Impact of perceived inappropiate cardiopulmonary resuscitation on emergency clinicians’ intention to leave the job: Results from a cross-sectional survey in 288 centres across 24 countries
Cardiopulmonary resuscitation (CPR) in patients with a poor prognosis increases the risk of perception of inappropriate care leading to moral distress in clinicians. We evaluated whether perception of inappropriate CPR is associated with intention to leave the job among emergency clinicians. A cross...
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| Veröffentlicht in: | Resuscitation 2021-01, Vol.158, p.41-48 |
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| creator | Druwé, Patrick Monsieurs, Koenraad G. Gagg, James Nakahara, Shinji Cocchi, Michael N. Élő, Gábor van Schuppen, Hans Alpert, Evan Avraham Truhlář, Anatolij Huybrechts, Sofie A. Mpotos, Nicolas Paal, Peter BjØrshol, Conrad Xanthos, Theodoros Joly, Luc-Marie Roessler, Markus Deasy, Conor Svavarsdóttir, Hildigunnur Nurmi, Jouni Owczuk, Radoslaw Salmeron, Pascual Piñera Cimpoesu, Diana Fuenzalida, Pablo Aguilera Raffay, Violetta Steen, Johan Decruyenaere, Johan De Paepe, Peter Piers, Ruth Benoit, Dominique D. |
| description | Cardiopulmonary resuscitation (CPR) in patients with a poor prognosis increases the risk of perception of inappropriate care leading to moral distress in clinicians. We evaluated whether perception of inappropriate CPR is associated with intention to leave the job among emergency clinicians.
A cross-sectional multi-centre survey was conducted in 24 countries. Factors associated with intention to leave the job were analysed by conditional logistic regression models. Results are expressed as odds ratios with 95% confidence intervals.
Of 5099 surveyed emergency clinicians, 1836 (36.0%) were physicians, 1313 (25.7%) nurses, 1950 (38.2%) emergency medical technicians. Intention to leave the job was expressed by 1721 (33.8%) clinicians, 3403 (66.7%) often wondered about the appropriateness of a resuscitation attempt, 2955 (58.0%) reported moral distress caused by inappropriate CPR. After adjustment for other covariates, the risk of intention to leave the job was higher in clinicians often wondering about the appropriateness of a resuscitation attempt (1.43 [1.23−1.67]), experiencing associated moral distress (1.44 [1.24−1.66]) and who were between 30−44 years old (1.53 [1.21−1.92] compared to |
| doi_str_mv | 10.1016/j.resuscitation.2020.10.043 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2464146603</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0300957220305645</els_id><sourcerecordid>2464146603</sourcerecordid><originalsourceid>FETCH-LOGICAL-c436t-2c65ed4adaafa602711e202fb4d087e1a6651d3e6b7ec3cd5803707db2cfdbcd3</originalsourceid><addsrcrecordid>eNqNkd-K1DAYxYMo7rj6CvKBN950zJ826eiVLKsuLAii1yFNvmqGtqlJOjB3voYv48P4JKYzq7B3QiCQ75dzknMIecHollEmX-23EdOSrM8m-zBtOeXrZEtr8YBsWKtExRpFH5INFZRWu0bxC_IkpT2lVDQ79ZhcCMG5Eju1Ib9uxtnYDKGHGaNFf0AHfjLzHMPsTUawJjof5mUYw2TiEe6ZQ1k4YvyKkz2CHfzkrTdT-v3jZ1HJOJ2gHGBAc0DI3xD2oXsNn4rIkBP0MYxgwMaQUpXQrrgZIC3xgMeiALxtwRaZ4grmhAGvwYalHHlMT8mj3gwJn93tl-TLu-vPVx-q24_vb67e3la2FjJX3MoGXW2cMb2RlCvGsMTWd7WjrUJmpGyYEyg7hVZY17RUKKpcx23vOuvEJXl51i2xfF8wZT36ZHEYzIRhSZrXsma1lFQU9M0ZPb02Yq_n6MeSnGZUrwXqvb6XoV4LXIelwHL7-Z3R0o3o_t3921gBrs8Alu8ePEZdhEr66Hws-WkX_H8Z_QH6abvl</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2464146603</pqid></control><display><type>article</type><title>Impact