used for developing research questions withsurgeons and the Oxford nursing research strategywill be presented. This will be followed by a sharingof thoughts and ideas around practice based ques-tions. Flip charts and a form of nominal group tech-nique will be used to rank questions in relation totheir importance. The session will finish with abrief discussion about possible ways forward forincreasing nursing research in Orthopaedic andTrauma Nursing. Notes from the flipcharts will betyped up and emailed out to participants. Partici-pants do not require any knowledge of researchto attend this work shop just an inquiring approachto practice.

Intended learning outcomes:

� To gain an understanding of identifying researchquestions using a Delphi approach.� To share questions arising from practice andconsider them from a research perspective.� To rate the research questions generated inorder of their importance.

Recommended reading:Keeney, S., Hasson, F., McKenna, H., 2006. Con-

sulting the oracle: ten lessons from using the Del-phi technique in nursing research. Journal ofAdvanced Nursing 53 (2), 205–212.

Tutton, E., Seers, K., Langstaff, D., 2008. Pro-fessional nursing culture on a trauma unit: experi-ences of patients and staff. Journal of AdvancedNursing 61 (2), 145–153.

Tutton, E., Gray, B., 2009. Fluid optimisationusing a peripherally inserted catheter (PICC) fol-lowing proximal femoral fracture: lessons learnedfrom a feasibility study. Journal of OrthopaedicNursing 13 (1), 11–18.

doi:10.1016/j.joon.2009.07.018

Debating issues and ethics in withdrawal oftreatment in the orthopaedic patient (workshop)Neil Boyland

Royal United Hospital NHS Trust, Bath, UK

Aim: To create discussion and raise awareness ofsituations where a decision has been made thatwithdrawal or no further treatment has beenmade.

Abstract: Arguably one of the most rewardingaspects of nursing is the successful involvement incardiopulmonary resuscitation and a good andeffective outcome for the patient. In stark con-

trast, when a patient is inappropriately resusci-tated this can be distressing for all involved,especially for nurses. Health professionals areaware that decisions about cardiopulmonary resus-citation (CPR) raise very sensitive and potentiallydistressing issues for patients, the people close tothem and also for the nurse caring for the individ-ual patient. Many nurses find it difficult to cometo terms with why medical staff have made thedecision to either withdraw or not escalate treat-ment or decide on a ‘‘do not resuscitate’’ order.For many nurses this difficulty might be relatedto lack of exposure to these situations or just poorunderstanding and knowledge. Nurses should be in-volved in the decision making process with patientsand their families.

The workshop will highlight nurses’ need to beproactive in deciding what is nursing care and whatis treatment. Orthopaedic patients are a specialgroup of individuals and will present with difficultconditions, situations and age differences. Under-pinning the knowledge and evidence in decisionmaking for withdrawal of treatment can only makethe nurse more effective in care delivery for thepatient, their family and the whole multi disciplin-ary team.

Intended learning outcomes:

� To raise awareness with the individual nurse howdecisions are made when to withdraw treatmentof patients.� To demonstrate the legal requirements in thedecision making process of withdrawal of treat-ment relating to this practice.� To discuss and share best practice in this diffi-cult decision making process.

Recommended reading:Ciccone, G., 2006. Don’t be a code breaker.

Nursing Standard 20 (25), 69Jevon, P., 1999. Do no resuscitate orders: the is-

sues. Nursing Standard 31 (40), 45–46.Resuscitation Council (UK), 2007. Decisions

relating to Cardiopulmonary Resuscitation. A Jointstatement from the British Medical Association, theResuscitation Council (UK) and the Royal College ofNursing.

Royal College of Nursing, 2002. Witnessing resus-citation. Guidance for Nursing Staff.

Wainwright, P., Gallagher, A., 2007 Ethical as-pects of withdrawing and withholding of treat-ment. Nursing Standard 21 (33), 46–50.

doi:10.1016/j.joon.2009.07.019

Selected abstracts from the 23rd Royal College of Nursing Society 139