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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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Hashavya S, Pines-Shwartz N, Guzner N, Ohana Sarna Cahan L, Gross I. The Impact of Parental Presence on Invasive Procedures in the Pediatric Emergency Department: A Prospective Study. J Clin Med 2023; 12:5527. [PMID: 37685594 PMCID: PMC10487884 DOI: 10.3390/jcm12175527] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 08/19/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
Parental presence during invasive pediatric procedures is controversial, and its benefits are under-researched. The objective of this study was to assess the effects of parental presence during invasive procedures on the parents themselves and the physician performing the procedure. This prospective study was conducted at a single tertiary center in Jerusalem, Israel. During 10 shifts, all physicians and the families of patients who underwent invasive procedures in the pediatric emergency department (PED) were asked to fill in questionnaires related to their experiences. A total of 98 parental questionnaires and 101 physician questionnaires were collected. The most commonly performed procedures were laceration repair (65%) and abscess drainage (18%). Sedation was required in 75% of cases. In total, 73% of the cited family members were present during these procedures. The main reason for refusing to allow family members access was the physicians' concern that the procedure would be hard for parents to watch. However, in more than 85% of cases, the physicians felt that the presence of a family member contributed to the success of the procedure, augmented the child's sense of safety and lessened the family members' feelings of anxiety. All parents who opted to be present during the procedure felt very satisfied, compared to 67% of parents who were not present (p < 0.0001). When asked if, in retrospect, they would have made the same decision, 100% of the parents who were present during the procedure indicated that they would have made the same decision, compared to only 68% of the parents who were not present (p < 0.001). Overall, these findings highlight the positive effects of parental presence during invasive procedures performed in the PED, even when procedures were performed under sedation. Encouraging parental attendance during invasive procedures may, thus, enhance family-centered practices in the PED.
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Affiliation(s)
- Saar Hashavya
- Department of Pediatric Emergency Medicine, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel; (S.H.); (N.P.-S.); (L.O.S.C.)
| | - Naama Pines-Shwartz
- Department of Pediatric Emergency Medicine, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel; (S.H.); (N.P.-S.); (L.O.S.C.)
| | - Noa Guzner
- Faculty of Medicine, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel;
| | - Lea Ohana Sarna Cahan
- Department of Pediatric Emergency Medicine, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel; (S.H.); (N.P.-S.); (L.O.S.C.)
| | - Itai Gross
- Department of Pediatric Emergency Medicine, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel; (S.H.); (N.P.-S.); (L.O.S.C.)
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Bush RN, Woodley L. Increasing Nurses' Knowledge of and Self-confidence With Family Presence During Pediatric Resuscitation. Crit Care Nurse 2022; 42:27-37. [PMID: 35908769 DOI: 10.4037/ccn2022898] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Family presence during resuscitation is becoming more common, and pediatric critical care nurses regularly facilitate this process. However, most hospitals lack policies and education to support nurses in this practice. OBJECTIVE To increase pediatric intensive care unit nurses' knowledge and self-confidence with family presence during resuscitation through an educational intervention. METHODS The project used a pre-post intervention study design with anonymous online cross-sectional surveying. Participant demographic data were collected along with participants' responses to 2 instruments measuring perceived risks and benefits of family presence during resuscitation and participant self-confidence with the process. The educational session consisted of a 2-hour structured session incorporating content presentation, discussion, simulation videos, and parental testimony. RESULTS Thirty-six nurses participated in this project. Overall mean scores of both tools and scores of almost every item within each tool significantly increased after the intervention. CONCLUSION Formalized and structured education on family presence during resuscitation appears to promote pediatric intensive care unit nurses' knowledge, increase their perception of benefits outweighing risks, and enhance their self-confidence in supporting family members. Providing information about family presence during resuscitation and how best to facilitate this practice should be a priority and included as part of standard educational support for pediatric intensive care unit nurses.
