The findings of the study suggested that patient safety educational interventions could be used by nursing administrators to enhance subcultures of patient safety such as "reporting" and "blame free," and to decrease the rate of adverse events.
In Jordan, an Arabic Islamic country, decisions around withholding and/or withdrawing life support measures still present both moral and professional dilemmas. The purpose of this study was to explore the use of such measures among patients with cancer in Jordan. The medical records of 436 patients with cancer who were at least 18 years old and who died at a specialized cancer centre in Jordan in 2008 were reviewed retrospectively. Of those, 212 (48.6%) had a written decision to withhold or withdraw life support measures. Among the 436 charts reviewed, only 7 patients (1.6%) had treatment withdrawn, while 212 (48.6%) had treatment withheld. Resuscitation was the most common treatment withheld, followed by medication, and poor prognosis was the most common reason for the decision. The time period between a decision being made and the death of the patient was short, indicating that treatment plans are not being made well in advance. A cultural and religious consensus regarding such decisions is needed to help ensure that a greater proportion of terminally ill people plan their care in advance, and to aid health-care providers in advising their patients and acting in the patients' best interests.
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