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Bradford JY, Camarda A, Gilmore L, Horigan AE, Kaiser J, MacPherson-Dias R, Perry A, Slifko A, Slivinski A, Van Dusen K, Bishop-Royse J, Delao AM. ENA Clinical Practice Guideline Synopsis: Family Presence During Resuscitation and Invasive Procedures. J Emerg Nurs 2024; 50:463-468. [PMID: 38705706 DOI: 10.1016/j.jen.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 09/06/2023] [Indexed: 05/07/2024]
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Douglas CA, Smith MR. Family presence during resuscitation: Perceptions and confidence of intensive care nurses in an Australian metropolitan hospital. Aust Crit Care 2024; 37:295-300. [PMID: 37652791 DOI: 10.1016/j.aucc.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 07/13/2023] [Accepted: 07/17/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND While literature supporting family presence during resuscitation (FPDR) was first published over three decades ago, the practice remains controversial. Benefits have been confirmed, and barriers to practice identified through international research. The extent that FPDR is practised in Australian intensive care units (ICUs) is currently unknown. OBJECTIVES To examine ICU nurses' previous exposure and experiences with FPDR To establish their perceptions of the risks and benefits of the practice, as well as their confidence participating. METHODS A descriptive, cross-sectional study design, using validated FPDR risk-benefits and confidence scales, was distributed electronically to registered nurses working within a single adult ICU in Australia. RESULTS Fifty-six percent (n = 45) of respondents had never witnessed FPDR. Respondents were divided on whether families had the right to be present or should be given the option. ICU nurses perceived benefits for families but not for the patients involved or for the nurses participating. Nurses indicated they felt conflicted between the needs of the family, preserving the quality of the care delivered to a deteriorating patient, and protecting the safety of all stakeholders. Support for FPDR was often dependent on the availability of resources such as a family-support person. CONCLUSION This research establishes that ICU nurses lacked exposure to FPDR but were confident in their ability to perform, be observed, and support families during a resuscitation event. Therefore, confidence is likely not a factor in a decision to reject the practice. Further education is indicated as there remained a reluctance to adopt FPDR practice, despite many of the barriers reported having already been largely disproven by the available literature. Institutions have a role in policy development, ensuring adequate resources, and education.
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Affiliation(s)
- Candice Ann Douglas
- Adelaide Nursing School, The University of Adelaide, Corner of North Tce and George St, Adelaide SA, 5000, Australia.
| | - Morgan Roberta Smith
- Adelaide Nursing School, The University of Adelaide, Corner of North Tce and George St, Adelaide SA, 5000, Australia.
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Rubin MA, Meulengracht SES, Frederiksen KAP, Thomsen T, Møller AM. The healthcare professionals' perspectives and experiences with family presence during resuscitation: A qualitative evidence synthesis. Acta Anaesthesiol Scand 2024; 68:101-121. [PMID: 37669907 DOI: 10.1111/aas.14323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 07/31/2023] [Accepted: 08/15/2023] [Indexed: 09/07/2023]
Abstract
INTRODUCTION Family presence during resuscitation (FPDR) is a growing hospital praxis despite lack of high-quality evidence. The aim of this qualitative evidence synthesis review was to synthesize current evidence regarding healthcare professionals (HCP) perspectives on barriers and facilitating factors of FPDR and the potential impact of FPDR on HCP performance. METHODS We conducted a systematic literature search May 17, 2023 including primary studies with qualitative study designs. We applied NVivo for data analysis. Data was coded with line-by-line coding and organized into themes and categories following the method for thematic synthesis described by Thomas and Harden to analyse data. The studies underwent quality appraisal by Critical Appraisal Skills Program. We used GRADE CERQual to assess the confidence in the evidence. RESULTS We identified 8241 articles suitable for screening, 141 articles were full text screened, and nine studies included from Australia, UK and USA. In total, 134 HCP participated, between 2005 and 2019. Most studies lacked sufficiently rigorous data analysis and findings were appraised to have moderate GRADE CERQual confidence. We identified three analytical themes ("Facilitating factors for FPDR", "Barriers for FPDR" and "How staff are affected by FPDR") with eight descriptive subthemes. One finding was of high GRADE CERQual confidence: a belief that FPDR is "the right thing to do" which was a "Facilitating factor of FPDR." CONCLUSION The evidence on HCP perspectives is of low to moderate confidence. The interviewed consent that FPDR is the "right thing to do", and an ethical principle of beneficence is dominant, especially regarding children.
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Affiliation(s)
- Monika Afzali Rubin
- Department of Anaesthesiology and Herlev ACES, Herlev Anaesthesia Critical and Emergency Care Science Unit, Copenhagen University Hospital, Herlev-Gentofte, Denmark
| | | | - Katja Anna Poulsen Frederiksen
- Department of Anaesthesiology and Herlev ACES, Herlev Anaesthesia Critical and Emergency Care Science Unit, Copenhagen University Hospital, Herlev-Gentofte, Denmark
| | - Thordis Thomsen
- Department of Anaesthesiology and Herlev ACES, Herlev Anaesthesia Critical and Emergency Care Science Unit, Copenhagen University Hospital, Herlev-Gentofte, Denmark
| | - Ann Merete Møller
- Department of Anaesthesiology and Herlev ACES, Herlev Anaesthesia Critical and Emergency Care Science Unit, Copenhagen University Hospital, Herlev-Gentofte, Denmark
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Toy J. Family-Witnessed Cardiopulmonary Resuscitation During Emergency Department Cardiac Arrest Care: A Resident Perspective. Ann Emerg Med 2023; 82:207-215. [PMID: 36841662 DOI: 10.1016/j.annemergmed.2023.01.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 01/10/2023] [Accepted: 01/24/2023] [Indexed: 02/27/2023]
Affiliation(s)
- Jake Toy
- Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA.