of perceived inappropiate cardiopulmonary resuscitation on emergency clinicians’ intention to leave the job: Results from a cross-sectional survey in 288 centres across 24 countries</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Druwé, Patrick ; Monsieurs, Koenraad G. ; Gagg, James ; Nakahara, Shinji ; Cocchi, Michael N. ; Élő, Gábor ; van Schuppen, Hans ; Alpert, Evan Avraham ; Truhlář, Anatolij ; Huybrechts, Sofie A. ; Mpotos, Nicolas ; Paal, Peter ; BjØrshol, Conrad ; Xanthos, Theodoros ; Joly, Luc-Marie ; Roessler, Markus ; Deasy, Conor ; Svavarsdóttir, Hildigunnur ; Nurmi, Jouni ; Owczuk, Radoslaw ; Salmeron, Pascual Piñera ; Cimpoesu, Diana ; Fuenzalida, Pablo Aguilera ; Raffay, Violetta ; Steen, Johan ; Decruyenaere, Johan ; De Paepe, Peter ; Piers, Ruth ; Benoit, Dominique D.</creator><creatorcontrib>Druwé, Patrick ; Monsieurs, Koenraad G. ; Gagg, James ; Nakahara, Shinji ; Cocchi, Michael N. ; Élő, Gábor ; van Schuppen, Hans ; Alpert, Evan Avraham ; Truhlář, Anatolij ; Huybrechts, Sofie A. ; Mpotos, Nicolas ; Paal, Peter ; BjØrshol, Conrad ; Xanthos, Theodoros ; Joly, Luc-Marie ; Roessler, Markus ; Deasy, Conor ; Svavarsdóttir, Hildigunnur ; Nurmi, Jouni ; Owczuk, Radoslaw ; Salmeron, Pascual Piñera ; Cimpoesu, Diana ; Fuenzalida, Pablo Aguilera ; Raffay, Violetta ; Steen, Johan ; Decruyenaere, Johan ; De Paepe, Peter ; Piers, Ruth ; Benoit, Dominique D. ; on behalf of the REAPPROPRIATE study group ; REAPPROPRIATE study group</creatorcontrib><description>Cardiopulmonary resuscitation (CPR) in patients with a poor prognosis increases the risk of perception of inappropriate care leading to moral distress in clinicians. We evaluated whether perception of inappropriate CPR is associated with intention to leave the job among emergency clinicians.
A cross-sectional multi-centre survey was conducted in 24 countries. Factors associated with intention to leave the job were analysed by conditional logistic regression models. Results are expressed as odds ratios with 95% confidence intervals.
Of 5099 surveyed emergency clinicians, 1836 (36.0%) were physicians, 1313 (25.7%) nurses, 1950 (38.2%) emergency medical technicians. Intention to leave the job was expressed by 1721 (33.8%) clinicians, 3403 (66.7%) often wondered about the appropriateness of a resuscitation attempt, 2955 (58.0%) reported moral distress caused by inappropriate CPR. After adjustment for other covariates, the risk of intention to leave the job was higher in clinicians often wondering about the appropriateness of a resuscitation attempt (1.43 [1.23−1.67]), experiencing associated moral distress (1.44 [1.24−1.66]) and who were between 30−44 years old (1.53 [1.21−1.92] compared to <30 years). The risk was lower when the clinician felt valued by the team (0.53 [0.42−0.66]), when the team leader acknowledged the efforts delivered by the team (0.61 [0.49−0.75]) and in teams that took time for debriefing (0.70 [0.60−0.80]).
Resuscitation attempts perceived as inappropriate by clinicians, and the accompanying moral distress, were associated with an increased likelihood of intention to leave the job. Interprofessional collaboration, teamwork, and regular interdisciplinary debriefing were associated with a lower risk of intention to leave the job.