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Affiliation(s)
- Renee N Bush
- Renee N. Bush is a lung transplant nurse coordinator (posttransplant and inpatient), UNC Health, Jason Ray Transplant Clinic, Chapel Hill, North Carolina
| | - Lisa Woodley
- Lisa Woodley is a clinical associate professor, University of North Carolina School of Nursing, Chapel Hill, North Carolina
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Frampton S, Agrawal S, Guastello S. Guidelines for Family Presence Policies During the COVID-19 Pandemic. JAMA HEALTH FORUM 2020; 1:e200807. [DOI: 10.1001/jamahealthforum.2020.0807] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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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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Barriers to family presence during resuscitation and strategies for improving nurses' invitation to families. Appl Nurs Res 2017; 38:22-28. [DOI: 10.1016/j.apnr.2017.08.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 08/30/2017] [Accepted: 08/31/2017] [Indexed: 11/23/2022]
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Blanco AP. How Do Healthcare Providers Feel About Family Presence During Cardiopulmonary Resuscitation? THE JOURNAL OF CLINICAL ETHICS 2017. [DOI: 10.1086/jce2017282102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Bradley C, Keithline M, Petrocelli M, Scanlon M, Parkosewich J. Perceptions of Adult Hospitalized Patients on Family Presence During Cardiopulmonary Resuscitation. Am J Crit Care 2017; 26:103-110. [PMID: 28249861 DOI: 10.4037/ajcc2017550] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Family presence during cardiopulmonary resuscitation in acute care is not widespread. Patients are not likely to be asked about their wishes for family presence or if they wish to be the decision makers about who should be present. OBJECTIVE To explore the perceptions of patients on general medical units and to find factors independently associated with family presence during cardiopulmonary resuscitation. METHODS A cross-sectional study of 117 randomly selected adult patients was conducted at an academic medical center. Participants were interviewed via a survey to obtain information on demographics, knowledge of cardiopulmonary resuscitation, sources of information on resuscitation, and preferences for family presence. RESULTS About half of the participants agreed or strongly agreed that family presence during cardiopulmonary resuscitation was important (52.1%), that the participant should be the decision maker about who should be present (50.4%), and that the patient should give consent ahead of time (47.0%). Participants indicated that they would want an adult sibling, parents, or others (20.5%); spouse (14.5%); adult child (8.5%); close friend (5.1%); or companion (4.3%) present during cardiopulmonary resuscitation. Younger participants (20-45 years old) were 6.28 times more likely than those ≥ 66 years old (P = .01) and nonwhite participants were 2.7 times more likely than white participants (P = .049) to want family presence. CONCLUSION Patients have strong preferences about family presence during cardiopulmonary resuscitation, and they should have the opportunity to make the decision about having family present.
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Affiliation(s)
- Carolyn Bradley
- Carolyn Bradley is a service line educator, Michelle Keithline, Meghan Petrocelli, and Mary Scanlon are clinical nurses, and Janet Parkosewich is the nurse researcher, Yale New Haven Hospital, New Haven, Connecticut
| | - Michelle Keithline
- Carolyn Bradley is a service line educator, Michelle Keithline, Meghan Petrocelli, and Mary Scanlon are clinical nurses, and Janet Parkosewich is the nurse researcher, Yale New Haven Hospital, New Haven, Connecticut
| | - Meghan Petrocelli
- Carolyn Bradley is a service line educator, Michelle Keithline, Meghan Petrocelli, and Mary Scanlon are clinical nurses, and Janet Parkosewich is the nurse researcher, Yale New Haven Hospital, New Haven, Connecticut
| | - Mary Scanlon
- Carolyn Bradley is a service line educator, Michelle Keithline, Meghan Petrocelli, and Mary Scanlon are clinical nurses, and Janet Parkosewich is the nurse researcher, Yale New Haven Hospital, New Haven, Connecticut
| | - Janet Parkosewich
- Carolyn Bradley is a service line educator, Michelle Keithline, Meghan Petrocelli, and Mary Scanlon are clinical nurses, and Janet Parkosewich is the nurse researcher, Yale New Haven Hospital, New Haven, Connecticut
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Nursing Practices and Policies Related to Family Presence During Resuscitation. Dimens Crit Care Nurs 2017; 36:53-59. [DOI: 10.1097/dcc.0000000000000218] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Olding M, McMillan SE, Reeves S, Schmitt MH, Puntillo K, Kitto S. Patient and family involvement in adult critical and intensive care settings: a scoping review. Health Expect 2016; 19:1183-1202. [PMID: 27878937 PMCID: PMC5139045 DOI: 10.1111/hex.12402] [Citation(s) in RCA: 146] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2015] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Despite international bodies calling for increased patient and family involvement, these concepts remain poorly defined within literature on critical and intensive care settings. OBJECTIVE This scoping review investigates the extent and range of literature on patient and family involvement in critical and intensive care settings. Methodological and empirical gaps are identified, and a future agenda for research into optimizing patient and family involvement is outlined. METHODS Searches of MEDLINE, CINAHL, Social Work Abstracts and PsycINFO were conducted. English-language articles published between 2003 and 2014 were retrieved. Articles were included if the studies were undertaken in an intensive care or critical care setting, addressed the topic of patient and family involvement, included a sample of adult critical care patients, their families and/or critical care providers. Two reviewers extracted and charted data and analysed findings using qualitative content analysis. FINDINGS A total of 892 articles were screened, 124 were eligible for analysis, including 61 quantitative, 61 qualitative and 2 mixed-methods studies. There was a significant gap in research on patient involvement in the intensive care unit. The analysis identified five different components of family and patient involvement: (i) presence, (ii) having needs met/being supported, (iii) communication, (iv) decision making and (v) contributing to care. CONCLUSION Three research gaps were identified that require addressing: (i) the scope, extent and nature of patient involvement in intensive care settings; (ii) the broader socio-cultural processes that shape patient and family involvement; and (iii) the bidirectional implications between patient/family involvement and interprofessional teamwork.
