The opinion of health professionals regarding the presence of relatives during cardiopulmonary resucitation

Family witnessed resuscitation and invasive procedures: Patient and family opinions

BACKGROUND

Family presence during invasive procedures and cardiopulmonary resuscitation (FPDR) is a highly controversial issue, with divergence of opinion among health professionals, with clinical evidence in favor, and with barriers to its implementation in comprehensive patient care. Many international organizations support health policies for its implementation, but it is not a widespread practice. Little research has been conducted on this subject from the perspective of patients and families.

OBJECTIVE

To learn opinions, perceptions, and desires of family members and patients in terms of family presence during invasive procedures and cardiopulmonary resuscitation.

METHOD

Qualitative descriptive study, using semi-structured interviews with relatives and patients regarding their experiences and perceptions about FPDR (n = 18) from 8 October 2017 to 8 March 2018. The interviews were recorded and transcribed verbatim for later analysis using the method of content analysis.

ETHICAL CONSIDERATIONS

This study has the approval of the Clinical Research Ethics Committee of the Fundació Unió Catalana d'Hospitals and ethical considerations were carefully regarded throughout the study.

RESULTS

Three significant categories were identified: knowledge, respect for rights, and accompaniment of the patient, relating FPDR to courage, emotional support, and trust in professionals.

CONCLUSION

FPDR is an unusual practice; it is not offered to patients or their families, and it is not considered a patient's right, although most of the interviewees support it. The desire for accompaniment is conditioned by the courage and knowledge of the accompanying persons, as well as the degree of invasiveness of the procedures. The results of this study provide information for a change of vision in patient-centered care.

Nurse-family relationship. Beyond the opening of doors and schedules

INTRODUCTION

Care in the Intensive Care Unit involves contemplating, among other dimensions of the patient, the family. For this, it is necessary for the nurse to establish relationships with the patient's relatives.

OBJECTIVE

To identify the way in which the nurse-family relationship is established in the adult ICU, as well as the conditions, elements and factors that favour or hinder it.

METHOD

Integrative narrative review of the scientific literature. The databases consulted were Ovid, PubMed, Science Direct, Scopus, Clinical Key, Google Scholar and Scielo. Articles in English and Spanish published between 2014 and 2018 were searched. The descriptors and formulas used were selected according to the acronym Population and their problems, Exposure and Outcomes or themes- PEO. The population comprised ICU nurses and the relatives of patients in critical condition; Adult Intensive Care Unit exposure or context; the expected results, and how they are related. For the methodological evaluation, the STROBE guide was used for observational articles, PRISMA for review articles, COREQ for qualitative articles and CASPe for articles derived from projects.

RESULTS

We identified 214 articles, of which 63 were selected to be included in the review. The central themes identified were: the ICU environment and its effects on the family, empathy as an indicator of relationship, interaction as a means of relating, communication as the centre of relationships and barriers to the establishment of relationships.

CONCLUSIONS

The nurse-family relationship in the Intensive Care Unit is based on interaction and communication amidst human, physical, regulatory and administrative barriers. Improving the nurse-family relationship contributes to the humanization of Adult Intensive Care Units.

Incremento del conocimiento en soporte vital básico facilitado por un recurso educativo digital

Introducción: La enfermedad cardiovascular es responsable de 17.3 millones de muertes por año en el mundo y conlleva a complicaciones como el paro cardiorrespiratorio, el cual se puede presentar tanto en el escenario intra como extrahospitalario. Tener una comunidad capacitada posibilita la sobrevida y/o mitigación de secuelas. Con el propósito de aumentar la población capacitada en soporte vital básico, favorecer el aprendizaje y dedicar más tiempo al desarrollo de habilidades prácticas, se construyó un recurso educativo digital. Objetivo: Determinar el efecto de un recurso educativo digital en el proceso de aprendizaje de soporte vital básico en integrantes de la comunidad de una institución de educación superior. Métodos: Estudio cuantitativo, pre-experimental tipo pre-prueba/pos-prueba en un solo grupo. Resultados: El recurso educativo digital para el aprendizaje de soporte vital básico en 110 estudiantes incrementó el conocimiento, mostró una diferencia estadísticamente significativa en los resultados del post-test en comparación con el pre-test: p<0.01 para grupos ajustados al modelo gaussiano y p<0.05 para el grupo no ajustado. Discusión: Los resultados de implementar un recurso educativo digital para la enseñanza de soporte vital básico es consecuente con los beneficios hallados en otros estudios similares. Los Objetos Virtuales de Aprendizaje favorecen en los estudiantes la motivación, el aprendizaje autorregulado y la apropiación de conocimientos, por lo que los proponen como estrategia de aprendizaje. Conclusión: El recurso educativo digital favoreció el aprendizaje e incrementó el conocimiento, requisito necesario en la formación como primer respondiente en los tres grupos de estudiantes de pregrado que participaron en el presente estudio.