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Abuzeyad FH, Elhobi A, Kamkoum W, Bashmi L, Al-Qasim G, Alqasem L, Mansoor NMA, Hsu S, Das P. Healthcare providers' perspectives on family presence during resuscitation in the emergency departments of the Kingdom of Bahrain. BMC Emerg Med 2020; 20:69. [PMID: 32867700 PMCID: PMC7460739 DOI: 10.1186/s12873-020-00365-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 08/25/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Worldwide, policies exist on family presence during resuscitation (FPDR), however, this is still lacking in the Gulf Corporation Countries (GCC) in general and in the Kingdom of Bahrain in particular. The aim of this study is to assess the perspectives of healthcare providers (HP) on FPDR among those working in the emergency departments (EDs) in the Kingdom. METHODS A self-administered anonymous electronic survey was collected from 146 HPs (emergency physicians and nurses) working in the three major EDs in the Kingdom of Bahrain. Besides demographic data, 18 items measuring HPs' perceptions of FPDR were generated using the 5-point Likert scale. RESULTS Surveys (n = 146) from physicians and nurses were analysed (45.9% vs. 54.1%, respectively). There were significant differences between physicians and nurses in terms of personal beliefs, FPDR enhancing professional satisfaction and behaviour, and the importance of a support person and saying goodbye (p < 0.001). However, general responses demonstrated that the majority of HPs encouraged and supported FPDR, but with greater support from physicians than nurses. CONCLUSION The study reflects that many HPs in EDs participated in and are familiar with FPDR, with the majority of ED physicians supporting it. Further studies should investigate the reasons for the lack of support from nurses. Results may contribute to the development of hospital ED policies that allow FPDR in the region.
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Affiliation(s)
- Feras H. Abuzeyad
- Department of Emergency Medicine, King Hamad University Hospital, Building 2345, Road 2835, Block 228, P. O. Box 24343, Busaiteen, Kingdom of Bahrain
| | - Ahmed Elhobi
- Department of Emergency Medicine, King Hamad University Hospital, Building 2345, Road 2835, Block 228, P. O. Box 24343, Busaiteen, Kingdom of Bahrain
| | - Wael Kamkoum
- Department of Emergency Medicine, King Hamad University Hospital, Building 2345, Road 2835, Block 228, P. O. Box 24343, Busaiteen, Kingdom of Bahrain
| | - Luma Bashmi
- Scientific Research & Development, King Hamad University Hospital, Building 2345, Road 2835, Block 228, P. O. Box 24343, Busaiteen, Kingdom of Bahrain
| | - Ghada Al-Qasim
- Emergency Medicine Department–Royal Medical Services, Bahrain Defence Force, Riffa, Kingdom of Bahrain
| | - Leena Alqasem
- National Health Regulatory Authority, Sanabis, Kingdom of Bahrain
| | | | - Stephanie Hsu
- Scientific Research & Development, King Hamad University Hospital, Building 2345, Road 2835, Block 228, P. O. Box 24343, Busaiteen, Kingdom of Bahrain
| | - Priya Das
- Scientific Research & Development, King Hamad University Hospital, Building 2345, Road 2835, Block 228, P. O. Box 24343, Busaiteen, Kingdom of Bahrain
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Sucu Dağ G, Dicle A, Firat MZ. Psychometric properties of the critical care family needs inventory-emergency department. Appl Nurs Res 2017; 33:113-120. [DOI: 10.1016/j.apnr.2016.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 10/08/2016] [Accepted: 11/06/2016] [Indexed: 10/20/2022]
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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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Family presence during resuscitation: A Canadian Critical Care Society position paper. Can Respir J 2015; 22:201-5. [PMID: 26083541 DOI: 10.1155/2015/532721] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Recent evidence suggests that patient outcomes are not affected by the offering of family presence during resuscitation (FPDR), and that psychological outcomes are neutral or improved in family members of adult patients. The exclusion of family members from the resuscitation area should, therefore, be reassessed. OBJECTIVE The present Canadian Critical Care Society position paper is designed to help clinicians and institutions decide whether to incorporate FPDR as part of their routine clinical practice, and to offer strategies to implement FPDR successfully. METHODS The authors conducted a literature search of the perspectives of health care providers, patients and families on the topic of FPDR, and considered the relevant ethical values of beneficence, nonmaleficence, autonomy and justice in light of the clinical evidence for FPDR. They reviewed randomized controlled trials and observational studies of FPDR to determine strategies that have been used to screen family members, select appropriate chaperones and educate staff. RESULTS FPDR is an ethically sound practice in Canada, and may be considered for the families of adult and pediatric patients in the hospital setting. Hospitals that choose to implement FPDR should develop transparent policies regarding which family members are to be offered the opportunity to be present during the resuscitation. Experienced chaperones should accompany and support family members in the resuscitation area. Intensive educational interventions and increasing experience with FPDR are associated with increased support for the practice from health care providers. CONCLUSIONS FPDR should be considered to be an important component of patient and family-centred care.