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Affiliation(s)
- Michelle Olding
- British Columbia Centre for Excellence in HIV/AIDSVancouverBCCanada
| | - Sarah E. McMillan
- Collaborative Academic PracticeUniversity Health NetworkTorontoONCanada
| | - Scott Reeves
- Centre for Health and Social Care ResearchKingston University and St. George's University of LondonLondonUK
| | | | | | - Simon Kitto
- Department of Innovation in Medical EducationFaculty of MedicineUniversity of OttawaOttawaONCanada
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Family presence during management of acute deterioration: Clinician attitudes, beliefs and perceptions of current practices. ACTA ACUST UNITED AC 2016; 19:159-65. [DOI: 10.1016/j.aenj.2016.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 05/02/2016] [Accepted: 05/02/2016] [Indexed: 11/15/2022]
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Powers KA, Candela L. Family Presence During Resuscitation: Impact of Online Learning on Nurses' Perception and Self-confidence. Am J Crit Care 2016; 25:302-9. [PMID: 27369028 DOI: 10.4037/ajcc2016814] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Family presence during resuscitation (FPDR) is supported by patients and their family members. Nurses, however, including critical care nurses who frequently implement resuscitative care, have mixed views. OBJECTIVES To determine the impact of online learning on critical care nurses' perception of and self-confidence with FPDR. METHODS A 2-group, random assignment, pretest and posttest quasi-experimental study was conducted with critical care nurses recruited nationally. An online learning module on FPDR was developed and administered to the intervention group. Perceptions and self-confidence for FPDR were measured by using the Family Presence Risk- Benefit Scale (FPR-BS) and the Family Presence Self-confidence Scale (FPS-CS). Two-factor, mixed-model factorial analysis of variance was used to compare mean scores. RESULTS A total of 74 critical care nurses participated in the study. Mean FPR-BS and FPS-CS scores were significantly greater in the intervention group than in the control group. For the intervention group, mean scores on the FPR-BS increased from 3.63 to 4.07 (P < .001) and on the FPS-CS increased from 4.24 to 4.57 (P < .001), signifying improved perception and self-confidence. Scores did not change significantly in the control group: mean FPR-BS score increased from 3.82 to 3.88 (P = .23) and the mean FPS-CS score of 4.40 did not change (P > .99). CONCLUSIONS Online learning is a feasible and effective method for educating large numbers of critical care nurses about FPDR. Online learning can improve perceptions and self-confidence related to FPDR, which may promote more widespread adoption of FPDR into practice.
