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Halm MA, Ruppel H, Sexton JR, Guzzetta CE. Facilitating Family Presence During Resuscitation and Invasive Procedures Throughout the Life Span. Crit Care Nurse 2024; 44:e1-e13. [PMID: 38096905 DOI: 10.4037/ccn2023733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
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2
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Felipe VS, Salinas Sanz JA, Barrios Miras E, Del Río Pastoriza I, Noriega Echevarría I, Alijas Merillas MJ, Moreno Madrid F, Peláez Cantero MJ, García Iñiguez JP, Riaño Galán I. Accompaniment of minors during health care procedures. An Pediatr (Barc) 2023; 99:321-328. [PMID: 37977964 DOI: 10.1016/j.anpede.2023.09.013] [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: 06/27/2023] [Accepted: 09/08/2023] [Indexed: 11/19/2023] Open
Abstract
In clinical practice, it is not rare to encounter situations in which parents and families are asked to leave the child alone with the health care team in rooms full of devices throughout the performance of procedures, which at times may give rise not only to conflicts but, more importantly, emotional sequelae in children or adolescents. We conducted a narrative review of the literature by searching the digital library of the public health care system of Andalusia for articles concerning the experiences of health care professionals and families with the accompaniment of paediatric patients during health care procedures. We restricted the search to studies published in Spanish or English and conducted in humans. The review evinced the need to humanise care in order to improve care quality. The need to accompany minors is supported by the evidence from works that have analysed the factors involved in the persistence of these behaviours and attitudes in both professionals and parents. We consider it necessary to develop institutional policies and appoint mediators to compile the statements of different national and international societies, taking into account legal aspects but, above all, the pertinent values from a health care ethics perspective, and in pursuit of the best interests of the child.
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Affiliation(s)
- Verjano Sánchez Felipe
- Área integrada de Pediatría y Neonatología, Hospital Universitario Costa del Sol, Marbella, Spain.
| | | | | | | | - Iñigo Noriega Echevarría
- Hospital Universitario del Niño Jesús, Madrid, Spain; Universidad Internacional de La Rioja, La Rioja, Spain
| | | | | | | | | | - Isolina Riaño Galán
- Área Gestión Clínica Pediatría, Hospital Universitario Central, Asturias, Spain
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Kassam-Adams N, Butler L, Price J, Gawel M, Graham L, Myers S, Auerbach M. Trauma-informed and family-centered paediatric resuscitation: Defining domains and practices. Resusc Plus 2023; 14:100374. [PMID: 37007186 PMCID: PMC10064226 DOI: 10.1016/j.resplu.2023.100374] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/27/2023] [Accepted: 03/02/2023] [Indexed: 03/28/2023] Open
Abstract
Aim For paediatric patients and families, resuscitation can be an extremely stressful experience with significant medical and psychological consequences. Psychological sequelae may be reduced when healthcare teams apply patient- and family-centered care and trauma-informed care, yet there are few specific instructions for effective family-centered or trauma-informed behaviours that are observable and teachable. We aimed to develop a framework and tools to address this gap. Methods We reviewed relevant policy statements, guidelines, and research to define core domains of family-centered and trauma-informed care, and identified observable evidence-based practices in each domain. We refined this list of practices via review of provider/team behaviours in simulated paediatric resuscitation scenarios, then developed and piloted an observational checklist. Results Six domains were identified: (1) Sharing information with patient and family; (2) Promoting family involvement in care and decisions; (3) Addressing family needs and distress; (4) Addressing child distress; (5) Promoting effective emotional support for child; (6) Practicing developmental and cultural competence. A 71-item observational checklist assessing these domains was feasible for use during video review of paediatric resuscitation. Conclusion This framework can guide future research and provide tools for training and implementation efforts to improve patient outcomes through patient- and family-centered and trauma-informed care.
