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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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The Effect of Family Presence During Resuscitation and Invasive Procedures on Patients and Families: An Umbrella Review. J Emerg Nurs 2021; 47:752-760. [PMID: 34167849 DOI: 10.1016/j.jen.2021.04.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 04/21/2021] [Accepted: 04/22/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION The concept of family presence during resuscitation and invasive procedures is a controversial issue and has not been universally adopted by health care providers. Owing to the sheer number of studies in this field, we conducted this umbrella study to provide an overview of this concept with the aim of investigating the impact of family presence on patients, families, and resuscitation and invasive procedures. METHODS In this review, using the Joanna Briggs Institute levels of evidence umbrella methodology guidelines, the authors searched PubMed, Google Scholar, Embase, MEDLINE, Web of Science, Scopus, and the Cochrane database for systematic review and meta-analysis studies that evaluated the presence of family during resuscitation and invasive procedures without time limit until July 2020. The following key words were used for the search: family presence; family witness; parent presence; parent witness; and resuscitation. RESULTS A total of 254 articles published between January 1967 and July 2020 were screened. Five articles (1 meta-analysis and 4 systematic reviews) met the inclusion criteria. The review showed that family presence during resuscitation or invasive procedures does not have negative effects on family members, patients, or the resuscitation or invasive intervention process. Family members focus on the patients, not the ongoing treatment. The presence of family members is beneficial for both family members and health care staff. None of the reviewed studies reported a negative effect on family members. DISCUSSION The presence of parents and other immediate family members during resuscitation and invasive procedures has positive impacts on patients, families, and health care staff.
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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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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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Magowan E, Melby V. A survey of emergency department staff's opinions and experiences of family presence during invasive procedures and resuscitation. Emerg Nurse 2020; 27:13-19. [PMID: 31468771 DOI: 10.7748/en.2019.e1908] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2019] [Indexed: 11/09/2022]
Abstract
AIM To identify the views and experiences of emergency nurses and doctors of the presence of family members during invasive procedures and resuscitation events. METHODS 84 staff members from three emergency departments in one UK trust responded to a paper-based 22-item questionnaire developed by the authors. FINDINGS Staff expressed positive views about family presence during such traumatic events, but also expressed non-evidenced concerns about negative aspects of family presence. CONCLUSION Future research should focus on exploring the views of patients and their families in culturally diverse societies or across culturally different countries. Such data could underpin culturally sensitive policies to guide the practice of family presence and identify the education required to support successful development of such policies. Using simulation-based learning methodology integrated with existing advanced life-support/advanced trauma life-support training could support successful implementation of family presence policies.
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Affiliation(s)
- Emma Magowan
- Belfast Health and Social Care Trust, Belfast, Northern Ireland
| | - Vidar Melby
- School of Nursing, Ulster University, Derry, Northern Ireland
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Waldemar A, Thylen I. Healthcare professionals’ experiences and attitudes towards family-witnessed resuscitation: A cross-sectional study. Int Emerg Nurs 2019; 42:36-43. [DOI: 10.1016/j.ienj.2018.05.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 05/25/2018] [Accepted: 05/31/2018] [Indexed: 11/25/2022]
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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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Family Presence During Resuscitation: Physicians' Perceptions of Risk, Benefit, and Self-Confidence. Dimens Crit Care Nurs 2018; 37:167-179. [PMID: 29596294 DOI: 10.1097/dcc.0000000000000297] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Families often desire proximity to loved ones during life-threatening resuscitations and perceive clear benefits to being present. However, critical care nurses and physicians perceive risks and benefits. Whereas research is accumulating on nurses' perceptions of family presence, physicians' perspectives have not been clearly explicated. Psychometrically sound measures of physicians' perceptions are needed to create new knowledge and enhance collaboration among critical care nurses and physicians during resuscitation events. OBJECTIVE This study tests 2 new instruments that measure physicians' perceived risks, benefits, and self-confidence related to family presence during resuscitation. METHODS By a correlational design, a convenience sample of physicians (N = 195) from diverse clinical specialties in 1 hospital in the United States completed the Physicians' Family Presence Risk-Benefit Scale and Physicians' Family Presence Self-confidence Scale. RESULTS Findings supported the internal consistency reliability and construct validity of both new scales. Mean scale scores indicated that physicians perceived more risk than benefit and were confident in managing resuscitations with families present, although more than two-thirds reported feeling anxious. Higher self-confidence was significantly related to more perceived benefit and less perceived risk (P = .001). Younger physicians, family practice physicians, and physicians who previously had invited family presence expressed more positive perceptions (P = .05-.001). DISCUSSION These 2 new scales offer a means to assess key perceptions of physicians related to family presence. Further testing in diverse physician populations may further validate the scales and yield knowledge that can strengthen collaboration among critical care nurses and physicians and improve patient and family outcomes.
