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Park JY, Ha J. Predicting nurses' intentions in allowing family presence during resuscitation: A cross‐sectional survey. J Clin Nurs 2021; 30:1018-1025. [DOI: 10.1111/jocn.15647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 12/07/2020] [Accepted: 12/31/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Ju Young Park
- College of Nursing Konyang University Daejeon South Korea
| | - Jiyeon Ha
- College of Nursing Konyang University Daejeon South Korea
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Tíscar-González V, Gea-Sánchez M, Blanco-Blanco J, Pastells-Peiró R, De Ríos-Briz N, Moreno-Casbas MT. Witnessed resuscitation of adult and paediatric hospital patients: An umbrella review of the evidence. Int J Nurs Stud 2020; 113:103740. [PMID: 33099179 DOI: 10.1016/j.ijnurstu.2020.103740] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine the research evidence about whether families were allowed to witness cardiopulmonary resuscitation on hospitalised adult and paediatric patients; and the views of patients, families and health professionals, about witnessed cardiopulmonary resuscitation. DESIGN An umbrella review methodology of systematic reviews with sufficient methodological quality. REVIEW METHODS Papers published in Spanish and English between, 1 January 2009 and 31 December 2018 were considered. The following databases were searched: PubMed, CINAHL, Web of Science, Scopus, Cochrane Central Register of Controlled Trials, PsycInfo, Embase, the Central Supplier Database and the Joanna Briggs Institute, Evidence-based Practice Database. Two independent reviewers assessed the papers for methodological quality employing instruments from the Joanna Briggs Institute. Critical appraisal, extraction and synthesis were carried out, employing the established methods for umbrella reviews and the protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO number CRD42019145610). RESULTS The search identified 12 systematic reviews with moderate-to-high quality, which covered 110 original papers. Habitually, health professionals expressed controversial views and showed some reluctance to let families be present during cardiopulmonary resuscitation. In contrast, family members felt strongly that they should be present and patients agreed. Key factors that facilitated witnessed cardiopulmonary were a formal institutional policy, educating health professionals, and designating a health professional to support the family. Educational and cultural backgrounds influenced healthcare professionals' experiences and their attitudes towards witnessed cardiopulmonary resuscitation. In general, Anglo-Saxon countries showed greater support for this practice. These included the United States, which was the country that dominated the literature on this subject. CONCLUSIONS The best available evidence supports allowing the family to be present during cardiopulmonary resuscitation. It is necessary to include this practice in educational curricula and to train emergency personnel in its implementation. Culturally sensitive policies need to be designed, and the public to be aware of their right to be present.
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Affiliation(s)
- Verónica Tíscar-González
- Nursing teaching Unit, OSI Araba (Osakidetza), Vitoria, Spain; Clinical nursing and community health group. BioAraba Health Research Institute, Vitoria, Spain
| | - Montserrat Gea-Sánchez
- Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain; Group for the Study of Society Health Education and Culture (GESEC), University of Lleida, Lleida, Spain; Health Care Research Group (GRECS) Biomedical Research Institute of Lleida, IRBLleida, Lleida, Spain
| | - Joan Blanco-Blanco
- Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain; Group for the Study of Society Health Education and Culture (GESEC), University of Lleida, Lleida, Spain; Health Care Research Group (GRECS) Biomedical Research Institute of Lleida, IRBLleida, Lleida, Spain.