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Affiliation(s)
- Nancy Kassam-Adams
- Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA
- University of Pennsylvania Perelman School of Medicine, 3400 Civic Center Blvd, Philadelphia, PA 19104, USA
| | - Lucas Butler
- Yale School of Medicine, 333 Cedar St, New Haven, CT 06510, USA
| | - Julia Price
- Nemours Children’s Health, 1600 Rockland Road, Wilmington, DE 19803, USA
- Sidney Kimmel Medical College at Thomas Jefferson University, 1025 Walnut St, Philadelphia, PA 19107, USA
| | - Marcie Gawel
- Yale New Haven Hospital, 20 York St, New Haven, CT 06510, USA
| | - Leila Graham
- Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA
| | - Sage Myers
- Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA
- University of Pennsylvania Perelman School of Medicine, 3400 Civic Center Blvd, Philadelphia, PA 19104, USA
| | - Marc Auerbach
- Yale School of Medicine, 333 Cedar St, New Haven, CT 06510, USA
- Yale New Haven Children’s Hospital, 35 Park St, New Haven, CT 06511, USA
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Power NM, North N, Leonard AL, Bonaconsa C, Coetzee M. A scoping review of mother-child separation in clinical paediatric settings. J Child Health Care 2021; 25:534-548. [PMID: 33035074 DOI: 10.1177/1367493520966415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
There is increasing evidence to suggest that autonomic regulation of hospitalised infants is affected by separation from their mother. This review explored the extent of the evidence relating to the impact of separation on infants and children and aimed to identify suitable measures of the impact of mother-child separation. We conducted a scoping review of seven databases using the main search terms 'physiological', 'psychological', 'infant/child', 'maternal separation' and 'hospital'. Thirty-four articles containing data relevant to the effects of mother-child separation on either member of the pair were included. Findings highlight the central importance of the mother's presence in mediating the stressful effects of hospitalisation on her child. The majority of articles reported on psychological effects of separation on mothers of infants or on younger children. We identified no articles reporting on physiological effects on the older child or mothers of older children or psychological effects on mothers of older children. Only nine articles used validated tools to measure the effects of separation. There is a need for more evidence, based on validated measurement, about the psychological effects of separation on the child, particularly the older child, and on the physiological effects of separation on the mother-child pair during hospitalisation.
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Affiliation(s)
- Nina M Power
- The Harry Crossley Children's Nursing Development Unit, Department of Paediatrics and Child Health, 37716University of Cape Town, South Africa
| | - Natasha North
- The Harry Crossley Children's Nursing Development Unit, Department of Paediatrics and Child Health, 37716University of Cape Town, South Africa
| | - Angela L Leonard
- The Harry Crossley Children's Nursing Development Unit, Department of Paediatrics and Child Health, 37716University of Cape Town, South Africa
| | - Candice Bonaconsa
- The Harry Crossley Children's Nursing Development Unit, Department of Paediatrics and Child Health, 37716University of Cape Town, South Africa
| | - Minette Coetzee
- The Harry Crossley Children's Nursing Development Unit, Department of Paediatrics and Child Health, 37716University of Cape Town, South Africa
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Auerbach M, Butler L, Myers SR, Donoghue A, Kassam-Adams N. Implementing Family Presence During Pediatric Resuscitations in the Emergency Department: Family-Centered Care and Trauma-Informed Care Best Practices. J Emerg Nurs 2021; 47:689-692. [PMID: 34530971 DOI: 10.1016/j.jen.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 07/12/2021] [Indexed: 10/20/2022]
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Acute psychosocial care of families in paediatric resuscitation settings: Variables associated with parent emotional response. Australas Emerg Care 2020; 24:224-229. [PMID: 33309546 DOI: 10.1016/j.auec.2020.11.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/29/2020] [Accepted: 11/08/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Family presence in paediatric resuscitation settings is now accepted practice. However, there is limited evidence to guide psychosocial care of these families. This study aimed to increase the understanding of family demographics and needs for psychosocial care at the Royal Children's Hospital, Melbourne, Australia and to identify the factors that impact on families at this time of emotional and social distress. METHOD A retrospective clinical data-mining methodology was utilised (n = 1123). Descriptive and inferential data analysis was undertaken using STATA software to identify population demographics, patterns in service usage and family experience, and to identify factors associated with parents' emotional responses. FINDINGS Four areas were identified that support evidence-informed psychosocial care for families in paediatric resuscitation contexts: 1) family and parent dynamics 2) families' experiences of distress in relation to patient diagnostic category 3) systemic nature of family response, and 4) the identification and analysis of family emotional support needs, which is central to the psychosocial response.