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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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Blanco AP. How Do Healthcare Providers Feel About Family Presence During Cardiopulmonary Resuscitation? THE JOURNAL OF CLINICAL ETHICS 2017. [DOI: 10.1086/jce2017282102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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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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Powers KA, Candela L. Family Presence During Resuscitation: Impact of Online Learning on Nurses' Perception and Self-confidence. Am J Crit Care 2016; 25:302-9. [PMID: 27369028 DOI: 10.4037/ajcc2016814] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Family presence during resuscitation (FPDR) is supported by patients and their family members. Nurses, however, including critical care nurses who frequently implement resuscitative care, have mixed views. OBJECTIVES To determine the impact of online learning on critical care nurses' perception of and self-confidence with FPDR. METHODS A 2-group, random assignment, pretest and posttest quasi-experimental study was conducted with critical care nurses recruited nationally. An online learning module on FPDR was developed and administered to the intervention group. Perceptions and self-confidence for FPDR were measured by using the Family Presence Risk- Benefit Scale (FPR-BS) and the Family Presence Self-confidence Scale (FPS-CS). Two-factor, mixed-model factorial analysis of variance was used to compare mean scores. RESULTS A total of 74 critical care nurses participated in the study. Mean FPR-BS and FPS-CS scores were significantly greater in the intervention group than in the control group. For the intervention group, mean scores on the FPR-BS increased from 3.63 to 4.07 (P < .001) and on the FPS-CS increased from 4.24 to 4.57 (P < .001), signifying improved perception and self-confidence. Scores did not change significantly in the control group: mean FPR-BS score increased from 3.82 to 3.88 (P = .23) and the mean FPS-CS score of 4.40 did not change (P > .99). CONCLUSIONS Online learning is a feasible and effective method for educating large numbers of critical care nurses about FPDR. Online learning can improve perceptions and self-confidence related to FPDR, which may promote more widespread adoption of FPDR into practice.
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Affiliation(s)
- Kelly A. Powers
- Kelly A. Powers is an assistant professor, School of Nursing, The University of North Carolina at Charlotte, Charlotte, North Carolina. Lori Candela is an associate professor, School of Nursing, University of Nevada, Las Vegas, Las Vegas, Nevada
| | - Lori Candela
- Kelly A. Powers is an assistant professor, School of Nursing, The University of North Carolina at Charlotte, Charlotte, North Carolina. Lori Candela is an associate professor, School of Nursing, University of Nevada, Las Vegas, Las Vegas, Nevada
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Bashayreh I, Saifan A, Batiha AM, Timmons S, Nairn S. Health professionals' perceptions regarding family witnessed resuscitation in adult critical care settings. J Clin Nurs 2015; 24:2611-9. [PMID: 26097992 DOI: 10.1111/jocn.12875] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2015] [Indexed: 11/24/2022]
Abstract
AIMS AND OBJECTIVES To deepen our understanding of the perceptions of health professionals regarding family witnessed resuscitation in Jordanian adult critical care settings. BACKGROUND The issue of family witnessed resuscitation has developed dramatically in the last three decades. The traditional practice of excluding family members during cardiopulmonary resuscitation had been questioned. Family witnessed resuscitation has been described as good practice by many researchers and health organisations. However, family witnessed resuscitation has been perceived by some practitioners to be unhealthy and harmful to the life-saving process. The literature showed that there are no policies or guidelines to allow or to prevent family witnessed resuscitation in Jordan. DESIGN An exploratory qualitative design was adopted. METHODS A purposive sample of 31 health professionals from several disciplines was recruited over a period of six months. Individual semi-structured interviews were used. These interviews were transcribed and analysed using thematic analysis. FINDINGS It was found that most healthcare professionals were against family witnessed resuscitation. They raised several concerns related to being verbally and physically attacked if they allowed family witnessed resuscitation. Almost all of the respondents expressed their fears of patients' family members' interfering in their work. Most of the participants in this study stated that family witnessed resuscitation is traumatic for family members. This was viewed as a barrier to allowing family witnessed resuscitation in Jordanian critical care settings. CONCLUSION The study provides a unique understanding of Jordanian health professionals' perceptions regarding family witnessed resuscitation. They raised some views that contest some arguments in the broader literature. Further research with patients, family members, health professionals and policy makers is still required. RELEVANCE TO CLINICAL PRACTICE This is the first study about family witnessed resuscitation in Jordan. Considering multi-disciplinary healthcare professionals' views would be helpful when starting to implement this practice in Jordanian hospitals.
