Table 5 Life-sustaining treatment decisions in intensive care
1. | Age_____ years | |||
|---|---|---|---|---|
2. | Sex | F □ M □ | ||
3. | Religion: | Catholic □ | Agnostic or atheist □ | Other________ |
4. | Speciality: | Anaesthesia □ | Internal Medicine □ | Pulmonary Medicine □ |
Other________ | ||||
5. | Years of clinical work in intensive care: | |||
< 2 years □ | 3–5 years □ | 6–10 years □ | > 10 years □ | |
6. | Number of beds of your ICU: | |||
≤ 4 beds □ | 5–8 beds □ | > 8 beds □ | ||
7. | Medium occupation rate of your ICU during last year: | |||
< 80% □ | 80–85% □ | 86–90% □ | > 90% □ | |
8. | In your ICU the patient is evaluate before admission by an: | |||
ICU doctor □ | Other doctor □ | No evaluation is made previously □ | ||
9. | Chose the 4 more important criteria for refusing ICU admission to a patient (1 to 4, being 1 the most important one): | |||
□ | Probability of survival from acute illness | |||
□ | Probability of long-term survival | |||
□ | Previous quality of life | |||
□ | Quality of life expected after discharge | |||
□ | Patients will | |||
□ | Relatives will | |||
□ | Age | |||
□ | Other________ | |||
10. | Are decisions not to perform cardiopulmonary resuscitation (DNR) applied in your ICU? | |||
Yes □ | No □ | |||
11. | Who is involved in DNR decisions? | |||
□ | Medical group | |||
□ | Nurses | |||
□ | Patient, if competent | |||
□ | Patients' relatives | |||
□ | The patient or relatives make the final decision | |||
□ | Only the doctor in duty that day | |||
12. | In your ICU, DNR orders are: | |||
□ | Recorded in a specific document | |||
□ | Recorded in clinical notes | |||
□ | Transmitted only verbally to the working group | |||
13. | In your opinion DNR decisions should involve: | |||
□ | Medical group | |||
□ | Nurses | |||
□ | Patient, if competent | |||
□ | Patients' relatives | |||
□ | The patient or relatives make the final decision | |||
□ | Only the doctor in duty that day | |||
14. | Chose the 4 more important criteria for a DNR decision (1 to 4, being 1 the most important one): | |||
□ | Probability of survival from the acute illness | |||
□ | Probability of long-term survival | |||
□ | Previous quality of life | |||
□ | Quality of life expected after discharge | |||
□ | Patient will | |||
□ | Relatives will | |||
□ | Age | |||
□ | Other________ | |||
15. | Are decisions not to proceed to further treatment escalade in some patients made in your ICU? | |||
Yes □ | No □ | |||
16. | In your ICU decisions not to proceed to further treatment escalade involve: | |||
□ | Medical group | |||
□ | Nurses | |||
□ | Patient, if competent | |||
□ | Patients' relatives | |||
□ | The patient or relatives make the final decision | |||
□ | Only the doctor in duty that day | |||
17. | In your ICU, decisions not to proceed to further treatment escalade are: | |||
□ | Recorded in a specific document | |||
□ | Recorded in clinical notes | |||
□ | Transmitted only verbally to the working group | |||
18. | In your opinion decisions not to proceed to further treatment escalade should involve: | |||
□ | Medical group | |||
□ | Nurses | |||
□ | Patient, if competent | |||
□ | Patients' relatives | |||
□ | The patient or relatives make the final decision | |||
□ | Only the doctor in duty that day | |||
19. | Chose the 4 more important criteria in deciding not to proceed to further treatment escalade (1 to 4, being 1 the most important one): | |||
□ | Probability of survival from the acute illness | |||
□ | Probability of long-term survival | |||
□ | Previous quality of life | |||
□ | Quality of life expected after discharge | |||
□ | Patient will | |||
□ | Relatives will | |||
□ | Age | |||
□ | Other________ | |||
20. | In your ICU are decisions to suspend treatment in some patients made: | |||
Yes □ | No □ | |||
21. | In your ICU, decisions to suspend treatment involve: | |||
□ | Doctors | |||
□ | Nurses | |||
□ | Patient, if competent | |||
□ | Relatives | |||
□ | The patient or relatives take the final decision | |||
22. | In your ICU, decisions to suspend treatment are: | |||
□ | Recorded in a specific document | |||
□ | Recorded in clinical notes | |||
□ | Transmitted only verbally to the working group | |||
23. | In your opinion, decisions to suspend treatment should involve: | |||
□ | Medical group | |||
□ | Nurses | |||
□ | Patient, if competent | |||
□ | Patients' relatives | |||
□ | The patient or relatives make the final decision | |||
□ | Only the doctor in duty that day | |||
24. | Chose the 4 more important criteria in decisions to suspend treatment (1 to 4, being 1 the most important one): | |||
□ | Probability of survival from the acute illness | |||
□ | Probability of long-term survival | |||
□ | Previous quality of life | |||
□ | Quality of life expected after discharge | |||
□ | Patient will | |||
□ | Relatives will | |||
□ | Age | |||
□ | Other________ | |||
25. | In your ICU a decision to suspend treatment is preceded by a DNR decision: | |||
Always □ | Most of the times □ | Sometimes □ | Never □ | |
26. | When you decide to suspend therapy in a patient which order do you usual follow (put in numerical order): | |||
□ | Mechanical ventilation | |||
□ | Nutrition and fluids | |||
□ | Haemodialysis or haemofiltration | |||
□ | Inotropic and vasopressor agents | |||
□ | Sedation | |||
□ | Paralysis | |||
27. | When you decide to suspend treatment do you: | |||
□ | Wait the inevitable end with minimal intervention | |||
□ | Start confort measures (like morphine infusion) | |||
□ | Administer drugs to accelerate the expected end | |||