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Affiliation(s)
- Kelly A. Powers
- Kelly A. Powers is an assistant professor, School of Nursing, The University of North Carolina at Charlotte, Charlotte, North Carolina. Lori Candela is an associate professor, School of Nursing, University of Nevada, Las Vegas, Las Vegas, Nevada
| | - Lori Candela
- Kelly A. Powers is an assistant professor, School of Nursing, The University of North Carolina at Charlotte, Charlotte, North Carolina. Lori Candela is an associate professor, School of Nursing, University of Nevada, Las Vegas, Las Vegas, Nevada
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Family Presence During Resuscitation Benefits-Risks Scale (FPDR-BRS): Instrument Development and Psychometric Validation. J Emerg Nurs 2016; 42:213-23. [DOI: 10.1016/j.jen.2015.08.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Revised: 08/05/2015] [Accepted: 08/30/2015] [Indexed: 11/23/2022]
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McLean J, Gill FJ, Shields L. Family presence during resuscitation in a paediatric hospital: health professionals' confidence and perceptions. J Clin Nurs 2016; 25:1045-52. [PMID: 26923310 DOI: 10.1111/jocn.13176] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2015] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To investigate medical and nursing staff's perceptions of and self-confidence in facilitating family presence during resuscitation in a paediatric hospital setting. BACKGROUND Family presence during resuscitation is the attendance of family members in a location that affords visual or physical contact with the patient during resuscitation. Providing the opportunity for families to be present during resuscitation embraces the family-centred care philosophy which underpins paediatric care. Having families present continues to spark much debate amongst health care professionals. DESIGN A descriptive cross-sectional randomised survey using the 'Family Presence Risk/Benefit Scale' and the 'Family Presence Self-Confidence Scale 'to assess health care professionals' (doctors and nurses) perceptions and self-confidence in facilitating family presence during resuscitation of a child in a paediatric hospital. METHODS Surveys were distributed to 300 randomly selected medical and nursing staff. Descriptive and inferential statistics were used to compare medical and nursing, and critical and noncritical care perceptions and self-confidence. RESULTS Critical care staff had statistically significant higher risk/benefit scores and higher self-confidence scores than those working in noncritical care areas. Having experience in paediatric resuscitation, having invited families to be present previously and a greater number of years working in paediatrics significantly affected participants' perceptions and self-confidence. There was no difference between medical and nursing mean scores for either scale. CONCLUSION Both medical and nursing staff working in the paediatric setting understood the needs of families and the philosophy of family-centred care is a model of care practised across disciplines. RELEVANCE TO CLINICAL PRACTICE This has implications both for implementing guidelines to support family presence during resuscitation and for education strategies to shift the attitudes of staff who have limited or no experience.
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Affiliation(s)
- Julie McLean
- Children's Cardiac Centre, Child & Adolescent Health Service, Perth, WA, Australia.,Children's Cardiac Centre, Princess Margaret Hospital, Australia
| | - Fenella J Gill
- School of Nursing, Midwifery & Paramedicine, Faculty of Health Sciences, Curtin University, GPO Box U1987 Perth, Western Australia 6845, Australia.,Princess Margaret Hospital for Children, Child & Adolescent Health Services, Western Australia, Australia
| | - Linda Shields
- Charles Sturt University, Bathurst, NSW, Australia.,The University of Queensland, Brisbane, Qld, Australia
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Mentzelopoulos SD, Bossaert L, Raffay V, Askitopoulou H, Perkins GD, Greif R, Haywood K, Van de Voorde P, Xanthos T. A survey of key opinion leaders on ethical resuscitation practices in 31 European Countries. Resuscitation 2016; 100:11-7. [PMID: 26776899 DOI: 10.1016/j.resuscitation.2015.12.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 11/25/2015] [Accepted: 12/25/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Europe is a patchwork of 47 countries with legal, cultural, religious, and economic differences. A prior study suggested variation in ethical resuscitation/end-of-life practices across Europe. This study aimed to determine whether this variation has evolved, and whether the application of ethical practices is associated with emergency care organisation. METHODS A questionnaire covering four domains of resuscitation ethics was developed based on consensus: (A) Approaches to end-of-life care and family presence during cardiopulmonary resuscitation; (B) Determinants of access to best resuscitation and post-resuscitation care; (C) Diagnosis of death and organ donation (D) Emergency care organisation. The questionnaire was sent to representatives of 32 countries. Responses to 4-choice or 2-choice questions pertained to local legislation and common practice. Positive responses were graded by 1 and negative responses by 0; grades were reconfirmed/corrected by respondents from 31/32 countries (97%). For each resuscitation/end-of-life practice a subcomponent score was calculated by grades' summation. Subcomponent scores' summation resulted in domain total scores. RESULTS Data from 31 countries were analysed. Domains A, B, and D total scores exhibited substantial variation (respective total score ranges, 1-41, 0-19 and 9-32), suggesting variable interpretation and application of bioethical principles, and particularly of autonomy. Linear regression revealed a significant association between domain A and D total scores (adjusted r(2)=0.42, P<0.001). CONCLUSIONS According to key experts, ethical practices and emergency care still vary across Europe. There is need for harmonised legislation, and improved, education-based interpretation/application of bioethical principles. Better application of ethical practices may be associated with improved emergency care organisation.