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Affiliation(s)
| | - Ahmad Saifan
- School of Nursing, Applied Science Private University, Amman, Jordan
| | | | - Stephen Timmons
- School of Health Science, University of Nottingham, Nottingham, UK
| | - Stuart Nairn
- School of Nursing, Midwifery & Physiotherapy, Royal Derby Hospital, University of Nottingham, Derby, UK
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Tudor K, Berger J, Polivka BJ, Chlebowy R, Thomas B. Nurses' perceptions of family presence during resuscitation. Am J Crit Care 2014; 23:e88-96. [PMID: 25362679 DOI: 10.4037/ajcc2014484] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Although strong evidence indicates that the presence of a patient's family during resuscitation has a positive effect on the family, the practice is still controversial and is not consistently implemented. OBJECTIVES To explore nurses' experience with resuscitation, perceptions of the benefits and risks of having a patient's family members present, and self-confidence in having family presence at their workplace. Differences in demographic characteristics and relationships between nurses' perceptions of self-confidence and perceived risks and benefits of family presence were evaluated. METHODS The study was descriptive, with a cross-sectional survey design. A convenience sample of 154 nurses working in inpatient and outpatient units at an urban hospital were surveyed. The 63-item survey included 2 previously validated scales, demographic questions, and opinion questions. RESULTS Nurses' self-confidence and perceived benefit of family presence were significantly related (r = 0.54; P < .001). Self-confidence was significantly greater in nurses who had completed training in Advanced Cardiac Life Support, had experienced 10 or more resuscitation events, were specialty certified, or were members of nurses' professional organizations. Barriers to family presence included fear of interference by the patient's family, lack of space, lack of support for the family members, fear of trauma to family members, and performance anxiety. CONCLUSIONS Changing the practice of family presence will require strengthening current policy, identifying a team member to attend to the patient's family during resuscitation, and requiring nurses to complete education on evidence that supports family presence and changes in clinical practice.