ClinicalTrials.gov; No.: NCT02356029</description><identifier>ISSN: 0300-9572</identifier><identifier>EISSN: 1873-1570</identifier><identifier>DOI: 10.1016/j.resuscitation.2020.10.043</identifier><identifier>PMID: 33227397</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>Adult ; Cardiopulmonary Resuscitation ; Cross-Sectional Studies ; Emergency department ; Emergency medical services ; Emergency Service, Hospital ; Futility ; Humans ; Inappropriate cardiopulmonary resuscitation ; Intention ; Moral distress ; Out of hospital cardiac arrest ; Physicians ; Surveys and Questionnaires</subject><ispartof>Resuscitation, 2021-01, Vol.158, p.41-48</ispartof><rights>2020 Elsevier B.V.</rights><rights>Copyright © 2020 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c436t-2c65ed4adaafa602711e202fb4d087e1a6651d3e6b7ec3cd5803707db2cfdbcd3</citedby><cites>FETCH-LOGICAL-c436t-2c65ed4adaafa602711e202fb4d087e1a6651d3e6b7ec3cd5803707db2cfdbcd3</cites><orcidid>0000-0003-4869-3283 ; 0000-0002-5968-6401 ; 0000-0002-5541-5209 ; 0000-0001-8776-6591 ; 0000-0002-1920-4869 ; 0000-0002-3655-4318 ; 0000-0003-2077-6466 ; 0000-0001-7307-384X ; 0000-0002-2939-4782 ; 0000-0001-5261-220X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.resuscitation.2020.10.043$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33227397$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Druwé, Patrick</creatorcontrib><creatorcontrib>Monsieurs, Koenraad G.</creatorcontrib><creatorcontrib>Gagg, James</creatorcontrib><creatorcontrib>Nakahara, Shinji</creatorcontrib><creatorcontrib>Cocchi, Michael N.</creatorcontrib><creatorcontrib>Élő, Gábor</creatorcontrib><creatorcontrib>van Schuppen, Hans</creatorcontrib><creatorcontrib>Alpert, Evan Avraham</creatorcontrib><creatorcontrib>Truhlář, Anatolij</creatorcontrib><creatorcontrib>Huybrechts, Sofie A.</creatorcontrib><creatorcontrib>Mpotos, Nicolas</creatorcontrib><creatorcontrib>Paal, Peter</creatorcontrib><creatorcontrib>BjØrshol, Conrad</creatorcontrib><creatorcontrib>Xanthos, Theodoros</creatorcontrib><creatorcontrib>Joly, Luc-Marie</creatorcontrib><creatorcontrib>Roessler, Markus</creatorcontrib><creatorcontrib>Deasy, Conor</creatorcontrib><creatorcontrib>Svavarsdóttir, Hildigunnur</creatorcontrib><creatorcontrib>Nurmi, Jouni</creatorcontrib><creatorcontrib>Owczuk, Radoslaw</creatorcontrib><creatorcontrib>Salmeron, Pascual Piñera</creatorcontrib><creatorcontrib>Cimpoesu, Diana</creatorcontrib><creatorcontrib>Fuenzalida, Pablo Aguilera</creatorcontrib><creatorcontrib>Raffay, Violetta</creatorcontrib><creatorcontrib>Steen, Johan</creatorcontrib><creatorcontrib>Decruyenaere, Johan</creatorcontrib><creatorcontrib>De Paepe, Peter</creatorcontrib><creatorcontrib>Piers, Ruth</creatorcontrib><creatorcontrib>Benoit, Dominique D.</creatorcontrib><creatorcontrib>on behalf of the REAPPROPRIATE study group</creatorcontrib><creatorcontrib>REAPPROPRIATE study group</creatorcontrib><title>Impact of perceived inappropiate cardiopulmonary resuscitation on emergency clinicians’ intention to leave the job: Results from a cross-sectional survey in 288 centres across 24 countries</title><title>Resuscitation</title><addtitle>Resuscitation</addtitle><description>Cardiopulmonary resuscitation (CPR) in patients with a poor prognosis increases the risk of perception of inappropriate care leading to moral distress in clinicians. We evaluated whether perception of inappropriate CPR is associated with intention to leave the job among emergency clinicians.
A cross-sectional multi-centre survey was conducted in 24 countries. Factors associated with intention to leave the job were analysed by conditional logistic regression models. Results are expressed as odds ratios with 95% confidence intervals.
Of 5099 surveyed emergency clinicians, 1836 (36.0%) were physicians, 1313 (25.7%) nurses, 1950 (38.2%) emergency medical technicians. Intention to leave the job was expressed by 1721 (33.8%) clinicians, 3403 (66.7%) often wondered about the appropriateness of a resuscitation attempt, 2955 (58.0%) reported moral distress caused by inappropriate CPR. After adjustment for other covariates, the risk of intention to leave the job was higher in clinicians often wondering about the appropriateness of a resuscitation attempt (1.43 [1.23−1.67]), experiencing associated moral distress (1.44 [1.24−1.66]) and who were between 30−44 years old (1.53 [1.21−1.92] compared to <30 years). The risk was lower when the clinician felt valued by the team (0.53 [0.42−0.66]), when the team leader acknowledged the efforts delivered by the team (0.61 [0.49−0.75]) and in teams that took time for debriefing (0.70 [0.60−0.80]).