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Porter JE, Cooper SJ, Taylor B. Family presence during resuscitation (FPDR): A survey of emergency personnel in Victoria, Australia. ACTA ACUST UNITED AC 2015; 18:98-105. [PMID: 25655467 DOI: 10.1016/j.aenj.2014.12.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 12/24/2014] [Accepted: 12/24/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Family presence during resuscitation (FPDR) has been endorsed internationally by resuscitation councils since the year 2000; however, the extent to which FPDR is practiced in emergency settings requires further investigation. METHODS Emergency personnel (n=347) from 18 participating emergency departments across the state of Victoria, Australia completed a 10-page questionnaire, which was designed to develop an understanding of the current practice and implementation of FPDR and to ascertain the differences in practice between adult and paediatric resuscitations. RESULTS Emergency personnel update their adult and paediatric advanced life support qualifications annually with 87% of nurses and 65% of doctors completing adult life support and 72% of nurses and 49% of doctors completing paediatric advanced life support training. The majority of nursing staff reported support for FPDR (83%) with over 70% indicating that it is apart of their current practice. There was strong agreement from both nurses (79%) and doctors (77%) that the family have the right to be present. A family support person was deemed as essential by nurses (92%) and doctors (89%) when allowing family to be present. A factor analysis was conducted on participant statements, revealing four codes; impact on professional practice and performance, personnel beliefs about FPDR, professional satisfaction and the importance of a support person and saying goodbye. CONCLUSION A family support person was highlighted as essential to the successful implementation of FPDR, together with the development of a comprehensive training the education program for emergency personnel. FPDR continues to be a significant issue and further investigation into FPDR practice and implementation in the ED is warranted.
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Affiliation(s)
- Joanne E Porter
- School of Nursing, Midwifery and Healthcare, Federation University, Churchill, Victoria, Australia.
