ADVOCACY IN INTENSIVE CARE AND HOSPITALIZATION BY COURT ORDER: WHAT ARE THE PERSPECTIVES OF NURSES?

Development of the Patient Advocacy Scale for Intensive Care Nurses

Background and Purpose: To describe the process of developing and validating the content of the Patient Advocacy Scale for Nurses in Intensive Care (EAPEnf-UTI). Methods: Methodological research. To achieve the elaboration objective, five stages were developed: (a) definition of the theme, (b) generation of the number of items, (c) determination of the measurement format, (d) validation of face and content, and (e) content adjustment. Results: The instrument elaborated from a survey and integrative literature review, and the measurement format chosen was the 5-point Likert scale. The validation of face and content was performed by expert judges and by pretest. The final instrument had 57 items. Conclusion: EAPEnf-UTI is a pioneering instrument built in the Brazilian context, whose future validation will allow the capturing of situations specific to intensive care units and the professional practice of intensive care nurses.

Ethical advocacy in the end-of-life nursing care: A concept analysis

AIM

This concept analysis was conducted to identify and define the features and functions of ethical advocacy in the end-of-life nursing care.

BACKGROUND

Ethical advocacy is key to the role of the nurse in delivering quality and competent care. Despite this, the dimensions of this concept are poorly understood.

DESIGN/DATA SOURCE

Databases such as Google Scholar, Scopus, Web of Science, Science Direct, and PubMed were searched systematically. To search these databases, the following keywords were used: "patient advocacy," "nursing," "ethics," "end-of-life care," and their combinations.

REVIEW METHODS

Walker and Avant's method was utilized as a comprehensive review of the literature to explore how ethical advocacy in nursing can be used to improve the quality of care.

RESULTS

The defining attributes of the concept of ethical advocacy included adhering to ethical principles of nursing, championing social justice in the provision of healthcare, safeguarding and defending patient's rights by applying collective wisdom, and involving hospital ethics committees. Antecedents are organizational and personal power and ethical leadership. The optimal consequence of ethical advocacy can be getting the best ethical governance.

CONCLUSION

Based on this analysis, the concept of ethical advocacy is one of the most important roles for nurses which requires their awareness of this concept.

The Experiences of Intensive Care Nurses in Advocacy of COVID-19 Patients

The lack of face-to-face interactions with families, the increase in the number of patients admitted to the ICU, nursing staff shortages, and inadequate personal protective equipment has created many challenges for nurses in advocacy of the COVID-19 patient with life-threatening conditions. This study aimed to explore the experiences of intensive care nurses in the advocacy of COVID-19 patients. This study was performed using a qualitative content analysis method with Graneheim and Lundman approach, Iran, 2020. Data were collected through semi-structured interviews with eighteen clinical nurses from the intensive care units of three hospitals. Themes extracted from the nurses’ statements were promoting patient safety (informing physicians about the complications and consequences of treatment, preventing medical errors, protecting patients from threats), respecting the patients’ values (providing comfort at the end of life, providing a comfortable environment, commitment to confidentiality, cultural observance, respect for individualism, fair care), and informing (clarifying clinical conditions, describing available services, and being the patients’ voice). ICU nurses in health crises such as COVID-19 as patient advocates should promote patient safety, respect patients’ values, and inform them. The results of this study could help enhance the active role of intensive care nurses in the advocacy of COVID-19 patients.