Resuscitation attempts perceived as inappropriate by clinicians, and the accompanying moral distress, were associated with an increased likelihood of intention to leave the job. Interprofessional collaboration, teamwork, and regular interdisciplinary debriefing were associated with a lower risk of intention to leave the job.
ClinicalTrials.gov; No.: NCT02356029</description><subject>Adult</subject><subject>Cardiopulmonary Resuscitation</subject><subject>Cross-Sectional Studies</subject><subject>Emergency department</subject><subject>Emergency medical services</subject><subject>Emergency Service, Hospital</subject><subject>Futility</subject><subject>Humans</subject><subject>Inappropriate cardiopulmonary resuscitation</subject><subject>Intention</subject><subject>Moral distress</subject><subject>Out of hospital cardiac arrest</subject><subject>Physicians</subject><subject>Surveys and Questionnaires</subject><issn>0300-9572</issn><issn>1873-1570</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkd-K1DAYxYMo7rj6CvKBN950zJ826eiVLKsuLAii1yFNvmqGtqlJOjB3voYv48P4JKYzq7B3QiCQ75dzknMIecHollEmX-23EdOSrM8m-zBtOeXrZEtr8YBsWKtExRpFH5INFZRWu0bxC_IkpT2lVDQ79ZhcCMG5Eju1Ib9uxtnYDKGHGaNFf0AHfjLzHMPsTUawJjof5mUYw2TiEe6ZQ1k4YvyKkz2CHfzkrTdT-v3jZ1HJOJ2gHGBAc0DI3xD2oXsNn4rIkBP0MYxgwMaQUpXQrrgZIC3xgMeiALxtwRaZ4grmhAGvwYalHHlMT8mj3gwJn93tl-TLu-vPVx-q24_vb67e3la2FjJX3MoGXW2cMb2RlCvGsMTWd7WjrUJmpGyYEyg7hVZY17RUKKpcx23vOuvEJXl51i2xfF8wZT36ZHEYzIRhSZrXsma1lFQU9M0ZPb02Yq_n6MeSnGZUrwXqvb6XoV4LXIelwHL7-Z3R0o3o_t3921gBrs8Alu8ePEZdhEr66Hws-WkX_H8Z_QH6abvl</recordid><startdate>202101</startdate><enddate>202101</enddate><creator>Druwé, Patrick</creator><creator>Monsieurs, Koenraad G.</creator><creator>Gagg, James</creator><creator>Nakahara, Shinji</creator><creator>Cocchi, Michael N.</creator><creator>Élő, Gábor</creator><creator>van Schuppen, Hans</creator><creator>Alpert, Evan Avraham</creator><creator>Truhlář, Anatolij</creator><creator>Huybrechts, Sofie A.</creator><creator>Mpotos, Nicolas</creator><creator>Paal, Peter</creator><creator>BjØrshol, Conrad</creator><creator>Xanthos, Theodoros</creator><creator>Joly, Luc-Marie</creator><creator>Roessler, Markus</creator><creator>Deasy, Conor</creator><creator>Svavarsdóttir, Hildigunnur</creator><creator>Nurmi, Jouni</creator><creator>Owczuk, Radoslaw</creator><creator>Salmeron, Pascual Piñera</creator><creator>Cimpoesu, Diana</creator><creator>Fuenzalida, Pablo Aguilera</creator><creator>Raffay, Violetta</creator><creator>Steen, Johan</creator><creator>Decruyenaere, Johan</creator><creator>De Paepe, Peter</creator><creator>Piers, Ruth</creator><creator>Benoit, Dominique D.</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4869-3283</orcidid><orcidid>https://orcid.org/0000-0002-5968-6401</orcidid><orcidid>https://orcid.org/0000-0002-5541-5209</orcidid><orcidid>https://orcid.org/0000-0001-8776-6591</orcidid><orcidid>https://orcid.org/0000-0002-1920-4869</orcidid><orcidid>https://orcid.org/0000-0002-3655-4318</orcidid><orcidid>https://orcid.org/0000-0003-2077-6466</orcidid><orcidid>https://orcid.org/0000-0001-7307-384X</orcidid><orcidid>https://orcid.org/0000-0002-2939-4782</orcidid><orcidid>https://orcid.org/0000-0001-5261-220X</orcidid></search><sort><creationdate>202101</creationdate><title>Impact of perceived inappropiate cardiopulmonary resuscitation on emergency clinicians’ intention to leave the job: Results from a cross-sectional survey in 288 centres across 24 countries</title><author>Druwé, Patrick ; 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We evaluated whether perception of inappropriate CPR is associated with intention to leave the job among emergency clinicians.