| | - Roland Pastells-Peiró
- Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain; Group for the Study of Society Health Education and Culture (GESEC), University of Lleida, Lleida, Spain; Health Care Research Group (GRECS) Biomedical Research Institute of Lleida, IRBLleida, Lleida, Spain
| | - Nuria De Ríos-Briz
- OSI Ezkerraldea-Enkarterri-Cruces (Osakidetza), Bizkaia, Spain; Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Maria Teresa Moreno-Casbas
- Nursing and Healthcare Research Unit (Investén-isciii), Madrid, Spain; CIBERFES, Institute of Health Carlos III, Madrid, Spain
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[Presence of relatives during cardiopulmonary resuscitation: Perspectives of health professionals, patients and family in the Basque Country]. Aten Primaria 2018; 51:269-277. [PMID: 29571750 PMCID: PMC6837081 DOI: 10.1016/j.aprim.2017.12.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 12/02/2017] [Accepted: 12/31/2017] [Indexed: 11/29/2022] Open
Abstract
Objetivo Explorar la percepción acerca de la presencia de familiares durante la reanimación cardiopulmonar (RCP) en pacientes adultos, de los propios pacientes y familiares, enfermeras y médicos. Diseño Se desarrolló un estudio cualitativo exploratorio y un análisis temático. Emplazamiento Atención Primaria, Atención Hospitalaria y Servicio de Emergencias del Servicio Vasco de Salud. Participantes La selección de los participantes se realizó a través de muestreo intencional. Se desarrollaron 4 grupos de discusión: uno de pacientes y familiares, 2 de enfermeras y uno de médicos. Método Se realizó un análisis temático. Se utilizaron técnicas de triangulación entre investigadores e investigador-informante. Se utilizó el programa informático Open Code 4.1. Resultados Se identificaron 3 categorías significativas: impacto de la actuación en la familia; peso de la responsabilidad ética y legal; poder, lugar donde sucede la parada y supuestos culturales. Conclusiones La RCP es un constructo social influido por los valores de los contextos socioculturales específicos. En este estudio, los pacientes y familiares describieron temor y resistencia a presenciar la RCP. Por su parte, los profesionales sanitarios consideran que su decisión reviste complejidad, siendo necesario valorar cada caso de forma independiente e integrando a pacientes y familiares en la toma de decisiones. Como líneas de investigación futuras sería recomendable profundizar sobre la experiencia subjetiva de familiares que hayan presenciado la RCP y el impacto de los elementos contextuales y socioculturales en sus percepciones.
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Abstract
The purpose of this study was to examine the effects of family presence during resuscitation (FPDR) in patients who survived trauma from motor vehicle crashes (MVC) and gunshot wounds (GSW). A convenience sample of family members participated within three days of admission to critical care. Family members of 140 trauma patients (MVC n = 110, 79%; GSW n = 30, 21%) participated. Family members ranged in age from 20-84 years (M = 46, SD = 15, Mdn = 47). The majority were female (n = 112, 80%) and related to the patient as spouse (n = 46, 33%). Participating in the FPDR option reduced anxiety (t = -2.43, p =.04), reduced stress (t = -2.86, p = .005), and fostered well-being (t = 3.46, p = .001). Results demonstrate the positive initial effects of FPDR on family members of patients surviving trauma injury.
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Affiliation(s)
- Jane S. Leske
- College of Nursing University of Wisconsin-Milwaukee, Milwaukee WI
- Froedtert and the Medical College of Wisconsin-Froedtert Hospital, Milwaukee WI
| | - Natalie S. McAndrew
- College of Nursing University of Wisconsin-Milwaukee, Milwaukee WI
- Froedtert and the Medical College of Wisconsin-Froedtert Hospital, Milwaukee WI
| | - Karen J. Brasel
- Oregon Heath & Science University, Division of Trauma, Critical Care & Acute Care Surgery, Portland OR
| | - Suzanne Feetham
- College of Nursing University of Wisconsin-Milwaukee, Milwaukee WI
- Children’s National Health System, Washington DC
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Experiences of families when present during resuscitation in the emergency department after trauma. J Trauma Nurs 2014; 20:77-85. [PMID: 23722216 DOI: 10.1097/jtn.0b013e31829600a8] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Several organizations have published national guidelines on providing the option of family presence during resuscitation (FPDR). Although FPDR is being offered in clinical practice, there is limited description of family experiences after FPDR. The aim of this study was to describe family experiences of the FPDR option after trauma from motor vehicle crashes and gunshot wounds. A descriptive, qualitative design based on content analysis was used to describe family experiences of the FPDR option. Family members (N = 28) were recruited from a major level 1 adult trauma center in the Midwest. Participants in this study were 1 family member per patient who were 18 years or older, visited the patient in the surgical intensive care unit, spoke and understood English, and had only one critically injured patient in the family. Family interview data on experiences during FPDR after trauma were used to identify themes. Two main categories were found. Families view the role of health care professionals (HCPs) to "fix" the patient, whereas they as family members have an important role to protect and support the patient. Subcategories related to the role of the HCP include the following: multiple people treating the patient, completion of many tasks with "assessment of the damages," and professionalism/teamwork. Important subcategories related to the family member role include the following: providing information to the HCP, ensuring that the medical team is doing its job, and remaining close to provide physical and emotional comfort to the patient. Health care professionals are viewed positively by the family, and the role of the family is viewed as important. Families wanted to be present and would recommend the choice to other family members. The findings of this study support that the FPDR option is an intervention that helps family members build trust in HCPs, fulfills informational needs, allows family members to gain close proximity to the patient, and support their family member emotionally.