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Niemczyk E, Ozga D, Przybylski A. Experiences and Opinions of Patients and Their Relatives to Family Presence During Adult Resuscitation in Poland: Quantitative Research. Patient Prefer Adherence 2020; 14:227-234. [PMID: 32103907 PMCID: PMC7023900 DOI: 10.2147/ppa.s229618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 01/06/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Scientific research and public opinion polls indicate that the majority of patients and their families believe that members of the patients' family should be offered the opportunity to be present during CPR, at the moment of their loved one's death, and throughout all aspects of emergency care. The study was designed to analyse the experiences and opinions of patients and family members towards Family Presence During Resuscitation (FPDR) in hospitals in Poland. PATIENTS AND METHODS We conducted a survey related to FPDR among patients and their families during 5 months in 2017. That was preceded by a pilot study. We asked the patients and the people accompanying them to complete the questionnaire during admission to the hospital; 1000 questionnaires (500 patient responses and 500 family responses) were included in the analysis. RESULTS Patients and their relatives more often wanted to be present during resuscitation of a loved one than they agreed to the presence of the family during their resuscitation. The vast majority of patients did not know the patient's rights regarding FPDR. 24.2% of patients and 29.2% of their relatives participated in the discussions on FPDR. The interest in FPDR indicated 29.0% of patients and 27.6% of family members. CONCLUSION In our survey study, both patients and their family members had a negative attitude towards FPDR. Respondents (both patients and family members) had a low level of awareness that their potential to be present during CPR was included in the patient's rights.
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Affiliation(s)
- Edyta Niemczyk
- Institute of Health Sciences, Collegium Medicum, The University of Rzeszow, Rzeszow35-310, Poland
| | - Dorota Ozga
- Institute of Health Sciences, Collegium Medicum, The University of Rzeszow, Rzeszow35-310, Poland
- Correspondence: Dorota Ozga Tel +48 178571955 Email
| | - Andrzej Przybylski
- Institute of Medical Sciences, Collegium Medicum, University of Rzeszow, Rzeszow35-310, Poland
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Parra C, Mele M, Alonso I, Trenchs V, Luaces C. Parent experience in the resuscitation room: how do they feel? Eur J Pediatr 2018; 177:1859-1862. [PMID: 30196426 DOI: 10.1007/s00431-018-3236-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 08/16/2018] [Accepted: 08/27/2018] [Indexed: 12/30/2022]
Abstract
The aim of this study is to describe the experience of parents present in the resuscitation room during the attention given to their children in the pediatric emergency department, and to identify areas for improvement in this regard. This was a prospective study carried out in a third-level pediatric hospital. Children with life-threatening pathologies are treated in the resuscitation room of the pediatric emergency department. A survey was carried out among parents present in the resuscitation room during the period September 2016-August 2017. Excluded were the parents of children that died and those with a language barrier. The parents were interviewed in person or over the phone within 72 h of the care provided in the resuscitation room. Fifty surveys were completed (15 in person and 35 by phone). Forty mothers and 10 fathers responded, with an average age of 41. In the resuscitation room, 39 parents were accompanied by a health professional and 22 were given information about how the resuscitation room operated. The feelings most frequently reported by the parents were nervousness (39) and trust in the healthcare provided (20). All of the parents wished to be present. They felt that their presence was beneficial for the child (46), for themselves (50), and for the healthcare personnel (28).Conclusion: The experience of the parents in our resuscitation room is a positive one. Nevertheless, some aspects need to be improved, such as accompaniment of the parents and the information that they are provided. What is Known: • There is an international recommendation for parental presence during invasive procedures and cardiopulmonary resuscitation. • Few studies have been carried out on how parents in the resuscitation room feel and how they encounter the experience. What is New: • Even though most of the parents feel nervous in the resuscitation room, they expressed confidence in the medical team and they would wish to be present under similar circumstances.