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Affiliation(s)
- Kelly Tudor
- Kelly Tudor is a CRNA/DNP student at Fairfield University, Bridgeport, Connecticut. Jill Berger is director of patient care operations, Norton Healthcare Institute for Nursing, Louisville, Kentucky. Beena Thomas is a staff nurse at Norton Hospital, Louisville, Kentucky. Barbara J. Polivka is Shirley B. Powers Endowed Chair and professor, University of Louisville School of Nursing, Louisville, Kentucky. Rachael Chlebowy is a staff nurse at University of Louisville Hospital, Louisville, Kentucky
| | - Jill Berger
- Kelly Tudor is a CRNA/DNP student at Fairfield University, Bridgeport, Connecticut. Jill Berger is director of patient care operations, Norton Healthcare Institute for Nursing, Louisville, Kentucky. Beena Thomas is a staff nurse at Norton Hospital, Louisville, Kentucky. Barbara J. Polivka is Shirley B. Powers Endowed Chair and professor, University of Louisville School of Nursing, Louisville, Kentucky. Rachael Chlebowy is a staff nurse at University of Louisville Hospital, Louisville, Kentucky
| | - Barbara J. Polivka
- Kelly Tudor is a CRNA/DNP student at Fairfield University, Bridgeport, Connecticut. Jill Berger is director of patient care operations, Norton Healthcare Institute for Nursing, Louisville, Kentucky. Beena Thomas is a staff nurse at Norton Hospital, Louisville, Kentucky. Barbara J. Polivka is Shirley B. Powers Endowed Chair and professor, University of Louisville School of Nursing, Louisville, Kentucky. Rachael Chlebowy is a staff nurse at University of Louisville Hospital, Louisville, Kentucky
| | - Rachael Chlebowy
- Kelly Tudor is a CRNA/DNP student at Fairfield University, Bridgeport, Connecticut. Jill Berger is director of patient care operations, Norton Healthcare Institute for Nursing, Louisville, Kentucky. Beena Thomas is a staff nurse at Norton Hospital, Louisville, Kentucky. Barbara J. Polivka is Shirley B. Powers Endowed Chair and professor, University of Louisville School of Nursing, Louisville, Kentucky. Rachael Chlebowy is a staff nurse at University of Louisville Hospital, Louisville, Kentucky
| | - Beena Thomas
- Kelly Tudor is a CRNA/DNP student at Fairfield University, Bridgeport, Connecticut. Jill Berger is director of patient care operations, Norton Healthcare Institute for Nursing, Louisville, Kentucky. Beena Thomas is a staff nurse at Norton Hospital, Louisville, Kentucky. Barbara J. Polivka is Shirley B. Powers Endowed Chair and professor, University of Louisville School of Nursing, Louisville, Kentucky. Rachael Chlebowy is a staff nurse at University of Louisville Hospital, Louisville, Kentucky
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Reeves S, McMillan SE, Kachan N, Paradis E, Leslie M, Kitto S. Interprofessional collaboration and family member involvement in intensive care units: emerging themes from a multi-sited ethnography. J Interprof Care 2014; 29:230-7. [PMID: 25238573 DOI: 10.3109/13561820.2014.955914] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This article presents emerging findings from the first year of a two-year study, which employed ethnographic methods to explore the culture of interprofessional collaboration (IPC) and family member involvement in eight North American intensive care units (ICUs). The study utilized a comparative ethnographic approach - gathering observation, interview and documentary data relating to the behaviors and attitudes of healthcare providers and family members across several sites. In total, 504 hours of ICU-based observational data were gathered over a 12-month period in four ICUs based in two US cities. In addition, 56 semi-structured interviews were undertaken with a range of ICU staff (e.g. nurses, doctors and pharmacists) and family members. Documentary data (e.g. clinical guidelines and unit policies) were also collected to help develop an insight into how the different sites engaged organizationally with IPC and family member involvement. Directed content analysis enabled the identification and categorization of major themes within the data. An interprofessional conceptual framework was utilized to help frame the coding for the analysis. The preliminary findings presented in this paper illuminate a number of issues related to the nature of IPC and family member involvement within an ICU context. These findings are discussed in relation to the wider interprofessional and health services literature.