| | - Simon J Cooper
- School of Nursing and Midwifery, Monash University, Berwick, Victoria, Australia; University of Brighton, UK
| | - Beverley Taylor
- School of Nursing, Midwifery and Healthcare, Federation University, Churchill, Victoria, Australia
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Masa'Deh R, Saifan A, Timmons S, Nairn S. Families' stressors and needs at time of cardio-pulmonary resuscitation: a Jordanian perspective. Glob J Health Sci 2013; 6:72-85. [PMID: 24576367 PMCID: PMC4825218 DOI: 10.5539/gjhs.v6n2p72] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 10/30/2013] [Indexed: 11/25/2022] Open
Abstract
Background: During cardio-pulmonary resuscitation, family members, in some hospitals, are usually pushed to stay out of the resuscitation room. However, growing literature implies that family presence during resuscitation could be beneficial. Previous literature shows controversial belief whether or not a family member should be present during resuscitation of their relative. Some worldwide association such as the American Heart Association supports family-witnessed resuscitation and urge hospitals to develop policies to ease this process. The opinions on family-witnessed resuscitation vary widely among various cultures, and some hospitals are not applying such polices yet. This study explores family members’ needs during resuscitation in adult critical care settings. Methods: This is a part of larger study. The study was conducted in six hospitals in two major Jordanian cities. A purposive sample of seven family members, who had experience of having a resuscitated relative, was recruited over a period of six months. Semi-structured interview was utilised as the main data collection method in the study. Findings:
The study findings revealed three main categories: families’ need for reassurance; families’ need for proximity; and families’ need for support. The need for information about patient’s condition was the most important need. Updating family members about patient’s condition would reduce their tension and improve their acceptance for the end result of resuscitation. All interviewed family members wanted the option to stay beside their loved one at end stage of their life. Distinctively, most of family members want this option for some religious and cultural reasons such as praying and supplicating to support their loved one. Conclusions: This study emphasizes the importance of considering the cultural and religious dimensions in any family-witnessed resuscitation programs. The study recommends that family members of resuscitated patients should be treated properly by professional communication and involving them in the treatment process. The implications concentrate on producing specific guidelines for allowing family-witnessed resuscitation in the Jordanian context. Finally, attaining these needs will in turn decrease stress of those witnessing resuscitation of their relative.
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Affiliation(s)
- Rami Masa'Deh
- Assistant Professor at the Applied Science Private University, Amman.
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Jordanian Professional Nurses' Attitudes and Experiences of Having Family Members Present During Cardiopulmonary Resuscitation of Adult Patients. Crit Care Nurs Q 2013; 36:218-27. [DOI: 10.1097/cnq.0b013e31828414c0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Vavarouta A, Xanthos T, Papadimitriou L, Kouskouni E, Iacovidou N. Family presence during resuscitation and invasive procedures: physicians' and nurses' attitudes working in pediatric departments in Greece. Resuscitation 2011; 82:713-6. [PMID: 21398020 DOI: 10.1016/j.resuscitation.2011.02.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Revised: 01/30/2011] [Accepted: 02/14/2011] [Indexed: 12/01/2022]
Abstract
BACKGROUND Family presence during resuscitation and invasive procedures (FPDRAIP) has been a frequent topic of debate among healthcare personnel worldwide. This paper determines the knowledge, experiences and views of Greek physicians and nurses on FPDRAIP and examines possible correlations and factors promoting or limiting the implementation of the issue. METHODS The data for this descriptive questionnaire study were collected between March and June 2009. The study population consisted of 44 physicians and 77 nurses working in neonatal-pediatric departments and intensive care units in Patras, Greece, who answered an anonymous questionnaire. RESULTS The majority of the participants (73.6%) were not familiar with FPDRAIP, were neither educated (72.7%) nor did they agree with the issue (71.9%). No written policy on FPDRAIP existed in the hospitals surveyed. Participants who were familiar with existing guidelines on the issue, or those who had relevant personal experience (76.9%), were positive for practising it as well. The degree of invasiveness of the medical intervention was the major determinant for healthcare personnel to consent for FPDRAIP. Finally, 43.2% of physicians believed that the decision of allowing FPDRAIP should be made only by them, whereas, 40.3% of nurses thought it should be a joint one. CONCLUSIONS This study reveals that healthcare personnel in Greece are not familiar with the issue of FPDRAIP. In view of the increasing evidence on the advantages of this practice, we recommend implementation of relevant educational programs and institutional guidelines and policies.