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Abstract
BACKGROUND Patients and their relatives often expect to be actively involved in decisions of treatment. Even during resuscitation and acute medical care, patients may want to have their relatives nearby, and relatives may want to be present if offered the possibility. The principle of family presence during resuscitation (FPDR) is a triangular relationship where the intervention of family presence affects the healthcare professionals, the relatives present, and the care of the patient involved. All needs and well-being must be balanced in the context of FPDR as the actions involving all three groups can impact the others. OBJECTIVES The primary aim of this review was to investigate how offering relatives the option to be present during resuscitation of patients affects the occurrence of post-traumatic stress disorder (PTSD)-related symptoms in the relatives. The secondary aim was to investigate how offering relatives the option to be present during resuscitation of patients affects the occurrence of other psychological outcomes in the relatives and what effect family presence compared to no family presence during resuscitation of patients has on patient morbidity and mortality. We also wanted to investigate the effect of FPDR on medical treatment and care during resuscitation. Furthermore, we wanted to investigate and report the personal stress seen in healthcare professionals and if possible describe their attitudes toward the FPDR initiative. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, PsycINFO, and CINAHL from inception to 22 March 2022 without any language limits. We also checked references and citations of eligible studies using Scopus, and searched for relevant systematic reviews using Epistomonikos. Furthermore, we searched ClinicalTrials.gov, WHO ICTRP, and ISRCTN registry for ongoing trials; OpenGrey for grey literature; and Google Scholar for additional trials (all on 22 March 2022). SELECTION CRITERIA We included randomized controlled trials of adults who have witnessed a resuscitation attempt of a patient (who was their relative) at the emergency department or in the pre-hospital emergency medical service. The participants of this review included relatives, patients, and healthcare professionals during resuscitation. We included relatives aged 18 years or older who have witnessed a resuscitation attempt of a patient (who is their relative) in the emergency department or pre-hospital. We defined relatives as siblings, parents, spouses, children, or close friends of the patient, or any other descriptions used by the study authors. There were no limitations on adult age or gender. We defined patient as a patient with cardiac arrest in need of cardiopulmonary resuscitation (CPR), a patient with a critical medical or traumatic life-threatening condition, an unconscious patient, or a patient in any other way at risk of sudden death. We included all types of healthcare professionals as described in the included studies. There were no limitations on age or gender. DATA COLLECTION AND ANALYSIS We checked titles and abstracts of studies identified by the search, and obtained the full reports of those studies deemed potentially relevant. Two review authors independently extracted data. As it was not possible to conduct meta-analyses, we synthesized data narratively. MAIN RESULTS The electronic searches yielded a total of 7292 records after deduplication. We included 2 trials (3 papers) involving a total of 595 participants: a cluster-randomized trial from 2013 involving pre-hospital emergency medical services units in France, comparing systematic offer for a relative to witness CPR with the traditional practice, and its 1-year assessment; and a small pilot study from 1998 of FPDR in an emergency department in the UK. Participants were 19 to 78 years old, and between 56% and 64% were women. PTSD was measured with the Impact of Event Scale, and the median score ranged from 0 to 21 (range 0 to 75; higher scores correspond to more severe disease). In the trial that accounted for most of the included participants (570/595), the frequency of PTSD-related symptoms was significantly higher in the control group after 3 and 12 months, and in the per-protocol analyses a significant statistical difference was found in favor of FPDR when looking at PTSD, anxiety and depression, and complicated grief after 1 year. One of the included studies also measured duration of patient resuscitation and personal stress in healthcare professionals during FPDR and found no difference between groups. Both studies had high risk of bias, and the evidence for all outcomes except one was assessed as very low certainty. AUTHORS' CONCLUSIONS There was insufficient evidence to draw any firm conclusions on the effects of FPDR on relatives' psychological outcomes. Sufficiently powered and well-designed randomized controlled trials may change the conclusions of the review in future.
