Perception of Inappropriate CPR: a Multicenter International Cross-sectional Survey

NCT02356029 | Completed

• 1 other identifier: B670201422126
• Study Type: observational
• Target: 5,882
• Locations: 1 country
• Sites: 5

Brief Summary

The primary objective of this study is to determine how often cardiopulmonary resuscitation (CPR) is perceived as inappropriate by Healthcare Providers (HCPs) working in prehospital Ambulance Services and Emergency Departments. Perception of inappropriate CPR is defined as resuscitation efforts perceived by HCPs as disproportionate to the expected prognosis of the patient in terms of survival or quality of life. When a HCP perceives CPR as inappropriate, this may cause moral and emotional distress. This perception may be modulated by the personal background and professional role of the HCP, but also by his/her working conditions. Apart from the workload, the resulting distress can be influenced by the way non-technical skills are developed within the team and the ethical environment in which the HCP functions. Frequent exposure to similar patient care situations and/or a professional environment not acknowledging the distress may lead to deficient coping mechanisms and accumulation of moral distress. This may be associated with job leave, burnout and a decreased quality of patient care. Acute distress may also influence the quality of care provided to actual and future patients. Secondary objectives of the study are to evaluate whether perceived inappropriateness of CPR is not only associated with patient related factors but also with personal characteristics and work related factors. Potential consequences for HCP's like moral distress and intentional job leave will be assessed.

Conditions

Cardiopulmonary Arrest

Keywords

Cardiopulmonary Arrest; Emergency Medical Services; Medical Futility; Decision Making; Emotional Stress; Burnout, Professional

Outcome Measures

Primary Outcomes (1)

• The number of Healthcare Providers (HCPs) reporting Perceived Inappropriateness of CPR (PICPR) in the last cardiac arrest situation attended divided by the total number of surveyed HCPs

  2 weeks

Secondary Outcomes (1)

• Moral distress and intentional job leave associated with Perceived Inappropriateness of CPR (PICPR)

  2 weeks

Study Arms (1)

EMS Healthcare Providers

Healthcare Providers working in Emergency Medical Services and directly involved in treatment of cardiac arrest patients (out-of-hospital or in the Emergency Department)

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The survey will focus on Healthcare Providers (HCPs) directly involved in treatment of cardiac arrest patients (out-of-hospital or in the Emergency Department (ED)): nurses, doctors, ED Technicians/Nurse Assistants and Emergency Medical Technicians(EMT)/Paramedics working in EDs and prehospital Ambulance Services active in the Emergency Medical Services system of the country. Hospitals in countries without established EDs but with a group of HCPs working inside the hospital and having as their daily duty the first care and stabilisation of patients arriving unplanned in the hospital are also eligible for participation in the study. The Local Investigator will clearly delineate this functional unit within the hospital thus determining the number of eligible HCPs within the center.

You may qualify if:

• Healthcare Provider working in Emergency Department or Ambulance Service directly involved in treatment of cardiac arrest patients

You may not qualify if:

• Healthcare Provider working in Emergency Department or Ambulance Service not directly involved in treatment of cardiac arrest patients

Sponsors & Collaborators

• University Hospital, Ghent: lead

Study Sites (5)

UMC Sint-Pieter

Brussels, 1000, Belgium

Location

UVC Brugmann

Brussels, 1020, Belgium

Location

Groupe Jolimont

Haine-Saint-Paul, 7100, Belgium

Location

CHU Tivoli

La Louvière, 7100, Belgium

Location

CHU Vesale Charleroi

Montigny-le-Tilleul, 6110, Belgium

Location

Related Publications (4)

• Marco CA, Bessman ES, Kelen GD. Ethical issues of cardiopulmonary resuscitation: comparison of emergency physician practices from 1995 to 2007. Acad Emerg Med. 2009 Mar;16(3):270-3. doi: 10.1111/j.1553-2712.2008.00348.x. Epub 2009 Jan 9.

  PMID: 19183108 RESULT

• Marco CA, Schears RM. Prehospital resuscitation practices: a survey of prehospital providers. J Emerg Med. 2003 Jan;24(1):101-6. doi: 10.1016/s0736-4679(02)00688-1.

  PMID: 12554050 RESULT

• Partridge RA, Virk A, Sayah A, Antosia R. Field experience with prehospital advance directives. Ann Emerg Med. 1998 Nov;32(5):589-93. doi: 10.1016/s0196-0644(98)70038-1.

  PMID: 9795323 RESULT

• Druwe P, Monsieurs KG, Gagg J, Nakahara S, Cocchi MN, Elo G, van Schuppen H, Alpert EA, Truhlar A, Huybrechts SA, Mpotos N, Paal P, BjOrshol C, Xanthos T, Joly LM, Roessler M, Deasy C, Svavarsdottir H, Nurmi J, Owczuk R, Salmeron PP, Cimpoesu D, Fuenzalida PA, Raffay V, Steen J, Decruyenaere J, De Paepe P, Piers R, Benoit DD; REAPPROPRIATE study group. 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. Resuscitation. 2021 Jan;158:41-48. doi: 10.1016/j.resuscitation.2020.10.043. Epub 2020 Nov 20.

  PMID: 33227397 DERIVED

MeSH Terms

Conditions

Heart Arrest; Stress, Psychological; Burnout, Professional

Condition Hierarchy (Ancestors)

Heart Diseases; Cardiovascular Diseases; Behavioral Symptoms; Behavior; Occupational Stress; Occupational Diseases; Burnout, Psychological

Study Officials

• Patrick M Druwé, MD

  University Hospital, Ghent

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 14, 2015
• First Posted: February 5, 2015
• Study Start: March 1, 2015
• Primary Completion: November 1, 2015
• Study Completion: November 1, 2015
• Last Updated: May 17, 2018

Record last verified: 2018-05

Locations

BE (5)