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Glad M, Grønlund IR, Møller AM. A survey of emergency medical service providers' perspectives regarding relatives influence on acute prehospital treatment of adult patients. Acta Anaesthesiol Scand 2024. [PMID: 38937943 DOI: 10.1111/aas.14480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 05/23/2024] [Accepted: 06/07/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND In the field of prehospital emergency medicine, specialized emergency medical service (EMS) providers interact with acutely ill patients and their relatives. The influence of family presence during in-hospital resuscitation is well described. However, no studies have previously assessed the influence of relatives' presence in the acute prehospital setting. The aim of this study was to investigate EMS providers' perspectives on relatives' impact on the acute prehospital treatment of adult patients. METHODS An online anonymous survey was distributed to all prehospital EMS providers in the Capital Region of Denmark. The survey included 25 research questions on a 5-point Likert scale, investigating relatives' influence on treatment in three different domains: positive, negative, and resuscitation. A higher domain score indicates a high level of agreement or frequency. RESULTS Two hundred forty-six EMS providers completed the survey (84 ambulance technicians, 87 paramedics, and 75 physicians). There were no significant differences in the positive domain across professions (p = .175). Physicians had a statistically significant lower median score in the negative domain, compared with ambulance technicians and paramedics (2.50 vs. 2.63 and 2.63, p = .024). In the resuscitation domain, paramedics and physicians had a significant lower median score compared with ambulance technicians (3.00 and 3.00 vs. 3.14, p = .003). CONCLUSION All professions were equally positive towards the relatives' presence and involvement in the acute prehospital setting. Physicians were less likely to be negatively influenced by the presence of relatives compared with ambulance technicians and paramedics. In all professions, increased experience led to improved comfort with handling relatives.
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Affiliation(s)
- Marie Glad
- Research Unit, Department of Anaesthesia, Surgery and Intensive Care, Herlev Hospital, Copenhagen, Denmark
| | - Ingeborg R Grønlund
- Research Unit, Department of Anaesthesia, Surgery and Intensive Care, Herlev Hospital, Copenhagen, Denmark
| | - Ann Merete Møller
- Research Unit, Department of Anaesthesia, Surgery and Intensive Care, Herlev Hospital, Copenhagen, Denmark
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2
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Berg KM, Bray JE, Ng KC, Liley HG, Greif R, Carlson JN, Morley PT, Drennan IR, Smyth M, Scholefield BR, Weiner GM, Cheng A, Djärv T, Abelairas-Gómez C, Acworth J, Andersen LW, Atkins DL, Berry DC, Bhanji F, Bierens J, Bittencourt Couto T, Borra V, Böttiger BW, Bradley RN, Breckwoldt J, Cassan P, Chang WT, Charlton NP, Chung SP, Considine J, Costa-Nobre DT, Couper K, Dainty KN, Dassanayake V, Davis PG, Dawson JA, Fernanda de Almeida M, De Caen AR, Deakin CD, Dicker B, Douma MJ, Eastwood K, El-Naggar W, Fabres JG, Fawke J, Fijacko N, Finn JC, Flores GE, Foglia EE, Folke F, Gilfoyle E, Goolsby CA, Granfeldt A, Guerguerian AM, Guinsburg R, Hatanaka T, Hirsch KG, Holmberg MJ, Hosono S, Hsieh MJ, Hsu CH, Ikeyama T, Isayama T, Johnson NJ, Kapadia VS, Daripa Kawakami M, Kim HS, Kleinman ME, Kloeck DA, Kudenchuk P, Kule A, Kurosawa H, Lagina AT, Lauridsen KG, Lavonas EJ, Lee HC, Lin Y, Lockey AS, Macneil F, Maconochie IK, John Madar R, Malta Hansen C, Masterson S, Matsuyama T, McKinlay CJD, Meyran D, Monnelly V, Nadkarni V, Nakwa FL, Nation KJ, Nehme Z, Nemeth M, Neumar RW, Nicholson T, Nikolaou N, Nishiyama C, Norii T, Nuthall GA, Ohshimo S, Olasveengen TM, Gene Ong YK, Orkin AM, Parr MJ, Patocka C, Perkins GD, Perlman JM, Rabi Y, Raitt J, Ramachandran S, Ramaswamy VV, Raymond TT, Reis AG, Reynolds JC, Ristagno G, Rodriguez-Nunez A, Roehr CC, Rüdiger M, Sakamoto T, Sandroni C, Sawyer TL, Schexnayder SM, Schmölzer GM, Schnaubelt S, Semeraro F, Singletary EM, Skrifvars MB, Smith CM, Soar J, Stassen W, Sugiura T, Tijssen JA, Topjian AA, Trevisanuto D, Vaillancourt C, Wyckoff MH, Wyllie JP, Yang CW, Yeung J, Zelop CM, Zideman DA, Nolan JP. 2023 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces. Resuscitation 2024; 195:109992. [PMID: 37937881 DOI: 10.1016/j.resuscitation.2023.109992] [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] [Indexed: 11/09/2023]