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Affiliation(s)
- Monika Afzali Rubin
- Department of Anaesthesiology and Herlev ACES, Herlev Anaesthesia Critical and Emergency Care Science Unit, Copenhagen University Hospital, Herlev-Gentofte, Copenhagen, Denmark
| | | | - Suzanne Forsyth Herling
- The Neuroscience Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- University of Copenhagen, Copenhagen, Denmark
| | - Patricia Jabre
- Assistance Publique-Hôpitaux de Paris (AP-HP), SAMU (Service d'Aide Médicale Urgente) de Paris, Hôpital Universitaire Necker-Enfants Malades, Paris, France
- Cochrane Pre-hospital and Emergency Care Field, Paris, France
- Université Paris Cité, Paris Cardiovascular Research Centre (PARCC), INSERM, Integrative Epidemiology of Cardiovascular Diseases Team, Paris, France
| | - Ann Merete Møller
- Department of Anaesthesiology and Herlev ACES, Herlev Anaesthesia Critical and Emergency Care Science Unit, Copenhagen University Hospital, Herlev-Gentofte, Copenhagen, Denmark
- University of Copenhagen, Copenhagen, Denmark
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Dainty KN, Atkins DL, Breckwoldt J, Maconochie I, Schexnayder SM, Skrifvars MB, Tijssen J, Wyllie J, Furuta M, Aickin R, Acworth J, Atkins D, Couto TB, Guerguerian AM, Kleinman M, Kloeck D, Nadkarni V, Ng KC, Nuthall G, Ong YKG, Reis A, Rodriguez-Nunez A, Schexnayder S, Scholefield B, Tijssen J, Voorde PVD, Wyckoff M, Liley H, El-Naggar W, Fabres J, Fawke J, Foglia E, Guinsburg R, Hosono S, Isayama T, Kawakami M, Kapadia V, Kim HS, McKinlay C, Roehr C, Schmolzer G, Sugiura T, Trevisanuto D, Weiner G, Greif R, Bhanji F, Bray J, Breckwoldt J, Cheng A, Duff J, Eastwood K, Gilfoyle E, Hsieh MJ, Lauridsen K, Lockey A, Matsuyama T, Patocka C, Pellegrino J, Sawyer T, Schnaubel S, Yeung J. Family presence during resuscitation in paediatric and neonatal cardiac arrest: A systematic review. Resuscitation 2021; 162:20-34. [PMID: 33577966 DOI: 10.1016/j.resuscitation.2021.01.017] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 12/17/2020] [Accepted: 01/11/2021] [Indexed: 10/22/2022]
Abstract
CONTEXT Parent/family presence at pediatric resuscitations has been slow to become consistent practice in hospital settings and has not been universally implemented. A systematic review of the literature on family presence during pediatric and neonatal resuscitation has not been previously conducted. OBJECTIVE To conduct a systematic review of the published evidence related to family presence during pediatric and neonatal resuscitation. DATA SOURCES Six major bibliographic databases was undertaken with defined search terms and including literature up to June 14, 2020. STUDY SELECTION 3200 titles were retrieved in the initial search; 36 ultimately included for review. DATA EXTRACTION Data was double extracted independently by two reviewers and confirmed with the review team. All eligible studies were either survey or interview-based and as such we turned to narrative systematic review methodology. RESULTS The authors identified two key sets of findings: first, parents/family members want to be offered the option to be present for their child's resuscitation. Secondly, health care provider attitudes varied widely (ranging from 15% to >85%), however, support for family presence increased with previous experience and level of seniority. LIMITATIONS English language only; lack of randomized control trials; quality of the publications. CONCLUSIONS Parents wish to be offered the opportunity to be present but opinions and perspectives on the family presence vary greatly among health care providers. This topic urgently needs high quality, comparative research to measure the actual impact of family presence on patient, family and staff outcomes. PROSPERO REGISTRATION NUMBER CRD42020140363.
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Affiliation(s)
- Katie N Dainty
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada.
| | - Dianne L Atkins
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Jan Breckwoldt
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Ian Maconochie
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Steve M Schexnayder
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Markus B Skrifvars
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Janice Tijssen
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Jonathan Wyllie
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Marie Furuta
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Richard Aickin
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Jason Acworth
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Dianne Atkins
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Thomaz Bittencourt Couto
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Anne-Marie Guerguerian
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Monica Kleinman
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - David Kloeck
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Vinay Nadkarni
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Kee-Chong Ng
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Gabrielle Nuthall
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Yong-Kwang Gene Ong
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Amelia Reis
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Antonio Rodriguez-Nunez
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Steve Schexnayder
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Barney Scholefield
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Janice Tijssen
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Patrick van de Voorde
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Myra Wyckoff
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Helen Liley
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Walid El-Naggar
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Jorge Fabres
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Joe Fawke
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Elizabeth Foglia
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Ruth Guinsburg
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Shigeharu Hosono
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Tetsuya Isayama
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Mandira Kawakami
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Vishal Kapadia
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Han-Suk Kim
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Chris McKinlay
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Charles Roehr
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Georg Schmolzer
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Takahiro Sugiura
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Daniele Trevisanuto
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Gary Weiner
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Robert Greif
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Farhan Bhanji
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Janet Bray
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Jan Breckwoldt
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Adam Cheng
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Jonathan Duff
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Kathryn Eastwood
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Elaine Gilfoyle
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Ming-Ju Hsieh
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Kasper Lauridsen
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Andrew Lockey
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Tasuku Matsuyama
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Catherine Patocka
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Jeffrey Pellegrino
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Taylor Sawyer
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Sebastian Schnaubel
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
| | - Joyce Yeung
- North York General Hospital, Li Ka Shing Knowledge Institute, 4001 Leslie Street, Toronto, Ontario M3K 3E1, Canada
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de Mingo-Fernández E, Belzunegui-Eraso Á, Jiménez-Herrera M. Family presence during resuscitation: adaptation and validation into Spanish of the Family Presence Risk-Benefit scale and the Self-Confidence scale instrument. BMC Health Serv Res 2021; 21:221. [PMID: 33706783 PMCID: PMC7953805 DOI: 10.1186/s12913-021-06180-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 02/16/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Family Presence during Cardiopulmonary Resuscitation has been studied both to identify the opinions of health professionals, patients, and family members, and to identify benefits and barriers, as well as to design protocols for its implementation. R. Twibell and her team designed an instrument that measured nurses' perceptions of Risks-Benefits and Self-Confidence regarding Family Presence during Resuscitation. There are few studies in Spain on this practice. METHODS The aim is to adapt and validate into Spanish the Family Presence Risk-Benefit scale and Family Presence Self-Confidence scale instrument. For this purpose, this instrument was translated cross-culturally, and administered in paper and online version. Statistical tests were carried out for the validity of the questionnaire. Five hundred forty-one healthcare professionals were invited to respond. The results were analyzed by the same statistical procedures as in the original scale. Ethical approvals and research permissions were obtained according to national standards. RESULTS Two hundred thirty-seven healthcare professionals (43.8%) answered the survey (69% women), of whom 167 were nurses. Validation of instruments: Cronbach's α in Family Presence Risk-Benefit scale was 0.94. Cronbach's α in Family Presence Self-Confidence scale was 0.96. Factor Analysis Kaiser, Meyer and Olkin (KMO) was greater than 0.9. The correlation between the two measured scales, is significant and has a moderate intensity of the relationship (r = 0.65 and α < 0.001). A lower predisposition to Family Presence during Cardiopulmonary Resuscitation is observed, but the pure detractors are only 12%. Doctors are more reluctant than nurses. CONCLUSIONS The psychometric properties of the questionnaire in Spanish indicate high validity and reliability. Risk-Benefit perception and Self-Confidence are related to the healthcare professionals who consider the Family Presence to be beneficial. More studies in different contexts are necessary to confirm the psychometric results and validity of this instrument in Spanish.