A cross-sectional multi-centre survey was conducted in 24 countries. Factors associated with intention to leave the job were analysed by conditional logistic regression models. Results are expressed as odds ratios with 95% confidence intervals.
Of 5099 surveyed emergency clinicians, 1836 (36.0%) were physicians, 1313 (25.7%) nurses, 1950 (38.2%) emergency medical technicians. Intention to leave the job was expressed by 1721 (33.8%) clinicians, 3403 (66.7%) often wondered about the appropriateness of a resuscitation attempt, 2955 (58.0%) reported moral distress caused by inappropriate CPR. After adjustment for other covariates, the risk of intention to leave the job was higher in clinicians often wondering about the appropriateness of a resuscitation attempt (1.43 [1.23−1.67]), experiencing associated moral distress (1.44 [1.24−1.66]) and who were between 30−44 years old (1.53 [1.21−1.92] compared to <30 years). The risk was lower when the clinician felt valued by the team (0.53 [0.42−0.66]), when the team leader acknowledged the efforts delivered by the team (0.61 [0.49−0.75]) and in teams that took time for debriefing (0.70 [0.60−0.80]).
Resuscitation attempts perceived as inappropriate by clinicians, and the accompanying moral distress, were associated with an increased likelihood of intention to leave the job. Interprofessional collaboration, teamwork, and regular interdisciplinary debriefing were associated with a lower risk of intention to leave the job.
ClinicalTrials.gov; No.: NCT02356029</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>33227397</pmid><doi>10.1016/j.resuscitation.2020.10.043</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-4869-3283</orcidid><orcidid>https://orcid.org/0000-0002-5968-6401</orcidid><orcidid>https://orcid.org/0000-0002-5541-5209</orcidid><orcidid>https://orcid.org/0000-0001-8776-6591</orcidid><orcidid>https://orcid.org/0000-0002-1920-4869</orcidid><orcidid>https://orcid.org/0000-0002-3655-4318</orcidid><orcidid>https://orcid.org/0000-0003-2077-6466</orcidid><orcidid>https://orcid.org/0000-0001-7307-384X</orcidid><orcidid>https://orcid.org/0000-0002-2939-4782</orcidid><orcidid>https://orcid.org/0000-0001-5261-220X</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0300-9572 |
| ispartof | Resuscitation, 2021-01, Vol.158, p.41-48 |
| issn | 0300-9572 1873-1570 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2464146603 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adult Cardiopulmonary Resuscitation Cross-Sectional Studies Emergency department Emergency medical services Emergency Service, Hospital Futility Humans Inappropriate cardiopulmonary resuscitation Intention Moral distress Out of hospital cardiac arrest Physicians Surveys and Questionnaires |
| title | Impact of perceived inappropiate cardiopulmonary resuscitation on emergency clinicians’ intention to leave the job: Results from a cross-sectional survey in 288 centres across 24 countries |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-20T20%3A47%3A17IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Impact%20of%20perceived%20inappropiate%20cardiopulmonary%20resuscitation%20on%20emergency%20clinicians%E2%80%99%20intention%20to%20leave%20the%20job:%20Results%20from%20a%20cross-sectional%20survey%20in%20288%20centres%20across%2024%20countries&rft.jtitle=Resuscitation&rft.au=Druw%C3%A9,%20Patrick&rft.aucorp=on%20behalf%20of%20the%20REAPPROPRIATE%20study%20group&rft.date=2021-01&rft.volume=158&rft.spage=41&rft.epage=48&rft.pages=41-48&rft.issn=0300-9572&rft.eissn=1873-1570&rft_id=info:doi/10.1016/j.resuscitation.2020.10.043&rft_dat=%3Cproquest_cross%3E2464146603%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2464146603&rft_id=info:pmid/33227397&rft_els_id=S0300957220305645&rfr_iscdi=true |