Abstract
The International Liaison Committee on Resuscitation engages in a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation and first aid science. Draft Consensus on Science With Treatment Recommendations are posted online throughout the year, and this annual summary provides more concise versions of the final Consensus on Science With Treatment Recommendations from all task forces for the year. Topics addressed by systematic reviews this year include resuscitation of cardiac arrest from drowning, extracorporeal cardiopulmonary resuscitation for adults and children, calcium during cardiac arrest, double sequential defibrillation, neuroprognostication after cardiac arrest for adults and children, maintaining normal temperature after preterm birth, heart rate monitoring methods for diagnostics in neonates, detection of exhaled carbon dioxide in neonates, family presence during resuscitation of adults, and a stepwise approach to resuscitation skills training. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, using Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces list priority knowledge gaps for further research. Additional topics are addressed with scoping reviews and evidence updates.
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3
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Berg KM, Bray JE, Ng KC, Liley HG, Greif R, Carlson JN, Morley PT, Drennan IR, Smyth M, Scholefield BR, Weiner GM, Cheng A, Djärv T, Abelairas-Gómez C, Acworth J, Andersen LW, Atkins DL, Berry DC, Bhanji F, Bierens J, Bittencourt Couto T, Borra V, Böttiger BW, Bradley RN, Breckwoldt J, Cassan P, Chang WT, Charlton NP, Chung SP, Considine J, Costa-Nobre DT, Couper K, Dainty KN, Dassanayake V, Davis PG, Dawson JA, de Almeida MF, De Caen AR, Deakin CD, Dicker B, Douma MJ, Eastwood K, El-Naggar W, Fabres JG, Fawke J, Fijacko N, Finn JC, Flores GE, Foglia EE, Folke F, Gilfoyle E, Goolsby CA, Granfeldt A, Guerguerian AM, Guinsburg R, Hatanaka T, Hirsch KG, Holmberg MJ, Hosono S, Hsieh MJ, Hsu CH, Ikeyama T, Isayama T, Johnson NJ, Kapadia VS, Kawakami MD, Kim HS, Kleinman ME, Kloeck DA, Kudenchuk P, Kule A, Kurosawa H, Lagina AT, Lauridsen KG, Lavonas EJ, Lee HC, Lin Y, Lockey AS, Macneil F, Maconochie IK, Madar RJ, Malta Hansen C, Masterson S, Matsuyama T, McKinlay CJD, Meyran D, Monnelly V, Nadkarni V, Nakwa FL, Nation KJ, Nehme Z, Nemeth M, Neumar RW, Nicholson T, Nikolaou N, Nishiyama C, Norii T, Nuthall GA, Ohshimo S, Olasveengen TM, Ong YKG, Orkin AM, Parr MJ, Patocka C, Perkins GD, Perlman JM, Rabi Y, Raitt J, Ramachandran S, Ramaswamy VV, Raymond TT, Reis AG, Reynolds JC, Ristagno G, Rodriguez-Nunez A, Roehr CC, Rüdiger M, Sakamoto T, Sandroni C, Sawyer TL, Schexnayder SM, Schmölzer GM, Schnaubelt S, Semeraro F, Singletary EM, Skrifvars MB, Smith CM, Soar J, Stassen W, Sugiura T, Tijssen JA, Topjian AA, Trevisanuto D, Vaillancourt C, Wyckoff MH, Wyllie JP, Yang CW, Yeung J, Zelop CM, Zideman DA, Nolan JP. 2023 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces. Circulation 2023; 148:e187-e280. [PMID: 37942682 PMCID: PMC10713008 DOI: 10.1161/cir.0000000000001179] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
The International Liaison Committee on Resuscitation engages in a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation and first aid science. Draft Consensus on Science With Treatment Recommendations are posted online throughout the year, and this annual summary provides more concise versions of the final Consensus on Science With Treatment Recommendations from all task forces for the year. Topics addressed by systematic reviews this year include resuscitation of cardiac arrest from drowning, extracorporeal cardiopulmonary resuscitation for adults and children, calcium during cardiac arrest, double sequential defibrillation, neuroprognostication after cardiac arrest for adults and children, maintaining normal temperature after preterm birth, heart rate monitoring methods for diagnostics in neonates, detection of exhaled carbon dioxide in neonates, family presence during resuscitation of adults, and a stepwise approach to resuscitation skills training. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, using Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces list priority knowledge gaps for further research. Additional topics are addressed with scoping reviews and evidence updates.
