PURPOSE: The purpose of this literature review is to describe the severity of and susceptibility for negative outcomes in patients with implantable cardioverter defibrillators (ICDs) who lack advanced directives. DATA SOURCES: A comprehensive review of literature was conducted with articles selected from CINAHL, Pubmed, Ovid, Medline, evidence-based medicine, evidence-based nursing, and the Web of Science from 1990 to the present. Key words such as ICD, randomized controlled trials, case studies, advanced directives, end-of-life, living will, health care proxy, and durable power of attorney were used to identify specific studies. CONCLUSIONS: Advanced directives are becoming an essential part of care for the ICD population. The recommendations in the literature suggest that clinicians should initiate end-of-life discussions with their patients when they are healthy. The patients' preferences should be discussed often in patient care in case they would like changes made to their advance directive as their condition changes. IMPLICATIONS FOR PRACTICE: Implementation of advanced directives in patients' medical care will need to be encouraged in the event of illness. Advanced practice nurses can provide clear explanations of patients' treatment choices in outpatient and inpatient settings.
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机译：目的：本文献综述的目的是描述缺乏先进指南的植入式心脏复律除颤器（ICD）患者的阴性结果的严重性和易感性。数据来源：从1990年至今，对选自CINAHL，Pubmed，Ovid，Medline，循证医学，循证护理和Web of Science的文章进行了文献综述。诸如ICD，随机对照试验，案例研究，高级指示，寿命终止，生前遗嘱，健康护理委托书和持久授权书等关键词被用来确定具体研究。结论：高级指令正成为ICD人群护理的重要组成部分。文献中的建议建议临床医生应在健康的情况下与患者进行临终讨论。在患者护理中，应经常讨论患者的喜好，以防他们希望随着病情的变化而更改其预先医疗指示。实践的含义：如果生病，则需要鼓励在患者的医疗保健中执行高级指令。高级实践护士可以在门诊和住院环境中为患者的治疗选择提供清晰的解释。
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