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Cho JL, Lee EN, Sim SH, Lee NY. Comparison of Physicians and Nurses' Attitudes toward Family Presence during Cardiopulmonary Resuscitation. ACTA ACUST UNITED AC 2013. [DOI: 10.7475/kjan.2013.25.1.41] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Jeong Lim Cho
- Department of Nursing, Dong-A University, Busan, Korea
| | - Eun Nam Lee
- Department of Nursing, Dong-A University, Busan, Korea
| | - Sang Hee Sim
- Pusan National University Hospital, Yangsan, Korea
| | - Na Youn Lee
- Graduate College of Nursing, Seoul National University, Seoul, Korea
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Belpomme V, Adnet F, Mazariegos I, Beardmore M, Duchateau FX, Mantz J, Ricard-Hibon A. Family witnessed resuscitation: nationwide survey of 337 prehospital emergency teams in France. Emerg Med J 2012; 30:1038-42. [PMID: 23221456 DOI: 10.1136/emermed-2012-201626] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To assess the practices and opinions of prehospital emergency medical services (EMS) with regard to family witnessed resuscitation (FWR) and to analyse the differences between physicians' and nurses' responses. DESIGN An anonymous questionnaire (30 yes/no questions on demographics and FWR) was sent to all prehospital emergency staff (physicians, nurses and support staff) working for the 377 Mobile Intensive Care Units in France. RESULTS Of the 2689 responses received 2664 were analysed. Mean respondent age was 38 ± 8 years, the male to female ratio was 1:2. 87% of respondents had already performed FWR and 38% had offered relatives the option to be present during resuscitation. Most respondents (90%) felt that FWR might cause psychological trauma to the family; 70% thought that FWR might impact on the duration of resuscitation and 68% on EMS team concentration. In the 28% of cases when relatives had asked to be present, 59% of respondents had acquiesced but only 27% were willing to invite relatives to be routinely present. CONCLUSIONS Prehospital EMS teams in France seems to support FWR but are not yet ready to offer it systematically to relatives. Following our survey, written guidelines are currently in development in our department. These guidelines could be the first step of a national strategy for developing FWR in France. We await results from other studies of family members' opinions to compare prehospital practitioners' and family members' views to further develop our practice.
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Affiliation(s)
- Vanessa Belpomme
- AP-HP, SMUR et DAR, Hôpital Beaujon, Université Paris 7, , Clichy, France
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Abstract
Emergency department (ED) staff confront death more frequently than any other specialty except oncology. These deaths are often traumatic, sudden, unexpected and occur in a younger age group. As a consequence, bereaved survivors have a greater risk of an abnormal grief reaction. [ Walters DT, Tupin JP (1991) Family grief in the emergency department. Emergency Medicine Clinics of North America 9(1): 189–206.] Whilst the severity or timing of traumatic injuries may preclude medical attempts to influence patient survival, the approach of the same resuscitation team to the bereaved before death, during resuscitation and after death may have profound influences on subsequent grief in the bereaved. Despite this, it can be argued that Emergency Medicine within the UK has given little thought and time for reflection upon how we treat the bereaved. That the care of the dying and the bereaved within the ED matters is greatly reinforced by the Scottish Government’s 2010 Consultation document on bereavement that states: ‘There is … evidence that the way [the] bereaved experience events around the time of death will influence their grief. Where health services get it right … bereaved people are supported to accept the death … Conversely if the health services get it wrong, then bereaved people may experience additional distress, and that distress will interfere with their successful transition through the grieving process’.