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4
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Toy J. Family-Witnessed Cardiopulmonary Resuscitation During Emergency Department Cardiac Arrest Care: A Resident Perspective. Ann Emerg Med 2023; 82:207-215. [PMID: 36841662 DOI: 10.1016/j.annemergmed.2023.01.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 01/10/2023] [Accepted: 01/24/2023] [Indexed: 02/27/2023]
Affiliation(s)
- Jake Toy
- Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA.
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5
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Considine J, Eastwood K, Webster H, Smyth M, Nation K, Greif R, Dainty K, Finn J, Bray J. Family presence during adult resuscitation from cardiac arrest: A systematic review. Resuscitation 2022; 180:11-23. [PMID: 36087636 DOI: 10.1016/j.resuscitation.2022.08.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/29/2022] [Accepted: 08/30/2022] [Indexed: 12/20/2022]
Abstract
AIM Objective: To conduct a systematic review of the published evidence related to family presence during adult resuscitation from cardiac arrest. METHODS This review, registered with PROSPERO (CRD42021242384) and reported according to PRISMA guidelines, included studies of adult cardiac arrest with family presence during resuscitation that reported one or more patient, family or provider outcomes. Three databases (Medline, CINAHL and EMBASE) were searched from inception to 10/05/2022. Two investigators screened the studies, extracted data, and assessed risks of bias using the Mixed Method Appraisal Tool (MMAT). The synthesis approach was guided by Synthesis Without Meta-Analysis (SWiM) reporting guidelines and a narrative synthesis method. RESULTS The search retrieved 9,459 citations of which 31 were included: 18 quantitative studies (including two RCTs), 12 qualitative studies, and one mixed methods study. The evidence was of very low or low certainty. There were four major findings. High-certainty evidence regarding the effect of family presence during resuscitation on patient outcomes is lacking. Family members had mixed outcomes in terms of depression, anxiety, post-traumatic stress disorder (PTSD) symptoms, and experience of witnessing resuscitation. Provider experience was variable and resuscitation setting, provider education, and provider experience were major influences on family presence during resuscitation. Finally, providers reported that a family support person and organisational guidelines were important for facilitating family presence during resuscitation. CONCLUSION The effect of family presence during resuscitation varies between individuals. There was variability in the effect of family presence during resuscitation on patient outcomes, family and provider outcomes and perceptions.
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Affiliation(s)
- Julie Considine
- School of Nursing and Midwifery and Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, Australia; Centre for Quality and Patient Safety Research - Eastern Health Partnership, Box Hill, Australia.