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Affiliation(s)
- Eva de Mingo-Fernández
- Universitat Rovira i Virgili, Departament d’Infermeria, Tarragona, Spain
- Consorci Sanitari de l’Alt Penedès i Garraf (CSAPG), Barcelona, Spain
- Universitat Rovira i Virgili, Fundació Martí-Franquès, Tarragona, Spain
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Dwyer T, Craswell A, Browne M. Predictive factors of the general public's willingness to be seen and seek treatment from a nurse practitioner in Australia: a cross-sectional national survey. HUMAN RESOURCES FOR HEALTH 2021; 19:21. [PMID: 33596928 DOI: 10.1186/s12960-021-00562-711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 02/01/2021] [Indexed: 05/24/2023]
Abstract
BACKGROUND Health care delivery in Australia is experiencing challenges with services struggling to keep up with the increasing demands of an aging population, rising levels of chronic disease and limited funding for care. Where adjunct models of health care such as the Nurse Practitioner (NP) have the potential to address this gap, in Australia, they remain an underutilised service. Clarifying the nature of the consumers 'willingness' to be seen by NPs warrants further investigation. METHODS Australia-wide, cross-sectional population-based survey was undertaken using computer-assisted telephone interviewing technique. RESULTS While just over 53% of the general public participants (n = 1318) had heard of an NP, once they became aware of their scope of practice, the majority agreed or strongly agreed they were willing to be seen by an NP in the community (91.6%), the emergency department 88.2%), to manage chronic conditions (86%), to have scrips written and referrals made (85.3%), and if they did not have to wait so long to see a medical doctor (81%). Factors significantly predicting willingness were being: female, less than 65 years of age, native English speakers, or residents from town/regional and rural settings. CONCLUSION Despite limited awareness of the NP role, a large proportion of the Australian population, across different demographic groups, are willing to be seen and treated by an NP. Expansion of this role to support medical services in areas of need could improve healthcare delivery.
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Affiliation(s)
- Trudy Dwyer
- CQUniversity Australia, Building 18 Rockhampton Campus, Bruce Highway, Rockhampton, Q 4702, Australia.
| | - Alison Craswell
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, 90 Sippy Downs Drive, Sippy Downs, Q 4556, Australia
| | - Matthew Browne
- CQUniversity Australia, University Drive, Building 8/G.47, Branyan Australia, Bundaberg, Qld, 4670, Australia
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Dwyer T, Craswell A, Browne M. Predictive factors of the general public's willingness to be seen and seek treatment from a nurse practitioner in Australia: a cross-sectional national survey. HUMAN RESOURCES FOR HEALTH 2021; 19:21. [PMID: 33596928 PMCID: PMC7890991 DOI: 10.1186/s12960-021-00562-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 02/01/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Health care delivery in Australia is experiencing challenges with services struggling to keep up with the increasing demands of an aging population, rising levels of chronic disease and limited funding for care. Where adjunct models of health care such as the Nurse Practitioner (NP) have the potential to address this gap, in Australia, they remain an underutilised service. Clarifying the nature of the consumers 'willingness' to be seen by NPs warrants further investigation. METHODS Australia-wide, cross-sectional population-based survey was undertaken using computer-assisted telephone interviewing technique. RESULTS While just over 53% of the general public participants (n = 1318) had heard of an NP, once they became aware of their scope of practice, the majority agreed or strongly agreed they were willing to be seen by an NP in the community (91.6%), the emergency department 88.2%), to manage chronic conditions (86%), to have scrips written and referrals made (85.3%), and if they did not have to wait so long to see a medical doctor (81%). Factors significantly predicting willingness were being: female, less than 65 years of age, native English speakers, or residents from town/regional and rural settings. CONCLUSION Despite limited awareness of the NP role, a large proportion of the Australian population, across different demographic groups, are willing to be seen and treated by an NP. Expansion of this role to support medical services in areas of need could improve healthcare delivery.
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Affiliation(s)
- Trudy Dwyer
- CQUniversity Australia, Building 18 Rockhampton Campus, Bruce Highway, Rockhampton, Q 4702, Australia.
| | - Alison Craswell
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, 90 Sippy Downs Drive, Sippy Downs, Q 4556, Australia
| | - Matthew Browne
- CQUniversity Australia, University Drive, Building 8/G.47, Branyan Australia, Bundaberg, Qld, 4670, Australia
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10
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Fernández EDM, Martín GM, Herrera MJ. Family witnessed resuscitation and invasive procedures: Patient and family opinions. Nurs Ethics 2020; 28:645-655. [PMID: 33325307 DOI: 10.1177/0969733020968171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
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.