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Affiliation(s)
- Cristina Parra
- Pediatric Emergency Department, Hospital Sant Joan de Déu Barcelona (Spain), Passeig Sant Joan de Déu, 2, Esplugues de Llobregat, 08950, Barcelona, Spain.
| | - Maria Mele
- Pediatric Emergency Department, Hospital Sant Joan de Déu Barcelona (Spain), Passeig Sant Joan de Déu, 2, Esplugues de Llobregat, 08950, Barcelona, Spain
| | - Iris Alonso
- Pediatric Emergency Department, Hospital Sant Joan de Déu Barcelona (Spain), Passeig Sant Joan de Déu, 2, Esplugues de Llobregat, 08950, Barcelona, Spain
| | - Victoria Trenchs
- Pediatric Emergency Department, Hospital Sant Joan de Déu Barcelona (Spain), Passeig Sant Joan de Déu, 2, Esplugues de Llobregat, 08950, Barcelona, Spain
| | - Carles Luaces
- Pediatric Emergency Department, Hospital Sant Joan de Déu Barcelona (Spain), Passeig Sant Joan de Déu, 2, Esplugues de Llobregat, 08950, Barcelona, Spain
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Psychosocial Care Models for Families of Critically Ill Children in Pediatric Emergency Department Settings: A Scoping Review. J Pediatr Nurs 2018; 38:46-52. [PMID: 29167080 DOI: 10.1016/j.pedn.2017.10.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 10/21/2017] [Accepted: 10/22/2017] [Indexed: 11/23/2022]
Abstract
PROBLEM Critical illness in children is a significant and stressful life event for families. Within pediatric emergency department (ED) settings it is acknowledged that these crises are challenging for both the families of these children, and for the clinical staff treating the child. Literature recommends routine care should include an offer to the family to be present with their critically ill child, however there is a lack of clarity regarding specific family care models or evidence-based interventions to guide clinical practice. ELIGIBILITY CRITERIA Peer reviewed articles written in English, published between 2006 and 2016, proposing or testing psychosocial care models in pediatric (or mixed) emergency settings. SAMPLE Nine articles met inclusion criteria. RESULTS Search results showed limited evidence available in the literature at this time. Thematic analysis of article content and proposed model showed strong support for the benefit of family presence, including shifting the family role from passive to active, needing to be inclusive of the psychological impact of critical health events, importance of multidisciplinary education, and the need for additional exploratory and empirical research to evaluate and refine proposed care models. CONCLUSIONS Pediatric emergency health events are challenging for both families and staff, and care models provide staff with a consistent, evidence-informed approach to caring for families in challenging situations. IMPLICATIONS There is a need to find common ground from specific discipline guidelines into a multidisciplinary team approach for the care of families within emergency care.
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Firn J, DeVries K, Morano D, Spano-English T. Social workers' experiences as the family support person during cardiopulmonary resuscitation attempts. SOCIAL WORK IN HEALTH CARE 2017; 56:541-555. [PMID: 28398144 DOI: 10.1080/00981389.2017.1292986] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
During inhospital cardiopulmonary resuscitation attempts, a designated family support person (FSP) may provide guidance and support to family members. Research on nurses and chaplains in this role has been published. Social workers also regularly fulfill this service, however, little is known about how they perceive and enact this role. To explore their experiences, qualitative interviews (n = 10) were conducted with FSP social workers. Critical realist thematic analysis identified five themes: walking in cold, promoting family presence, responding to the whole spectrum of grief, going beyond the family support role, and repercussions of bearing witness. Social workers perform a variety of tasks to promote family presence during resuscitation attempts and provide psychosocial support over the continuum of care. The FSP role impacts social workers emotionally and professionally. Implications for hospital policy, staffing, and clinical practice are discussed.