| | - Kathryn Eastwood
- Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Ambulance Victoria, Victoria, Australia
| | - Hannah Webster
- Monash University, Epidemiology and Preventive Medicine, Melbourne, Australia
| | - Michael Smyth
- Warwick Clinical Trials Unit, University of Warwick, Coventry, United Kingdom
| | - Kevin Nation
- New Zealand Resuscitation Council, Wellington, New Zealand
| | - Robert Greif
- Department of Anesthesiology and Pain Therapy, Bern University Hospital, Inselspital, Bern, Switzerland; School of Medicine, Sigmund Freud University Vienna, Vienna Austria
| | - Katie Dainty
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada; North York General Hospital, North York, Ontario, Canada
| | - Judith Finn
- Prehospital, Resuscitation & Emergency Care Research Unit (PRECRU), Curtin School of Nursing, Curtin University, Bentley, Western Australia, Australia; St John Western Australia, Australia
| | - Janet Bray
- Monash University, Epidemiology and Preventive Medicine, Melbourne, Australia; Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), Curtin School of Nursing, Curtin University, Bentley, Western Australia, Australia
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6
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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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Sak-Dankosky N, Andruszkiewicz P, Sherwood PR, Kvist T. Preferences of patients’ family regarding family-witnessed cardiopulmonary resuscitation: A qualitative perspective of intensive care patients’ family members. Intensive Crit Care Nurs 2019; 50:95-102. [DOI: 10.1016/j.iccn.2018.04.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 03/27/2018] [Accepted: 04/01/2018] [Indexed: 10/17/2022]
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Attitudes of Intensive Care Unit Nurses to Family Involvement and Their Presence During Cardiopulmonary Resuscitation: What Should Be Done to Make Family Presence During Cardiopulmonary Resuscitation a Common Practice in Hospitals? Dimens Crit Care Nurs 2019; 38:113-114. [PMID: 30702482 DOI: 10.1097/dcc.0000000000000345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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García-Martínez AL, Meseguer-Liza C. Emergency nurses’ attitudes towards the concept of witnessed resuscitation. Rev Lat Am Enfermagem 2018; 26:e3055. [PMID: 30208161 PMCID: PMC6136531 DOI: 10.1590/1518-8345.1382.3055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Accepted: 09/22/2016] [Indexed: 11/22/2022] Open
Abstract
Objective: to review the most relevant evidence on the nurses’ attitudes towards
witnessed resuscitation, in the inpatient and out-of-hospital spheres. Method: integrative literature review, covering the period from 2008 till 2015, using
the databases PubMed, Lilacs and SciELO; in Spanish, English and Portuguese.
The pediatric context was excluded from the study. Results: the synthesis of the data resulted in the inclusion of 10 articles,
categorized as: positive attitudes and negative attitudes. Conclusions: discrepancies exist among the nurses from different contexts and geographical
regions towards the concept; protocols need to be established for this
situation, in view of the advantages evidenced in the literature, for the
nursing professionals as well as the relatives. Witnessed resuscitation can
represent an opportunity to understand and cope with the rational and
irrational in the situation in a shared manner, as well as mitigate or
dignify the mourning.
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10
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Factors associated with nurses' perceptions, self-confidence, and invitations of family presence during resuscitation in the intensive care unit: A cross-sectional survey. Int J Nurs Stud 2018; 87:103-112. [PMID: 30096577 DOI: 10.1016/j.ijnurstu.2018.06.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 06/22/2018] [Accepted: 06/26/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Family presence during resuscitation is not widely implemented in clinical practice. Prior research about nurse factors that may influence their decision to invite family members to remain in the room during resuscitation is contradictory and inconclusive. OBJECTIVES To describe intensive care unit nurses' perceptions, self-confidence, and invitations of family presence during resuscitation, and to evaluate differences according to nurse factors. DESIGN A cross-sectional survey design was used for descriptive and correlational analyses. SETTING Data collection occurred online. PARTICIPANTS A convenience sample of 395 nurses working in intensive care units across the United States was obtained. METHODS Participants completed a survey to collect personal, professional, and workplace information. The Family Presence Risk-Benefit Scale and Family Presence Self-confidence Scale were administered, and frequency of inviting family members to be in the room during resuscitation was collected by self-report. Following descriptive analysis of univariate distributions, a series of hierarchical OLS regression analyses was used to identify which personal, professional, or workplace factors yielded the largest unique impact on nurse perceptions, self-confidence, and invitations of family presence during resuscitation. RESULTS Despite high frequency of performing resuscitative care, one-third of participants had never invited family members to be in the room during resuscitation during their careers, and another 33% had invited family members to be present just 1-5 times. Having had clinical experience with family presence during resuscitation was the strongest predictor of positive perceptions, higher self-confidence, and increased invitations. In addition, having received education on family presence during resuscitation and a written facility policy were found to be key professional and workplace predictors of perceptions and invitations. CONCLUSIONS Nurses who work in a facility with a policy on family presence during resuscitation, are educated on it, and have experienced it in the clinical setting are more likely to have positive perceptions and higher self-confidence, and to invite family members to be in the room during resuscitation with increased frequency. Nurses in leadership roles should create policies for their units and provide education to nurses and other healthcare providers. Due to the apparent importance of clinical experience with family presence during resuscitation, it is recommended to initially provide this experience using simulation and role modeling.