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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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Twibell RS, Siela D, Riwitis C, Wheatley J, Riegle T, Bousman D, Cable S, Caudill P, Harrigan S, Hollars R, Johnson D, Neal A. Nurses’ Perceptions of Their Self-confidence and the Benefits and Risks of Family Presence During Resuscitation. Am J Crit Care 2008. [DOI: 10.4037/ajcc2008.17.2.101] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Background Debate continues among nurses about the advantages and disadvantages of family presence during resuscitation. Knowledge development about such family presence is constrained by the lack of reliable and valid instruments to measure key variables.Objectives To test 2 instruments used to measure nurses’ perceptions of family presence during resuscitation, to explore demographic variables and perceptions of nurses’ self-confidence and the risks and benefits related to such family presence in a broad sample of nurses from multiple hospital units, and to examine differences in perceptions of nurses who have and who have not invited family presence.Methods Nurses (n = 375) completed the Family Presence Risk-Benefit Scale and the Family Presence Self-confidence Scale.Results Nurses’ perceptions of benefits, risks, and self-confidence were significantly and strongly interrelated. Nurses who invited family presence during resuscitation were significantly more self-confident in managing it and perceived more benefits and fewer risks (P < .001). Perceptions of more benefits and fewer risks were related to membership in professional organizations, professional certification, and working in an emergency department (P < .001). Data supported initial reliability and construct validity for the 2 scales.Conclusions Nurses’ perceptions of the risks and benefits of family presence during resuscitation vary widely and are associated with how often the nurses invite family presence. After further testing, the 2 new scales may be suitable for measuring interventional outcomes, serve as self-assessment tools, and add to conceptual knowledge about family presence.
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Affiliation(s)
- Renee Samples Twibell
- Authors are affiliated with Ball Memorial Hospital, Muncie, Indiana; Ball State University, School of Nursing, Muncie, Indiana; or Air-Evac EMS, West Plains, Missouri
| | - Debra Siela
- Authors are affiliated with Ball Memorial Hospital, Muncie, Indiana; Ball State University, School of Nursing, Muncie, Indiana; or Air-Evac EMS, West Plains, Missouri
| | - Cheryl Riwitis
- Authors are affiliated with Ball Memorial Hospital, Muncie, Indiana; Ball State University, School of Nursing, Muncie, Indiana; or Air-Evac EMS, West Plains, Missouri
| | - Joe Wheatley
- Authors are affiliated with Ball Memorial Hospital, Muncie, Indiana; Ball State University, School of Nursing, Muncie, Indiana; or Air-Evac EMS, West Plains, Missouri
| | - Tina Riegle
- Authors are affiliated with Ball Memorial Hospital, Muncie, Indiana; Ball State University, School of Nursing, Muncie, Indiana; or Air-Evac EMS, West Plains, Missouri
| | - Denise Bousman
- Authors are affiliated with Ball Memorial Hospital, Muncie, Indiana; Ball State University, School of Nursing, Muncie, Indiana; or Air-Evac EMS, West Plains, Missouri
| | - Sandra Cable
- Authors are affiliated with Ball Memorial Hospital, Muncie, Indiana; Ball State University, School of Nursing, Muncie, Indiana; or Air-Evac EMS, West Plains, Missouri
| | - Pam Caudill
- Authors are affiliated with Ball Memorial Hospital, Muncie, Indiana; Ball State University, School of Nursing, Muncie, Indiana; or Air-Evac EMS, West Plains, Missouri
| | - Sherry Harrigan
- Authors are affiliated with Ball Memorial Hospital, Muncie, Indiana; Ball State University, School of Nursing, Muncie, Indiana; or Air-Evac EMS, West Plains, Missouri
| | - Rick Hollars
- Authors are affiliated with Ball Memorial Hospital, Muncie, Indiana; Ball State University, School of Nursing, Muncie, Indiana; or Air-Evac EMS, West Plains, Missouri
| | - Doreen Johnson
- Authors are affiliated with Ball Memorial Hospital, Muncie, Indiana; Ball State University, School of Nursing, Muncie, Indiana; or Air-Evac EMS, West Plains, Missouri
| | - Alexis Neal
- Authors are affiliated with Ball Memorial Hospital, Muncie, Indiana; Ball State University, School of Nursing, Muncie, Indiana; or Air-Evac EMS, West Plains, Missouri
