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Factors Influencing Nurses' Participation in Voluntary‐Assisted Dying: A National Cross‐Sectional Study

ABSTRACT

Aim

To identify nurse practitioners' and registered nurses' willingness to participate in voluntary assisted dying, and the factors that influence these decisions.

Design

A cross-sectional design.

Methods

An online survey was disseminated to members of 16 professional nursing organisations and associations between April and August 2024.

Results

Responses from 396 participants were analysed. Most were registered nurses (n = 335, 84.6%), aged between 45 and 64 years (n = 217, 54.8%). Over half of the participants (n = 219, 55.3%) had some knowledge of voluntary assisted dying, and more than two-thirds (n = 274, 69.2%) strongly supported it. Respect for a person's rights (n = 345, 89.8%) and relieving suffering (n = 342, 89.1%) were the main reasons nurses participated. Most nurse practitioner participants would be prepared to assess a person's eligibility for voluntary assisted dying (n = 32, 82.1%) or prescribe a substance (n = 31, 79.5%), if permitted by law. Religion, age and years of experience were characteristics associated with reasons for participation.

Conclusion

In Australia, some RNs and NPs are willing to participate in a range of VAD-related activities. However, in some jurisdictions, nurses' engagement is limited by legislative and policy settings. Reconsideration of nurses' roles may enhance access.

Implications for the Profession

With appropriate support, nurses can make a valuable contribution to the sustainability of the voluntary assisted dying workforce.

Understanding how post-intensive care follow-up is delivered within the role of critical care outreach teams: a qualitative study protocol

Por: Bonner · A. · Gustafson · O. · Betteridge · S. · Pattison · N. · Watkinson · P. J. · Vollam · S.
Introduction

Each year over 130 000 patients in the UK are discharged from an intensive care unit (ICU), with many experiencing poor outcomes such as in-hospital mortality, emergency ICU readmission and/or significant morbidity. Despite current national guidance and the availability of follow-up services, post-ICU care remains variable. Critical Care Outreach Teams (CCOTs) are key in supporting this patient group, yet practice differs considerably. Recovery pathways have been successfully employed in other patient populations and are a potential option to standardise post-ICU care. Understanding how care is currently delivered by CCOT throughout the UK is essential to inform future development of an evidence-based recovery pathway for this patient group. Our primary aim is to understand how post-ICU follow-up care is delivered within the wider remit of CCOT workloads.

Methods and analysis

This is a pragmatic multicentre qualitative study of post-ICU follow-up care. The study will be split into two sub-studies: semi-structured interviews and ethnographic observations. Semi-structured interviews will be conducted with three groups of individuals: multi-professional staff members involved in the care of patients discharged from ICU to the wards, patients discharged from ICU to the wards and their family members. Direct participant observations alongside ad hoc informal discussions will be undertaken with members of the CCOT at participating sites focusing on their workflow to generate an understanding of the CCOT role and how post-ICU support fits within this. An overarching thematic analysis approach will be taken to analyse data from both sub-studies to clearly identify the barriers and facilitators to providing post-ICU support within the CCOT role.

Ethics and dissemination

Ethical approval has been obtained through the London—Chelsea Research Ethics Committee (25/PR/0773). We aim to disseminate the findings to local teams, at regional and international conferences, in peer-reviewed journals and through social media.

Trial registration number

ISRCTN14138257.

Remote symptom assessment and management via mobile app for adults with chronic kidney disease in Vietnam (SAM-CKD programme): a randomised feasibility trial protocol

Por: Bui · K. L. · Hyun · A. · Purtell · L. · Hoang · V. L. · Bonner · A.
Introduction

Adults with chronic kidney disease (CKD) experience a wide range of symptoms that significantly lower their health-related quality of life (HRQoL). Using mobile-based applications for symptom assessment and management has the potential to alleviate the symptom burden of CKD and improve patient outcomes.

Methods and analysis

This is a randomised feasibility trial to assess the feasibility, acceptability, usability and potential effects of a remote symptom assessment and management (SAM-CKD) 6 week programme delivered via a mobile application. Adults aged 18 years or older with CKD grade 4 or 5 (including those on dialysis) will be randomly assigned to the SAM-CKD programme or usual care. Primary outcomes assess the intervention’s feasibility, acceptability and usability. Secondary outcomes are changes in CKD symptoms and HRQoL between baseline, 3 weeks and 6 weeks later. Data analysis involves descriptive and intention-to-treat analyses. The study will be undertaken between December 2025 and March 2026. The findings will inform whether an effective trial is feasible and whether the study design and/or its methods need modification.

Ethics and dissemination

Ethical approval was granted by the Vin University and Griffith University Human Research Ethics Committee. Results will be disseminated at the participating hospital and CKD patient groups and shared via peer-reviewed publications and conference presentations.

Trial registration number

NCT07186361.

Distal Radius Interventions for Fracture Treatment (DRIFT) trial: study protocol for a multicentre randomised clinical trial of completely translated distal radius fractures at paediatric hospitals in North America

Por: Balmert Bonner · L. · Janicki · J. · Georgiadis · A. · Truong · W. · Harris Beauvais · D. · Belthur · M. · Daley · E. L. · Franzone · J. · Howard · A. · May · C. · Rockhold · F. · Schulz · J. · Bailey · M. · Chiswell · K. · DeLaRosa · J. · Brooks · J. T. · Cantanzano · A. A. · Chan · A.
Introduction

Distal radius fractures are the most common fractures seen in the emergency department in children in the USA. However, no established or standardised guidelines exist for the optimal management of completely displaced fractures in younger children. The proposed multicentre randomised trial will compare functional outcomes between children treated with fracture reduction under sedation versus children treated with simple immobilisation.

Methods and analysis

Participants aged 4–10 years presenting to the emergency department with 100% dorsally translated metaphyseal fractures of the radius less than 5 cm from the distal radial physis will be recruited for the study. Those patients with open fractures, other ipsilateral arm fractures (excluding ulna), pathologic fractures, bone diseases, or neuromuscular or metabolic conditions will be excluded. Participants who agree to enrol in the trial will be randomly assigned via a minimal sufficient balance algorithm to either sedated reduction or in situ immobilisation. A sample size of 167 participants per arm will provide at least 90% power to detect a difference in the primary outcome of Patient-Reported Outcomes Measurement Information System Upper Extremity computer adaptive test scores of 4 points at 1 year from treatment. Primary analyses will employ a linear mixed model to estimate the treatment effect at 1 year. Secondary outcomes include additional measures of perceived pain, complications, radiographic angulation, satisfaction and additional procedures (revisions, refractures, reductions and reoperations).

Ethics and dissemination

Ethical approval was obtained from the following local Institutional Review Boards: Advarra, serving as the single Institutional Review Board, approved the study (Pro00062090) in April 2022. The Hospital for Sick Children (Toronto, ON, Canada) did not rely on Advarra and received separate approval from their local Research Ethics Board (REB; REB number: 1000079992) on 19 July 2023. Results will be disseminated through publication in peer-reviewed journals and presentations at international conference meetings.

Trial registration number

NCT05131685.

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