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Egging D, Crowley M, Arruda T, Proehl J, Walker-Cillo G, Papa A, Li S, Walsh J, Bokholdt ML. Emergency nursing resource: family presence during invasive procedures and resuscitation in the emergency department. J Emerg Nurs 2011; 37:469-73. [PMID: 21600641 DOI: 10.1016/j.jen.2011.04.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Köberich S, Kaltwasser A, Rothaug O, Albarran J. Family witnessed resuscitation - experience and attitudes of German intensive care nurses. Nurs Crit Care 2010; 15:241-50. [PMID: 20712669 DOI: 10.1111/j.1478-5153.2010.00405.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To explore German intensive care nurses' experiences and attitudes toward family witnessed resuscitation (FWR). BACKGROUND The subject of FWR has fuelled much controversy among health professionals. Typically studies involving European critical and cardiac nurses' under-represent the perspective of individual countries. Arguably research exploring the experiences and attitudes of nurses by country may expand understanding and embrace cultural values. DESIGN Descriptive survey. METHODS Three hundred and ninety-four German intensive care nurses attending a conference were invited to complete a 36-item questionnaire on their experiences and attitudes towards FWR. Participants were also invited to share, in writing, other thoughts relevant to the study. Data was analysed using descriptive statistics. RESULTS A total of 166 (42.1%) questionnaires were returned completed. Seventy participants had experiences with family members being present and for 46 (65.7%) these were negative. Participants (68%) did not agree that family members should have the option to be with loved ones during resuscitation. Over half (56.0%) were concerned that family presence may adversely influence staff performance during resuscitation procedures. There was a lack of certainty about the outcomes of the practice, although 61% agreed that family presence could facilitate better understanding among relatives. Qualitative responses where characterized by four broad themes relating to individualized decision-making, supporting families, threats of violence and family involvement. CONCLUSIONS German intensive care nurses have guarded attitudes towards FWR because of their experiences and concerns for the well-being of relatives and staff. Introducing this topic within nursing curricula, as part of resuscitation training and by wider professional debate will help challenge and resolve practitioner concerns and objections. RELEVANCE TO CLINICAL PRACTICE Health professionals have anxieties about possible consequences of FWR, strategies involving education and simulation training may improve attitudes.
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Affiliation(s)
- Stefan Köberich
- Department of Cardiology/Angiology, University Medical Center Freiburg, Freiburg, Germany.
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Cloutier RL, Walthall JDH, Mull CC, Nypaver MM, Baren JM. Best educational practices in pediatric emergency medicine during emergency medicine residency training: guiding principles and expert recommendations. Acad Emerg Med 2010; 17 Suppl 2:S104-13. [PMID: 21199076 DOI: 10.1111/j.1553-2712.2010.00893.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The state of pediatric emergency medicine (PEM) education within emergency medicine (EM) residency programs is reviewed and discussed in the context of shifting practice environments and new demands for a greater focus on the availability and quality of PEM services. The rapid growth of PEM within pediatrics has altered the EM practice landscape with regard to PEM. The authors evaluate the composition, quantity, and quality of PEM training in EM residency programs, with close attention paid to the challenges facing programs. A set of best practices is presented as a framework for discussion of future PEM training that would increase the yield and relevance of knowledge and experiences within the constraints of 3- and 4-year residencies. Innovative educational modalities are discussed, as well as the role of simulation and pediatric-specific patient safety education. Finally, barriers to PEM fellowship training among EM residency graduates are discussed in light of the shortage of practitioners from this training pathway and in recognition of the ongoing importance of the EM voice in PEM.
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Affiliation(s)
- Robert L Cloutier
- Department of Emergency Medicine, Oregon Health and Science University, Portland, OR, USA.
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Patientsʼ and relativesʼ view on witnessed resuscitation in the emergency department: a prospective study. Eur J Emerg Med 2010; 17:203-7. [DOI: 10.1097/mej.0b013e328331477e] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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