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Gutysz-Wojnicka A, Ozga D, Dyk D, Mędrzycka-Dąbrowska W, Wojtaszek M, Albarran J. Family presence during resuscitation - The experiences and views of Polish nurses. Intensive Crit Care Nurs 2018; 46:44-50. [PMID: 29551224 DOI: 10.1016/j.iccn.2018.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Revised: 10/16/2017] [Accepted: 02/05/2018] [Indexed: 10/17/2022]
Abstract
Understanding healthcare professionals perceptions of family presence during resuscitation (FPDR) may help in choosing an effective strategy of implementing this concept in everyday clinical practice. OBJECTIVES To determine the experiences and views of Polish nurses about family witnessed resuscitation. DESIGN A cross sectional survey study. SETTING Delegates (n = 720) attending the Polish Association of Anaesthesia and Intensive Care Nurses conference participated in the study. A total of 240 questionnaires were correctly completed and returned. MAIN OUTCOME MEASURES Validation of the Polish version of the tool was undertaken. Exploratory factor analysis extracted three main factors: staff opinions on the benefits of FPDR (α-Cronbach 0.86), opinions on the negative effects (α-Cronbach 0.74) and general views on this practice (α-Cronbach 0.54). These three extracted factors were defined as dependent variables. RESULTS Out of the sample, 113 (47%) nurses worked in adult intensive care units (ICUs) and 127 (53%) in other acute clinical settings. ICU nurses reported having experiences of FPDR (n = 66, 54%); out of this group 12 (10%) had positive encounters and 46 (38%) reported negative ones. ICU nurses had undetermined opinions on the benefits and potential negative effects of FPDR. Having positive experiences with FPDR influenced ICU nurses' views on the negative effects of FPDR (Z = -2.16, p< 0.03). CONCLUSION A positive experience of FPDR influences a nurse's views and attitudes in this evolving area of practice.
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Affiliation(s)
| | - Dorota Ozga
- Department of Emergency Medicine, Faculty of Medicine, University of Rzeszow, Poland
| | - Danuta Dyk
- Department of Anaesthesiological and Intensive Care Nursing, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Marek Wojtaszek
- Department of Emergency Medicine, Faculty of Medicine, University of Rzeszow, Poland
| | - John Albarran
- Faculty of Health and Applied Sciences, Centre for Health and Clinical Research, University of the West of England, Bristol BS16 1DD, UK
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12
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Sak-Dankosky N, Andruszkiewicz P, Sherwood PR, Kvist T. Health care professionals' concerns regarding in-hospital family-witnessed cardiopulmonary resuscitation implementation into clinical practice. Nurs Crit Care 2017; 23:134-140. [PMID: 28391604 DOI: 10.1111/nicc.12294] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 12/01/2016] [Accepted: 03/07/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND In-hospital, family-witnessed cardiopulmonary resuscitation of adults has been found to help patients' family members deal with the short- and long-term emotional consequences of resuscitation. Because of its benefits, many national and international nursing and medical organizations officially recommend this practice. Research, however, shows that family-witnessed resuscitation is not widely implemented in clinical practice, and health care professionals generally do not favour this recommendation. AIM To describe and provide an initial basis for understanding health care professionals' views and perspectives regarding the implementation of an in-hospital, family-witnessed adult resuscitation practice in two European countries. STUDY DESIGN An inductive qualitative approach was used in this study. METHODS Finnish (n = 93) and Polish (n = 75) emergency and intensive care nurses and physicians provided written responses to queries regarding their personal observations, concerns and comments about in-hospital, family-witnessed resuscitation of an adult. Data were analysed using inductive thematic analysis. FINDINGS The study analysis yielded five themes characterizing health care professionals' main concerns regarding family-witnessed resuscitation: (1) family's horror, (2) disturbed workflow (3) no support for the family, (4) staff preparation and (5) situation-based decision. CONCLUSION Despite existing evidence revealing the positive influence of family-witnessed resuscitation on patients, relatives and cardiopulmonary resuscitation process, Finnish and Polish health care providers cited a number of personal and organizational barriers against this practice. The results of this study begin to examine reasons why family-witnessed resuscitation has not been widely implemented in practice. In order to successfully apply current evidence-based resuscitation guidelines, provider concerns need to be addressed through educational and organizational changes. RELEVANCE TO CLINICAL PRACTICE This study identified important implementation barriers for allowing families in critical care settings to be present during resuscitation efforts. These results can be further used in developing and adjusting clinical practice policies, protocols and guidelines related to family-witnessed resuscitation.