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Hadders H. Relatives' presence in connection with cardiopulmonary resuscitation and sudden death at the intensive care unit. Nurs Inq 2007; 14:224-32. [PMID: 17718748 DOI: 10.1111/j.1440-1800.2007.00371.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Within Norwegian intensive care units it is common to focus on the needs of the next of kin of patients undergoing end-of-life care. Offering emotional and practical support to relatives is regarded as assisting them in the initial stages of their grief process. It has also become usual to encourage relatives to be present at the time of death of close relatives. How can dignified end-of-life care coexist with the sometimes turbulent and dramatic character of intensive care in the highly technological environment of intensive care units? This paper describes a case study based on an incident that took place at the intensive care unit (ICU) of Trondheim University Hospital, Norway, in which the relatives of a newly deceased patient voiced unusually strong dissatisfaction with the way they were excluded in connection with cardiopulmonary resuscitation (CPR). The next of kin's criticism highlights an important paradox as well as a degree of inconsistency in lifesaving and end-of-life care at the ICU. I argue that an investigation of the multiple identities within medical practice can illuminate the potential for clashes between lifesaving and end-of-life care, as described and analysed in this paper.
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Affiliation(s)
- Hans Hadders
- Norwegian University of Science and Technology, Trondheim, Norway.
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Ryan G, Treston G. Do family members interfere in the delivery of care when present during invasive paediatric procedures in the emergency department? Emerg Med Australas 2007; 19:234-40. [PMID: 17564691 DOI: 10.1111/j.1742-6723.2007.00962.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine whether family members interfere with patient care when present during invasive procedures performed on their children in the ED. METHODS A prospective observational study of consecutive cases of procedural sedation of children aged between 12 months and 16 years was conducted between March 2002 and March 2006 in the ED of a secondary-level regional hospital in south-east Queensland. Procedures performed included laceration repair, fracture reduction, foreign body removal and abscess incision and drainage. Parents/primary caregivers were encouraged to stay with their child. A stepwise explanation of the procedure and sedation to be used was undertaken, informed consent obtained and telephone follow up attempted 5-14 days post procedure. RESULTS Six hundred and fifty-two patient encounters with parents or primary caregivers present for the procedure were included for a total of 656 procedures: 234 laceration repairs, 250 fracture reductions, 85 foreign body removals, 33 abscess incision and drainages, 14 dislocation reductions and 40 other procedures. Telephone follow up was successful in 65% (424) of cases. The mean age was 6.5 years. Family member interference occurred in one case (0.15%, 95% confidence interval 0-0.73%). In 17 cases (2.68%, 95% confidence interval 2.1-5.9%) family members present expressed concerns about the procedure during the telephone follow up but had not interfered at the time of the procedure. There were no significant differences between the concerned parents at follow up and the study group across key patient variables such as child's age (P = 0.369), weight (P = 0.379), respiratory rate (P = 0.477), sex (P = 0.308), procedure indication (P = 0.308) and airway manoeuvres (P = 0.153). CONCLUSION When family members are encouraged to stay for invasive procedures performed on their child, and careful explanation of the procedure, sedation, possible complications, choice of medication for sedation and possible side-effects is undertaken, family member interference is extremely rare.
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Affiliation(s)
- Glenn Ryan
- Redcliffe District Hospital, Redcliffe, Queensland, Australia.
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Golding M, Smallbane S. Relatives in resuscitations: Where is the harm? Emerg Med Australas 2005; 17:94. [PMID: 15675921 DOI: 10.1111/j.1742-6723.2005.00677.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Affiliation(s)
- Anne-Maree Kelly
- Joseph Epstein Centre for Emergency Medicine Research, Department of Emergency Medicine, Western Hospital, Melbourne, Victoria, Australia
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