title: [Experiences of Austrian nursing staff in dealing with advance directives].
abstract: BACKGROUND
  Advance directive is a contemporary issue because of accentuation of patients' autonomy and the increasing medical progress. But problems arise in drafting an advance directive as well as in realisation of advance directives in institutions. The duties and the influence of nursing in this context are hardly an object of scientific investigations. This article first describes empirically the role of nurses in connection with advance directives.
  
  
  OBJECTIVE
  AIM of this study is the description of nurses' experiences in connection with advance directives.
  
  
  METHODS
  A descriptive-explorative cross-section design was used for this study. Data were recorded by means of a semi-structured questionnaire. This questionnaire was handed out to 266 nurses working at an Austrian university hospital.
  
  
  RESULTS
  On the part of nurses there is a great insecurity with concurrent existence of sufficient theoretical professional knowledge and missing structures of the part of organisation. Because of these situations some interdisciplinary conflicts arise in connection with realisation of advanced directives.
  
  
  CONCLUSIONS
  To avoid conflicts and to improve the handling and realisation of advance directives in practice it is recommendable to establish clinical ethical consultation. The tasks of the clinical ethical consultation are the creation and implementation of ethical directives in the institution, the realisation of individual case discussions and the ethical education of the affected health care professionals.
authors.affiliation: Abteilung Organisationsentwicklung, AKH Wien Medizinischer Universitätscampus, Österreich.
authors.forename: Patrik
authors.initials: P
authors.lastname: Heindl
authors.affiliation: Abteilung Organisationsentwicklung, AKH Wien Medizinischer Universitätscampus, Österreich.
authors.forename: Sabine
authors.initials: S
authors.lastname: Ruppert
authors.affiliation: Abteilung Organisationsentwicklung, AKH Wien Medizinischer Universitätscampus, Österreich.
authors.forename: Vlastimil
authors.initials: V
authors.lastname: Kozon
mesh_terms: D000328:Adult; D016223:Advance Directives / Q000331:legislation & jurisprudence* / Q000523:psychology*; D001291:Attitude of Health Personnel; D001317:Austria; D064648:Critical Care Nursing; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D005260:Female; D006302:Health Services Research; D006785:Hospitals, University; D006801:Humans; D007318:Inservice Training; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role / Q000523:psychology*; D010166:Palliative Care / Q000523:psychology; D026684:Personal Autonomy; D016414:Resuscitation Orders / Q000331:legislation & jurisprudence* / Q000523:psychology*; D013041:Specialties, Nursing; D011795:Surveys and Questionnaires
keywords: Advance Care Planning; Lebensende; Palliative Care; Patientenverfügung; Pflegepraxis; advance care planning; advance directive; end-of-life; nursing practice; palliative care