title: Risky procedures by nurses in hospitals: problems and (contemplated) refusals of orders by physicians, and views of physicians and nurses.
abstract: Occurrence of problems with, refusals of orders and contemplated refusals of orders for risky procedures by nurses in Dutch hospitals and views on the safety of performance was studied using postal questionnaires (600 physicians and 3200 nurses, response 60-71%). Of the respondents, 11-30% experienced problems with and (contemplated) refusals of orders for risky procedures in the previous 12 months. Gynaecologists and internists most frequently mentioned problems concerning the practical performance of the procedure (44% and 30%, respectively). The reason for a problem or a contemplated refusal most frequently given by nurses was that they disagreed with the medication policy (34% and 35%, respectively). The reason for a refusal most frequently given by the gynaecologists, internists and nurses was that the nurses themselves were of the opinion that they did not have the necessary authorisation (95%, 67%, and 62%, respectively). With regard to certain procedures, the views of professionals are more strict than the current legal regulations.
authors.affiliation: Department of Public and Occupational Health, Institute for Research in Extramural Medicine, VU University Medical Centre, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. j.debie@vumc.nl
authors.forename: J
authors.initials: J
authors.lastname: de Bie
authors.forename: J M
authors.initials: JM
authors.lastname: Cuperus-Bosma
authors.forename: M A B
authors.initials: MA
authors.lastname: van der Jagt
authors.forename: J K M
authors.initials: JK
authors.lastname: Gevers
authors.forename: G
authors.initials: G
authors.lastname: van der Wal
mesh_terms: D001291:Attitude of Health Personnel; D032022:Delegation, Professional; D006176:Gynecology; D006801:Humans; D007388:Internal Medicine; D009426:Netherlands; D024802:Nurse's Role; D009741:Nursing Staff, Hospital / Q000592:standards*; D019555:Physician-Nurse Relations; D012308:Risk Management / Q000331:legislation & jurisprudence