Use of nursing resources and comfort of cancer patients with and without do-not-resuscitate orders in the intensive care unit.
BACKGROUND
Little is known about the level of comfort experienced by cancer patients with do-not-resuscitate orders and how use of nursing resources affects their comfort.


OBJECTIVE
To explore the relationship between use of nursing resources and comfort in cancer patients with and without do-not-resuscitate orders in the intensive care unit.


METHODS
The sample consisted of 30 adult patients who had do-not-resuscitate orders and 30 randomly selected patients who did not. Pairs consisting of 1 patient from each group were admitted to the study simultaneously and were evaluated during the same observation period. Level of comfort was assessed by using the PACU Behavioral Pain Rating Scale. Data on use of nursing resources, determined with the Therapeutic Intervention Scoring System, and on demographics and severity of illness were abstracted from the medical records.


RESULTS
Chi-square analyses revealed no significant relationship between comfort and use of nursing resources. Differences between the 2 types of patients in comfort and in use of resources were not significant. Evaluation of the multivariate relationship between comfort and use of resources, with do-not-resuscitate status added as a further predictor variable, revealed no significant relationships. Severity of illness and a patient's number of visitors were predictors of use of nursing resources.


CONCLUSIONS
Despite high use of nursing resources, nurses continue to focus on comfort as an outcome of care irrespective of patients' do-not-resuscitate status.
Kaplow
R
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Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
D000293:Adolescent; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D003422:Critical Care / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000150:complications*; D015401:Nursing Administration Research; D009741:Nursing Staff, Hospital / Q000706:statistics & numerical data* / Q000600:supply & distribution*; D010146:Pain / Q000175:diagnosis / Q000209:etiology* / Q000451:nursing* / Q000517:prevention & control; D010147:Pain Measurement; D011237:Predictive Value of Tests; D011787:Quality of Health Care; D016414:Resuscitation Orders; D012720:Severity of Illness Index; D013996:Time and Motion Studies; D014789:Visitors to Patients / Q000706:statistics & numerical data; D000078329:Workforce; D016526:Workload