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Affiliation(s)
- Eva de Mingo Fernández
- 16777Universitat Rovira i Virgili (URV), Spain; Consorci Sanitari Alt Penedès i Garraf, Spain
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Grimes C. The effects of family-witnessed resuscitation on health professionals. ACTA ACUST UNITED AC 2020; 29:892-896. [DOI: 10.12968/bjon.2020.29.15.892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Aim: To gain an understanding of the effects of family-witnessed resuscitation (FWR) on health professionals. Background: FWR has been the subject of an ongoing debate for almost 30 years. Historically, emergency departments (EDs) have excluded family members of a critically ill or injured patient from the treatment area during resuscitation. Methodology: A systematic literature search of six nursing-focused databases was undertaken using pertinent keywords. Only studies published in English, focused on ED staff and undertaken after 2007 (published up to 2017) were included. Findings: FWR is not commonly practised by health professionals. The four themes identified were: fear of adverse litigation; the importance of the role of the facilitator; lack of FWR policies in the workplace; and staff lack of knowledge and education regarding FWR, resulting in fear and stress. Conclusion: By implementing policies in the workplace, and having a facilitator to provide support and guidance to families, stress and anxiety can be greatly reduced. The implementation of educational programmes can increase staff awareness and knowledge surrounding the benefits of FWR
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Affiliation(s)
- Cathy Grimes
- Practice Development Nurse Accident and Emergency, London North West University Healthcare NHS Trust
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12
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Afzali Rubin M, Svensson TLG, Herling SF, Wirenfeldt Klausen T, Jabre P, Møller AM. Family presence during resuscitation. Hippokratia 2020. [DOI: 10.1002/14651858.cd013619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Monika Afzali Rubin
- Department of Anaesthesia; Herlev and Gentofte Hospital, University of Copenhagen; Herlev Denmark
- Cochrane Emergency and Critical Care; Herlev and Gentofte Hospital, University of Copenhagen; Herlev Denmark
- Cochrane Anaesthesia; Herlev and Gentofte Hospital, University of Copenhagen; Herlev Denmark
| | | | | | | | - Patricia Jabre
- Assistance Publique-Hôpitaux de Paris (AP-HP), SAMU (Service d'Aide Médicale Urgente) de Paris; Hôpital Universitaire Necker-Enfants Malades; Paris France
- Cochrane Pre-hospital and Emergency Care Field; Paris France
- Université de Paris, Paris Cardiovascular Research Centre (PARCC); INSERM, Integrative Epidemiology of Cardiovascular Diseases Team; Paris France
| | - Ann Merete Møller
- Department of Anaesthesia; Herlev and Gentofte Hospital, University of Copenhagen; Herlev Denmark
- Cochrane Emergency and Critical Care; Herlev and Gentofte Hospital, University of Copenhagen; Herlev Denmark
- Cochrane Anaesthesia; Herlev and Gentofte Hospital, University of Copenhagen; Herlev Denmark
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13
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Sak-Dankosky N, Andruszkiewicz P, Sherwood PR, Kvist T. Preferences of patients’ family regarding family-witnessed cardiopulmonary resuscitation: A qualitative perspective of intensive care patients’ family members. Intensive Crit Care Nurs 2019; 50:95-102. [DOI: 10.1016/j.iccn.2018.04.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 03/27/2018] [Accepted: 04/01/2018] [Indexed: 10/17/2022]
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14
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Barreto MDS, Garcia-Vivar C, Matsuda LM, Angelo M, Oliveira MLFD, Marcon SS. PRESENCE OF THE FAMILY DURING EMERGENCY CARE: PATIENT AND FAMILY LIVING. TEXTO & CONTEXTO ENFERMAGEM 2019. [DOI: 10.1590/1980-265x-tce-2018-0150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to understand how family members and adult patients perceive the family's presence in emergency care. Method: qualitative study that used Symbolic Interactionism as a theoretical reference and the Data Grounded Theory as a methodological reference. Data collection took place in two emergency rooms, located in southern Brazil, between October 2016 and February 2017, through open interviews with four patients and eight relatives. Results: the relative presence in the emergency care was signified/perceived as positive, due to the benefits identified for patients, family members and health professionals. However, the experience was also marked by mishaps for the family-patient relationship, such as fear, doubts, anguish about the forced separation of family members and the experience of feelings of regret. Conclusion: due to the fact that the presence of the family in the emergency room is perceived as positive and beneficial, it is suggested that the health services, to the extent of their possibilities, implement this practice. However, such units need to be better prepared to mitigate the pitfalls faced by patients and their families.
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Vanhoy MA, Horigan A, Stapleton SJ, Valdez AM, Bradford JY, Killian M, Reeve NE, Slivinski A, Zaleski ME, Proehl J, Wolf L, Delao A, Gates L. Clinical Practice Guideline: Family Presence. J Emerg Nurs 2019; 45:76.e1-76.e29. [DOI: 10.1016/j.jen.2018.11.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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16
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Breach J. Exploring the implementation of family-witnessed resuscitation. Nurs Stand 2018; 33:76-81. [PMID: 29583168 DOI: 10.7748/ns.2018.e11003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2018] [Indexed: 06/08/2023]
Abstract
Cardiac arrest is a traumatic event, both for patients and their family members. Traditionally, healthcare professionals have often been reluctant to offer family members the opportunity to witness cardiopulmonary resuscitation (CPR) attempts. However, professional bodies globally have begun to recommend the use of family-witnessed resuscitation (FWR) during CPR, identifying a range of potential benefits including supporting the patient, increasing family members' confidence in healthcare professionals and, in some cases, promoting acceptance of the patient's death. This article explores the benefits of, and barriers to, the implementation of FWR during CPR. Despite the perceived benefits of FWR identified by professional bodies, healthcare professionals, and patients and their families, the evidence indicates there is ongoing reluctance among some healthcare professionals to incorporate FWR in practice. Therefore, standardised global policies aimed at the multidisciplinary implementation of FWR are required. Additionally, multidisciplinary training and education in CPR should be readily available, particularly in areas where CPR is frequently used, such as emergency departments.