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Affiliation(s)
- Natalia Sak-Dankosky
- Early Stage Researcher, University of Eastern Finland, Faculty of Health Sciences, Department of Nursing Science, Kuopio, Finland
| | - Paweł Andruszkiewicz
- The Medical University of Warsaw, 2nd Department of Anaesthesiology and Intensive Therapy, Public Central Teaching HospitalWarsaw, Poland
| | - Paula R Sherwood
- Vice Chair for Research, University of Pittsburgh, School of Nursing, Department of Acute & Tertiary Care, Pittsburgh, PA, USA
| | - Tarja Kvist
- University Researcher, University of Eastern Finland, Faculty of Health Sciences, Department of Nursing Science, Kuopio, Finland
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13
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A literature review examining the barriers to the implementation of family witnessed resuscitation in the Emergency Department. Int Emerg Nurs 2016; 30:31-35. [PMID: 27915124 DOI: 10.1016/j.ienj.2016.11.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 10/27/2016] [Accepted: 11/04/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND Caring for people near death in the Emergency Department (ED) is challenging for professionals, duty bound to respond to the needs of the dying. Family witnessed resuscitation (FWR) is practiced internationally, allowing relatives to be present at the time of a patient's death, offering comfort to the dying and aiding the bereaved along a healthy grief trajectory. AIM The literature review elicits barriers to the implementation of FWR in the ED, examining why practice is sporadic despite numerous professional bodies calling for implementation. FWR is often met with opposition from staff, subsequently largely dependent upon who is on duty as opposed to adherence with best practice guidelines, risking inconsistent idiosyncratic practice. FINDINGS Barriers include; a lack of organisational support; shortage of manpower for provision of a family support person; absence of champions for the concept; willful non-adherence due to personal beliefs; restriction on coping strategies reliant upon the ability to emotionally detach, enhancing staff resilience facing repeated exposure to emotionally labile events. CONCLUSION All resuscitation efforts can be successful, whether the patient lives or dies, if practice supports healthy grieving. The challenge remains with such divided, entrenched and passionate views, how FWR can be adopted as accepted practice.
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14
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Barreto MDS, Marcon SS, Garcia-Vivar C. Patterns of behaviour in families of critically ill patients in the emergency room: a focused ethnography. J Adv Nurs 2016; 73:633-642. [PMID: 27653638 DOI: 10.1111/jan.13156] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2016] [Indexed: 11/29/2022]
Abstract
AIM The aim of this study was to understand the patterns of behaviour from relatives of critically ill patients admitted to the emergency room. BACKGROUND Admission of a critically ill family member to an accident and emergency department is often a sudden and unexpected experience for the family. This stressful event often creates feelings of instability and intense suffering in relatives. Understanding the experiences of these families is essential for the provision of comprehensive health care in the emergency room. DESIGN A focused ethnography design was applied to the study. METHODS Peripheral participant observation and informal conversations were conducted in an emergency room in southern Brazil during January 2015. Analysis of data was based on Leininger. FINDINGS Suffering was recurrent among family members of critically ill patients admitted to the emergency room. The environment, which was conditioned by the patient's life-threatening situation and professionals' attitudes, resulted in relatives experiencing a range of feelings from suffering to calm. A distant approach and poor communication of professionals made relatives confused and silent. Factors that seemed to foster feelings of calm in families were the establishment of a continuous and close communication with professionals and the possibility to remain with the patient outside the established visiting hours. CONCLUSION The findings of this study challenge emergency department providers and managers to promote comprehensive care in the emergency room by inviting family members to be with the patient and by engaging in family-centred care.
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Affiliation(s)
- Mayckel da Silva Barreto
- Department of Nursing, State University of Maringá, Maringá, Paraná, Brazil.,Faculty of Philosophy Sciences and Languages of Mandaguari, Mandaguari Paraná, Brazil.,Faculty Intermunicipal Northwest of Paraná, Loanda, Paraná, Brazil
| | - Sonia Silva Marcon
- Department of Nursing, State University of Maringá, Maringá, Paraná, Brazil
| | - Cristina Garcia-Vivar
- School of Nursing, University of Navarra, IdiSNA, Navarra Institute for Health Research, Pamplona, Navarra, Spain
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Intention of Korean Nurses to Allow Family Presence During Resuscitation. J Hosp Palliat Nurs 2016. [DOI: 10.1097/njh.0000000000000260] [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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