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Affiliation(s)
- Janice Firn
- a Department of Social Work , University of Michigan Health System , Ann Arbor , Michigan , USA
| | - Keli DeVries
- b Department of Care Management , University of Michigan Health System , Ann Arbor , Michigan , USA
| | - Dawnielle Morano
- b Department of Care Management , University of Michigan Health System , Ann Arbor , Michigan , USA
| | - Toni Spano-English
- a Department of Social Work , University of Michigan Health System , Ann Arbor , Michigan , USA
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12
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AL-Sagarat AY, Al-Ghwyeen WS. Attitudes of Health Care Providers Toward the Presence of Family Members During Invasive Procedures in Children. Compr Child Adolesc Nurs 2016. [DOI: 10.1080/24694193.2016.1200694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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13
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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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Sawyer A, Ayers S, Bertullies S, Thomas M, Weeks AD, Yoxall CW, Duley L. Providing immediate neonatal care and resuscitation at birth beside the mother: parents' views, a qualitative study. BMJ Open 2015; 5:e008495. [PMID: 26384723 PMCID: PMC4577942 DOI: 10.1136/bmjopen-2015-008495] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 06/18/2015] [Accepted: 07/17/2015] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aims of this study were to assess parents' views of immediate neonatal care and resuscitation at birth being provided beside the mother, and their experiences of a mobile trolley designed to facilitate this bedside care. DESIGN Qualitative study with semistructured interviews. Results were analysed using thematic analysis. SETTING Large UK maternity hospital. PARTICIPANTS Mothers whose baby received initial neonatal care in the first few minutes of life at the bedside, and their birth partners, were eligible. 30 participants were interviewed (19 mothers, 10 partners and 1 grandmother). 5 babies required advanced neonatal resuscitation. RESULTS 5 themes were identified: (1) Reassurance, which included 'Baby is OK', 'Having baby close', 'Confidence in care', 'Knowing what's going on' and 'Dad as informant'; (2) Involvement of the family, which included 'Opportunity for contact', 'Family involvement' and 'Normality'; (3) Staff communication, which included 'Communication' and 'Experience'; (4) Reservations, which included 'Reservations about witnessing resuscitation', 'Negative emotions' and 'Worries about the impact on staff' and (5) Experiences of the trolley, which included 'Practical issues' and 'Comparisons with standard resuscitation equipment'. CONCLUSIONS Families were positive about neonatal care being provided at the bedside, and felt it gave reassurance about their baby's health and care. They also reported feeling involved as a family. Some parents reported experiencing negative emotions as a result of witnessing resuscitation of their baby. Parents were positive about the trolley.
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Affiliation(s)
- Alexandra Sawyer
- Centre for Health Research, School of Health Sciences, University of Brighton, Brighton, UK
| | - Susan Ayers
- Centre for Maternal and Child Health Research, City University London, London, UK
| | - Sophia Bertullies
- Centre for Maternal and Child Health Research, City University London, London, UK
| | | | - Andrew D Weeks
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
| | | | - Lelia Duley
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
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Dudley N, Ackerman A, Brown KM, Snow SK. Patient- and family-centered care of children in the emergency department. Pediatrics 2015; 135:e255-72. [PMID: 25548335 DOI: 10.1542/peds.2014-3424] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Patient- and family-centered care is an approach to the planning, delivery, and evaluation of health care that is grounded in a mutually beneficial partnership among patients, families, and health care professionals. Providing patient- and family-centered care to children in the emergency department setting presents many opportunities and challenges. This revised technical report draws on previously published policy statements and reports, reviews the current literature, and describes the present state of practice and research regarding patient- and family-centered care for children in the emergency department setting as well as some of the complexities of providing such care.
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Rellensmann G, Laumann K, Gillner J, Kosmann F, Roth B. Anwesenheit der Eltern bei Notfallsituationen in der Pädiatrie. Monatsschr Kinderheilkd 2013. [DOI: 10.1007/s00112-013-3053-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Suresh S, Crowe E. Family-centered Care: Generating Evidence in Pediatric Clinical Practice. Am J Respir Crit Care Med 2012. [DOI: 10.1164/rccm.201209-1740ed] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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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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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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James J, Cottle E, Hodge RD. Registered nurse and health care Chaplains experiences of providing the family support person role during family witnessed resuscitation. Intensive Crit Care Nurs 2011; 27:19-26. [DOI: 10.1016/j.iccn.2010.09.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2010] [Revised: 07/27/2010] [Accepted: 09/07/2010] [Indexed: 10/18/2022]
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Health Care Providers' Evaluations of Family Presence During Resuscitation. J Emerg Nurs 2010; 36:524-33. [DOI: 10.1016/j.jen.2010.06.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2010] [Revised: 06/09/2010] [Accepted: 06/10/2010] [Indexed: 11/24/2022]
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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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Dougal RL, Anderson JH, Reavy K, Shirazi CC. Family presence during resuscitation and/or invasive procedures in the Emergency Department: one size does not fit all. J Emerg Nurs 2010; 37:152-7. [PMID: 21397129 DOI: 10.1016/j.jen.2010.02.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2009] [Revised: 12/29/2009] [Accepted: 02/12/2010] [Indexed: 11/30/2022]
Affiliation(s)
- Renae L Dougal
- Clinical Education and Research Department, and Co-Chair, Evidence-Based Practice Committee, Saint Alphonsus Regional Medical Center, Boise, ID, USA.