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Giles T, de Lacey S, Muir-Cochrane E. How do clinicians practise the principles of beneficence when deciding to allow or deny family presence during resuscitation? J Clin Nurs 2018; 27:e1214-e1224. [PMID: 29266508 DOI: 10.1111/jocn.14222] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2017] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To examine how clinicians practise the principles of beneficence when deciding to allow or deny family presence during resuscitation. BACKGROUND Family presence during resuscitation has important benefits for family and is supported by professional bodies and the public. Yet, many clinicians restrict family access to patients during resuscitation, and rationales for decision-making are unclear. DESIGN Secondary analysis of an existing qualitative data set using deductive category application of content analysis. METHODS We analysed 20 interview transcripts from 15 registered nurses, two doctors and three paramedics who had experienced family presence during resuscitation in an Australian hospital. The transcripts were analysed for incidents of beneficent decision-making when allowing or denying family presence during resuscitation. RESULTS Decision-making around family presence during resuscitation occurred in time poor environments and in the absence of local institutional guidelines. Clinicians appeared to be motivated by doing "what's best" for patients and families when allowing or denying family presence during resuscitation. However, their individual interpretations of "what's best" was subjective and did not always coincide with family preferences or with current evidence that promotes family presence during resuscitation as beneficial. CONCLUSIONS The decision to allow or deny family presence during resuscitation is complex, and often impacted by personal preferences and beliefs, setting norms and tensions between clinicians and consumers. As a result, many families are missing the chance to be with their loved ones at the end of life. The introduction of institutional guidelines and policies would help to establish what safe and effective practice consists of, reduce value-laden decision-making and guide beneficent decision-making. RELEVANCE TO CLINICAL PRACTICE These findings highlight current deficits in decision-making around FPDR and could prompt the introduction of clinical guidelines and policies and in turn promote the equitable provision of safe, effective family-centred care during resuscitation events.
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Affiliation(s)
- Tracey Giles
- Flinders University School of Nursing and Midwifery, Adelaide, SA, Australia
| | - Sheryl de Lacey
- Flinders University School of Nursing and Midwifery, Adelaide, SA, Australia
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Twibell R, Siela D, Riwitis C, Neal A, Waters N. A qualitative study of factors in nurses' and physicians' decision-making related to family presence during resuscitation. J Clin Nurs 2017; 27:e320-e334. [PMID: 28677220 DOI: 10.1111/jocn.13948] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2017] [Indexed: 10/19/2022]
Abstract
AIMS AND OBJECTIVES To explore the similarities and differences in factors that influence nurses' and physicians' decision-making related to family presence during resuscitation. BACKGROUND Despite the growing acceptance of family presence during resuscitation worldwide, healthcare professionals continue to debate the risks and benefits of family presence. As many hospitals lack a policy to guide family presence during resuscitation, decisions are negotiated by resuscitation teams, families and patients in crisis situations. Research has not clarified the factors that influence the decision-making processes of nurses and physicians related to inviting family presence. This is the first study to elicit written data from healthcare professionals to explicate factors in decision-making about family presence. DESIGN Qualitative exploratory-descriptive. METHODS Convenience samples of registered nurses (n = 325) and acute care physicians (n = 193) from a Midwestern hospital in the United States of America handwrote responses to open-ended questions about family presence. Through thematic analysis, decision-making factors for physicians and nurses were identified and compared. RESULTS Physicians and nurses evaluated three similar factors and four differing factors when deciding to invite family presence during resuscitation. Furthermore, nurses and physicians weighted the factors differently. Physicians weighted most heavily the family's potential to disrupt life-saving efforts and compromise patient care and then the family's knowledge about resuscitations. Nurses heavily weighted the potential for the family to be traumatised, the potential for the family to disrupt the resuscitation, and possible family benefit. CONCLUSIONS Nurses and physicians considered both similar and different factors when deciding to invite family presence. Physicians focused on the patient primarily, while nurses focused on the patient, family and resuscitation team. RELEVANCE TO CLINICAL PRACTICE Knowledge of factors that influence the decision-making of interprofessional colleagues can improve collaboration and communication in crisis events of family presence during resuscitation.
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Affiliation(s)
- Renee Twibell
- School of Nursing, Ball State University, Muncie, IN, USA.,Indiana University Health Ball Memorial Hospital, Muncie, IN, USA
| | - Debra Siela
- School of Nursing, Ball State University, Muncie, IN, USA
| | - Cheryl Riwitis
- Indiana University Health LifeLine, Indianapolis, IN, USA
| | - Alexis Neal
- Indiana University Health Ball Memorial Hospital, Muncie, IN, USA
| | - Nicole Waters
- Indiana University Health Ball Memorial Hospital, Muncie, IN, USA
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19
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Asencio-Gutiérrez JM, Reguera-Burgos I. The opinion of health professionals regarding the presence of relatives during cardiopulmonary resucitation. ENFERMERIA INTENSIVA 2017. [PMID: 28633761 DOI: 10.1016/j.enfi.2017.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The latest recommendations from the American Heart Association and the European Resuscitation Council invite allowance for the presence of relatives (PR) during cardiopulmonary resuscitation (CPR) as an extra measure of family care. OBJECTIVE To discover the opinion of health professionals on the PR during CPR. METHOD Cross-sectional observational study through an online survey in Spain, based on a non-probability sample (n=315). RESULTS 45% consider that the PR during CPR is not demanded by users. 64% value the implementation of this practice in a negative or a very negative way. 45% believe that the practice would avoid the feeling of abandonment that is instilled in the relatives, this being the most widely perceived potential benefit. 30% do not believe that it can help reduce the anxiety of relatives. The majority remarked that PR would cause situations of violence, psychological harm in witnesses, and more mistakes during care. 48% feel prepared to perform the role of companion. CONCLUSIONS Most professionals perceive more risks than benefits, and are not in favour of allowing PR due to a paternalistic attitude, and fear of the reactions that could be presented to the team. Extra-hospital emergency personnel seems to be the group most open to allowing this practice. Most professionals do not feel fully prepared to perform the role of companion.