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Affiliation(s)
- Scott Reeves
- Centre for Health and Social Care Research, Kingston University & St George's, University of London , Kingston upon Thames , UK
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The Effect of Intensive Care Unit Environments on Nurse Perceptions of Family Presence During Resuscitation and Invasive Procedures. Dimens Crit Care Nurs 2014; 33:34-9. [DOI: 10.1097/dcc.0000000000000010] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Fry M, Gallagher R, Chenoweth L, Stein-Parbury J. Nurses’ experiences and expectations of family and carers of older patients in the emergency department. Int Emerg Nurs 2014; 22:31-6. [DOI: 10.1016/j.ienj.2013.03.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 03/21/2013] [Accepted: 03/24/2013] [Indexed: 11/24/2022]
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Kantrowitz-Gordon I, Bennett D, Wise Stauffer D, Champ-Gibson E, Fitzgerald C, Corbett C. Facilitated family presence at resuscitation: effectiveness of a nursing student toolkit. NURSE EDUCATION TODAY 2013; 33:1258-1263. [PMID: 22944019 DOI: 10.1016/j.nedt.2012.08.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2012] [Revised: 08/15/2012] [Accepted: 08/20/2012] [Indexed: 06/01/2023]
Abstract
BACKGROUND Facilitated family presence at resuscitation is endorsed by multiple nursing and specialty practice organizations. Implementation of this practice is not universal so there is a need to increase familiarity and competence with facilitated family presence at resuscitation during this significant life event. One strategy to promote this practice is to use a nursing student toolkit for pre-licensure and graduate nursing students. The toolkit includes short video simulations of facilitated family presence at resuscitation, a PowerPoint presentation of evidence-based practice, and questions to facilitate guided discussion. METHODS This study tested the effectiveness of this toolkit in increasing nursing students' knowledge, perceptions, and confidence in facilitated family presence at resuscitation. Nursing students from five universities in the United States completed the Family Presence Risk-Benefit Scale, Family Presence Self-Confidence Scale, and a knowledge test before and after the intervention. RESULTS Implementing the facilitated family presence at resuscitation toolkit significantly increased nursing students' knowledge, perceptions, and confidence related to facilitated family presence at resuscitation (p<.001). The effect size was large for knowledge (d=.90) and perceptions (d=1.04) and moderate for confidence (d=.51). CONCLUSIONS The facilitated family presence at resuscitation toolkit used in this study had a positive impact on students' knowledge, perception of benefits and risks, and self-confidence in facilitated family presence at resuscitation. The toolkit provides students a structured opportunity to consider the presence of family members at resuscitation prior to encountering this situation in clinical practice.
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Affiliation(s)
- Ira Kantrowitz-Gordon
- School of Nursing, University of Washington, Box 357262, Seattle, WA 98195, United States; College of Nursing, Washington State University, Spokane, WA, United States.
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Snowdon C, Elbourne D, Forsey M, Alfirevic Z. Information-hungry and disempowered: A qualitative study of women and their partners' experiences of severe postpartum haemorrhage. Midwifery 2012; 28:791-9. [DOI: 10.1016/j.midw.2011.12.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Revised: 12/14/2011] [Accepted: 12/29/2011] [Indexed: 10/28/2022]
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Affiliation(s)
- Joanne Disch
- University of Minnesota School of Nursing, Minneapolis, MN, USA
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Leung NY, Chow SKY. Attitudes of healthcare staff and patients' family members towards family presence during resuscitation in adult critical care units. J Clin Nurs 2012; 21:2083-93. [PMID: 22672465 DOI: 10.1111/j.1365-2702.2011.04013.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM AND OBJECTIVES This study examines the attitudes of healthcare staff and patients' family members towards family presence during resuscitation (FPDR) in critical care units in Hong Kong. BACKGROUND A wealth of literature is available on FPDR in various hospital and healthcare settings. The findings include many anecdotal accounts of both the positive and the negative effects of family presence. There is little documentation on the comparisons of staff and family members' perceptions and the predictors of staff attitudes towards FPDR practice. DESIGN Cross-sectional survey design. METHOD A convenience sample of 163 healthcare staff and 69 family members was recruited from the intensive care units. RESULTS There was significant difference in the attitudes of healthcare staff and patients' families towards FPDR. The regression analysis showed that the healthcare staff would be more supportive to FPDR if family members could share the dying moments with patients, family members were accompanied by a bereavement team member, there was adequate staff to support the family and staff members were adequately trained. If healthcare staff feel that family members may have the impression that the resuscitation is chaotic, witness resuscitation is traumatic experience for the family, family presence will increase risk of litigation and colleagues will not allow family members to stay during resuscitation making them less supportive of FPDR. Nurses were more supportive to FPDR than doctors. CONCLUSION The results provide information for healthcare professionals on the development of FPDR programmes for patients and their family members. Through multi-disciplinary collaborations, the effective and safe implementation of FPDR practice can be enhanced. RELEVANCE TO CLINICAL PRACTICE The results could help the clinical staff to develop written guidelines to produce an integrated and consistent approach to this sensitive issue in clinical practice.
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Affiliation(s)
- Nga Yee Leung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
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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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Abstract
This is the sixth in a series of articles from Planetree, an international nonprofit organization founded in 1978 that's "committed to improving medical care from the patient's perspective." For more information, go to www.planetree.org.
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