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Moving evidence into practice in the pediatric intensive care unit: how it saved one child's life. AACN Adv Crit Care 2009; 20:328-33. [PMID: 19893371 DOI: 10.1097/nci.0b013e3181ac22a9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Dudley NC, Hansen KW, Furnival RA, Donaldson AE, Van Wagenen KL, Scaife ER. The Effect of Family Presence on the Efficiency of Pediatric Trauma Resuscitations. Ann Emerg Med 2009; 53:777-84.e3. [DOI: 10.1016/j.annemergmed.2008.10.002] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2008] [Revised: 09/19/2008] [Accepted: 10/01/2008] [Indexed: 10/21/2022]
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Should relatives witness resuscitation in the emergency department? The point of view of the Belgian Emergency Department staff. Eur J Emerg Med 2009; 16:87-91. [DOI: 10.1097/mej.0b013e32830abe17] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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[Presence of parents in the emergency room during invasive procedures: do they prefer to be present?]. An Pediatr (Barc) 2009; 70:230-4. [PMID: 19409240 DOI: 10.1016/j.anpedi.2008.10.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2008] [Revised: 10/28/2008] [Accepted: 10/31/2008] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Parents are not usually present during procedures in the paediatric emergency room (ER), although an increasing number of them would like to. Our goal was to find out how parents felt about them being present in ER during procedures. MATERIAL AND METHODS This is an observational study. Questionnaires were distributed among parents of patients in the ER during January and February 2007. Data included demographic questions as well as the opinion regarding their preference on being present during venipuncture, stitching, lumbar puncture or cardiopulmonary resuscitation. They were also asked about who should take the decision whether to allow the family to be present or not. RESULTS A total of 98 questionnaires were analyzed. The median age of participants was 32 years-old, of which 84.5% would prefer to be present for venipuncture, 70.4% for stitching, 66.3% for lumbar puncture and 61.2% for cardiopulmonary resuscitation. Venipuncture was performed on 21% of the children, stitching on 4%, and lumbar puncture on 2%. There was no cardiopulmonary resuscitation. Parents considered that the decision about being present should be taken by the professional in 74% (venipuncture), 75% (stitching), 80% (lumbar puncture) and 81% (cardiopulmonary resuscitation). The mean age of the group that preferred to be present was lower (32 vs. 40 years; p = 0.039). CONCLUSIONS Most parents surveyed preferred to be present during invasive procedures in ER. The more invasive the procedure is the higher reluctance from parents to be present. Most parents thought the decision should be taken by the health care professional, particularly when the procedure is more invasive.
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The death of children in the emergency department: the psychosocial and administrative response. Pediatr Emerg Care 2008; 24:632-7; quiz 638-9. [PMID: 18797377 DOI: 10.1097/pec.0b013e318185d931] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Patient- and family-centered care is an innovative approach to the planning, delivery, and evaluation of health care that is grounded in a mutually beneficial partnership among patients, families, and health care professionals. Providing patient- and family-centered care to children in the emergency department setting presents many opportunities and challenges. This technical report draws on previously published policy statements and reports, reviews the current literature, and describes the present state of practice and research regarding patient- and family-centered care for children in the emergency department setting as well as some of the complexities of providing such care. This technical report has been endorsed by the Academic Pediatric Association (formerly the Ambulatory Pediatric Association), the American College of Osteopathic Emergency Physicians, the National Association of Emergency Medical Technicians, the Institute for Family-Centered Care, and the American College of Emergency Physicians. This report is also supported by the Emergency Nurses Association.
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Twibell R, Siela D, Riwitis C, Wheatley J, Riegle T, Bousman D, Cable S, Caudill P, Harrigan S, Hollars R, Johnson D, Neal A. Response. Am J Crit Care 2008. [DOI: 10.4037/ajcc2008.17.4.310-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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