护士参与临终决策相关的四个问题： 谁发起了临终讨论？是否与护士讨论过停止或撤回治疗？护士是否参与了临终决定？医生和护士之间是否达成一致？这4个问题是我们分析的基础。对全球各地区进行了比较。医生完成了 91.8% 的数据输入。北欧和澳大利亚/新西兰与护士讨论最多的地区之间存在统计学显着差异（p<0.001），拉丁美洲、非洲、亚洲和北美最少。护士参与临终决策的比例在 3% 到 44% 之间。这些差异具有统计学意义。医生和护士之间就决策达成一致导致了广泛的反应 (27-86%) (p<0.001)。 对于医生和护士就 EOL 决定达成一致的问题，有很多人回答“不适用”（0-41%）。护士参与 ICU 临终决策的情况存在很大差异。最令人担忧的发现是，根据医生的说法，在某些地区，护士没有参与 EOL 决策，也没有启动决策过程。需要发展护士和医生之间的合作。护士为尽可能以患者为中心的决策做出了宝贵贡献，应作为跨学科团队的重要组成部分受到尊重。在护士临终决策参与方面发现了广泛的全球差异，北美、南美和非洲的参与程度较低，而欧洲和澳大利亚/新西兰的参与程度较高。