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Affiliation(s)
| | - I Reguera-Burgos
- Socióloga, especialista en investigación social y análisis de datos, , España
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20
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Zali M, Hassankhani H, Powers KA, Dadashzadeh A, Rajaei Ghafouri R. Family presence during resuscitation: A descriptive study with Iranian nurses and patients' family members. Int Emerg Nurs 2017; 34:11-16. [PMID: 28528270 DOI: 10.1016/j.ienj.2017.05.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 04/29/2017] [Accepted: 05/01/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Family presence during resuscitation (FPDR) has advantages for the patients' family member to be present at the bedside. However, FPDR is not regularly practiced by nurses, especially in low to middle income countries. The purpose of this study was to determine Iranian nurses' and family members' attitudes towards FPDR. METHOD In a descriptive study, data was collected from the random sample of 178 nurses and 136 family members in four hospitals located in Iran. A 27-item questionnaire was used to collect data on attitudes towards FPDR, and descriptive and correlational analyses were conducted. RESULTS Of family members, particularly the women, 57.2% (n=78) felt it is their right to experience FPDR and that it has many advantages for the family; including the ability to see that everything was done and worry less. However, 62.5% (n=111) of the nurses disagreed with an adult implementation of FPDR. Nurses perceived FPDR to have many disadvantages. Family members becoming distressed and interfering with the patient which may prolong the resuscitation effort. Nurses with prior education on FPDR were more willing to implement it. CONCLUSION FPDR was desired by the majority of family members. To meet their needs, it is important to improve Iranian nurses' views about the advantages of the implementation of FPDR. Education on FPDR is recommended to improve Iranian nurses' views about the advantages of the implementation of FPDR.
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Affiliation(s)
- Mahnaz Zali
- Student's Research Committee, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Hadi Hassankhani
- Center of Qualitative Studies, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Kelly A Powers
- School of Nursing, UNC Charlotte, College of Health and Human Services 428, 9201 University City Blvd., Charlotte, NC 28223, United States.
| | - Abbas Dadashzadeh
- Road Traffic Injury Research Center, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
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21
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Bradley C, Keithline M, Petrocelli M, Scanlon M, Parkosewich J. Perceptions of Adult Hospitalized Patients on Family Presence During Cardiopulmonary Resuscitation. Am J Crit Care 2017; 26:103-110. [PMID: 28249861 DOI: 10.4037/ajcc2017550] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Family presence during cardiopulmonary resuscitation in acute care is not widespread. Patients are not likely to be asked about their wishes for family presence or if they wish to be the decision makers about who should be present. OBJECTIVE To explore the perceptions of patients on general medical units and to find factors independently associated with family presence during cardiopulmonary resuscitation. METHODS A cross-sectional study of 117 randomly selected adult patients was conducted at an academic medical center. Participants were interviewed via a survey to obtain information on demographics, knowledge of cardiopulmonary resuscitation, sources of information on resuscitation, and preferences for family presence. RESULTS About half of the participants agreed or strongly agreed that family presence during cardiopulmonary resuscitation was important (52.1%), that the participant should be the decision maker about who should be present (50.4%), and that the patient should give consent ahead of time (47.0%). Participants indicated that they would want an adult sibling, parents, or others (20.5%); spouse (14.5%); adult child (8.5%); close friend (5.1%); or companion (4.3%) present during cardiopulmonary resuscitation. Younger participants (20-45 years old) were 6.28 times more likely than those ≥ 66 years old (P = .01) and nonwhite participants were 2.7 times more likely than white participants (P = .049) to want family presence. CONCLUSION Patients have strong preferences about family presence during cardiopulmonary resuscitation, and they should have the opportunity to make the decision about having family present.
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Affiliation(s)
- Carolyn Bradley
- Carolyn Bradley is a service line educator, Michelle Keithline, Meghan Petrocelli, and Mary Scanlon are clinical nurses, and Janet Parkosewich is the nurse researcher, Yale New Haven Hospital, New Haven, Connecticut
| | - Michelle Keithline
- Carolyn Bradley is a service line educator, Michelle Keithline, Meghan Petrocelli, and Mary Scanlon are clinical nurses, and Janet Parkosewich is the nurse researcher, Yale New Haven Hospital, New Haven, Connecticut
| | - Meghan Petrocelli
- Carolyn Bradley is a service line educator, Michelle Keithline, Meghan Petrocelli, and Mary Scanlon are clinical nurses, and Janet Parkosewich is the nurse researcher, Yale New Haven Hospital, New Haven, Connecticut
| | - Mary Scanlon
- Carolyn Bradley is a service line educator, Michelle Keithline, Meghan Petrocelli, and Mary Scanlon are clinical nurses, and Janet Parkosewich is the nurse researcher, Yale New Haven Hospital, New Haven, Connecticut
| | - Janet Parkosewich
- Carolyn Bradley is a service line educator, Michelle Keithline, Meghan Petrocelli, and Mary Scanlon are clinical nurses, and Janet Parkosewich is the nurse researcher, Yale New Haven Hospital, New Haven, Connecticut
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Silva ACD, Bernardes A, Évora YDM, Dalri MCB, Silva ARD, Sampaio CSJC. Development of a virtual learning environment for cardiorespiratory arrest training. Rev Esc Enferm USP 2016; 50:990-997. [DOI: 10.1590/s0080-623420160000700016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 10/18/2016] [Indexed: 11/22/2022] Open
Abstract
Abstract OBJECTIVE To develop a Virtual Learning Environment (VLE) aiming at the training of nursing team workers and emergency vehicle drivers in Basic Life Support (BLS) to attend Cardiorespiratory arrest, and to evaluate the quality of its contents among specialists in the area of Emergency and Urgent care. METHOD Applied research of technological development. The methodology used was based on the Instructional Design Model (ADDIE), which structures the teaching-learning planning in different stages (analysis, design, development, implementation and evaluation). The VLE was composed of texts elaborated from bibliographic research, links, edited video from a simulation scenario in the laboratory and questions to evaluate the fixation of the content, organized in modules. RESULTS After its development, it was evaluated as adequate to satisfy the needs of the target public, by eight expert judges, which was made available for electronic access. CONCLUSION The VLE has potential as a tool for training and qualification in BLS, as it can be easily integrated with other pedagogical approaches and strategies with active methodologies.
