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OP22 Consideration and impact of advance directives on therapeutic decisions in ten intensive care units in german speaking switzerland
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  1. B Affolter1,
  2. J Schefold2 and
  3. S Eychmüller2
  1. 1Centre for Palliative Care, Berne, Switzerland
  2. 2University Hospital of Berne, Berne, Switzerland

Abstract

Background Since 2013 advance directives (AD) are binding in Switzerland. Regularly ICU doctors complain that they are not helpful for making therapeutic choices. But there is no data how often intensive care staff ask for advance directives at all and whether this represents the experience of the majority of intensive care doctors and nurses.

Methods We performed a survey in 10 Intensive Care Units (ICUs) from the German speaking part of Switzerland. The survey was sent either electronically or in paper format to 1041 professionals. Analysis was descriptive.

Results 355 (34% response rate) professionals completed the questions concerning advance directives. Of the respondents 82% were nurses, 18% were ICU specialists or residents working in ICU. The majority of the staff asks always (33%) or regularly (50%) whether their patients have an AD. 6% of the doctors and 3% of the nurses say that an AD is always helpful for treatment decisions, while 29% of the doctors and 33% of the nurses judge it as usually helpful. 60% of doctors and 53% of nurses rated them as sometimes helpful for making therapeutic choices, while 4% of doctors and 11% of nurses estimated ADs did not or hardly ever assisted them.

Conclusions In our survey, 83% of participants stated that they usually ask their patient or their relatives whether an AD exists. In contrast to the impressions from public media and personal conversations the majority of the respondents indicated that ADs are at least sometimes helpful for therapeutic decisions.

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