Advance directives: attitude of emergency department professionals

Mateos Rodríguez AA, Huerta Arroyo A, Benito Vellisca MA

Aims and purpose: Through a document of “aforegoing instructions”

(Vital Testament, Previous Dispositions), any person may

lay down documentarily his or her preferences regarding health

care and the final destination of his/her body and/or organs whenever

the time should come that he/she is not able to personally exptress

them. The aim of the present work is to assess thre degree of knowledge

and acceptance of such “Aforegoing Instructions” documnts

among health care professionals (medical and nursing staff) of an extrahospitalary

emergency service.

Material and methods: Self-administered survey questionnaires with a

number of items / questions were sent to all health care professionals

in the Service.

Results:Only 49 questionnaires out of 200 mailed were completed and returned.

Among the total number of responders, 58.3% were nurses (male

and female) and 41.7% physicians. The question asking whether the surveyee

knew what an “aforegoing instructions” (anticipated will, vital testament,

etc.) document is was answered in the positive by 73.5% of the responders;

81.6% answered affirmatively to the question whether they knew

what an order not to begin advanced cardiopulmonary resuscitation or

DNAR. Fifty-one per cent stated they had sometime asked whether anyone

knew or was aware of the patient’s preferences before starting CPR

manoeuvres. Some 83.3% of the responders stated they would be willing

to prepare an “Aforegoing Instructions” document for themselves, yet none

had done so. Only 18.4% stated they knew the current legislation involved.

Conclusions: Considering the above data, we conclude that “Aforegoing

Instructions” documents enjoy good acceptance among health care professionals,

yet that the latter have as yet but scanty information on this subject.

Benito Vellisca MA, Huerta Arroyo A, Mateos Rodríguez AA