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A literature review examining the barriers to the implementation of family witnessed resuscitation in the Emergency Department. Int Emerg Nurs 2016; 30:31-35. [PMID: 27915124 DOI: 10.1016/j.ienj.2016.11.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 10/27/2016] [Accepted: 11/04/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND Caring for people near death in the Emergency Department (ED) is challenging for professionals, duty bound to respond to the needs of the dying. Family witnessed resuscitation (FWR) is practiced internationally, allowing relatives to be present at the time of a patient's death, offering comfort to the dying and aiding the bereaved along a healthy grief trajectory. AIM The literature review elicits barriers to the implementation of FWR in the ED, examining why practice is sporadic despite numerous professional bodies calling for implementation. FWR is often met with opposition from staff, subsequently largely dependent upon who is on duty as opposed to adherence with best practice guidelines, risking inconsistent idiosyncratic practice. FINDINGS Barriers include; a lack of organisational support; shortage of manpower for provision of a family support person; absence of champions for the concept; willful non-adherence due to personal beliefs; restriction on coping strategies reliant upon the ability to emotionally detach, enhancing staff resilience facing repeated exposure to emotionally labile events. CONCLUSION All resuscitation efforts can be successful, whether the patient lives or dies, if practice supports healthy grieving. The challenge remains with such divided, entrenched and passionate views, how FWR can be adopted as accepted practice.
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Giles T, de Lacey S, Muir-Cochrane E. Factors influencing decision-making around family presence during resuscitation: a grounded theory study. J Adv Nurs 2016; 72:2706-2717. [PMID: 27323333 DOI: 10.1111/jan.13046] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2016] [Indexed: 11/30/2022]
Abstract
AIM The aim of this study was to examine factors impacting family presence during resuscitation practices in the acute care setting. BACKGROUND Family presence during resuscitation was introduced in the 1980s, so family members/significant others could be with their loved ones during life-threatening events. Evidence demonstrates important benefits; yet despite growing support from the public and endorsement from professional groups, family presence is practiced inconsistently and rationales for poor uptake are unclear. DESIGN Constructivist grounded theory design. METHODS Twenty-five health professionals, family members and patients informed the study. In-depth interviews were undertaken between October 2013-November 2014 to interpret and explain their meanings and actions when deciding whether to practice or participate in FPDR. FINDINGS The Social Construction of Conditional Permission explains the social processes at work when deciding to adopt or reject family presence during resuscitation. These processes included claiming ownership, prioritizing preferences and rights, assessing suitability, setting boundaries and protecting others/self. In the absence of formal policies, decision-making was influenced primarily by peoples' values, preferences and pre-existing expectations around societal roles and associated status between health professionals and consumers. As a result, practices were sporadic, inconsistent and often paternalistic rather than collaborative. CONCLUSION An increased awareness of the important benefits of family presence and the implementation of clinical protocols are recommended as an important starting point to address current variations and inconsistencies in practice. These measures would ensure future practice is guided by evidence and standards for health consumer safety and welfare rather than personal values and preferences of the individuals 'in charge' of permissions.
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Affiliation(s)
- Tracey Giles
- Flinders University School of Nursing and Midwifery, Adelaide, South Australia, Australia.
| | - Sheryl de Lacey
- Flinders University School of Nursing and Midwifery, Adelaide, South Australia, Australia
| | - Eimear Muir-Cochrane
- Flinders University School of Nursing and Midwifery, Adelaide, South Australia, Australia
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Inviting family to be present during cardiopulmonary resuscitation: Impact of education. Nurse Educ Pract 2016; 16:274-9. [DOI: 10.1016/j.nepr.2015.10.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 10/01/2015] [Accepted: 10/06/2015] [Indexed: 11/23/2022]
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Coding, Constant Comparisons, and Core Categories: A Worked Example for Novice Constructivist Grounded Theorists. ANS Adv Nurs Sci 2016; 39:E29-44. [PMID: 26836999 DOI: 10.1097/ans.0000000000000109] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Grounded theory method has been described extensively in the literature. Yet, the varying processes portrayed can be confusing for novice grounded theorists. This article provides a worked example of the data analysis phase of a constructivist grounded theory study that examined family presence during resuscitation in acute health care settings. Core grounded theory methods are exemplified, including initial and focused coding, constant comparative analysis, memo writing, theoretical sampling, and theoretical saturation. The article traces the construction of the core category "Conditional Permission" from initial and focused codes, subcategories, and properties, through to its position in the final substantive grounded theory.
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