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Affiliation(s)
| | | | - Violetta Raffay
- Municipal Institute for Emergency Medicine Novi Sad, Novi Sad, Serbia
| | - Helen Askitopoulou
- Medical School, University of Crete, Heraklion, Greece; Ethics Committee of the European Society for Emergency Medicine (EuSEM), London, UK
| | - Gavin D Perkins
- Warwick Medical School, University of Warwick, Coventry, UK; Critical Care Unit, Heart of England NHS Foundation Trust, Birmingham, UK
| | - Robert Greif
- University Hospital Bern and University of Bern, Bern, Switzerland
| | - Kirstie Haywood
- Royal College of Nursing Research Institute, Warwick Medical School, University of Warwick, Coventry, UK
| | - Patrick Van de Voorde
- University Hospital and University Ghent, Ghent, Belgium; Federal Department Health, Ghent, Belgium
| | - Theodoros Xanthos
- University of Athens, Medical School, Athens, Greece; Midwestern University, Chicago, IL, USA
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Evaluation of Physicians' and Nurses' Knowledge, Attitudes, and Compliance With Family Presence During Resuscitation in an Emergency Department Setting After an Educational Intervention. Adv Emerg Nurs J 2016; 38:32-42. [DOI: 10.1097/tme.0000000000000086] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chew KS, Ghani ZA. Attitudes and perceptions of the general Malaysian public regarding family presence during resuscitation. Singapore Med J 2015; 55:439-42. [PMID: 25189307 DOI: 10.11622/smedj.2014104] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Family presence (FP) during resuscitation is an increasingly favoured trend, as it affords many benefits to the critically ill patient's family members. However, a previously conducted study showed that only 15.8% of surveyed Malaysian healthcare staff supported FP during resuscitation. METHODS This cross-sectional study used a bilingual self-administered questionnaire to examine the attitudes and perceptions of the general Malaysian public toward the presence of family members during resuscitation of their loved ones. The questionnaires were randomly distributed to Malaysians in three different states and in the federal territory of Kuala Lumpur. RESULTS Out of a total of 190 survey forms distributed, 184 responses were included for analysis. Of the 184 respondents, 140 (76.1%) indicated that they favoured FP during resuscitation. The most common reason cited was that FP during resuscitation provides family members with the assurance that everything possible had been done for their loved ones (n = 157, 85.3%). Respondents who had terminal illnesses were more likely to favour FP during resuscitation than those who did not, and this was statistically significant (95.0% vs. 73.8%; p = 0.04). CONCLUSION FP during resuscitation was favoured by a higher percentage of the general Malaysian public as compared to Malaysian healthcare staff. This could be due to differences in concerns regarding the resuscitation process between members of the public and healthcare staff.
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Affiliation(s)
- Keng Sheng Chew
- Emergency Medicine Department, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Malaysia.
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Bashayreh I, Saifan A, Batiha AM, Timmons S, Nairn S. Health professionals' perceptions regarding family witnessed resuscitation in adult critical care settings. J Clin Nurs 2015; 24:2611-9. [PMID: 26097992 DOI: 10.1111/jocn.12875] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2015] [Indexed: 11/24/2022]
Abstract
AIMS AND OBJECTIVES To deepen our understanding of the perceptions of health professionals regarding family witnessed resuscitation in Jordanian adult critical care settings. BACKGROUND The issue of family witnessed resuscitation has developed dramatically in the last three decades. The traditional practice of excluding family members during cardiopulmonary resuscitation had been questioned. Family witnessed resuscitation has been described as good practice by many researchers and health organisations. However, family witnessed resuscitation has been perceived by some practitioners to be unhealthy and harmful to the life-saving process. The literature showed that there are no policies or guidelines to allow or to prevent family witnessed resuscitation in Jordan. DESIGN An exploratory qualitative design was adopted. METHODS A purposive sample of 31 health professionals from several disciplines was recruited over a period of six months. Individual semi-structured interviews were used. These interviews were transcribed and analysed using thematic analysis. FINDINGS It was found that most healthcare professionals were against family witnessed resuscitation. They raised several concerns related to being verbally and physically attacked if they allowed family witnessed resuscitation. Almost all of the respondents expressed their fears of patients' family members' interfering in their work. Most of the participants in this study stated that family witnessed resuscitation is traumatic for family members. This was viewed as a barrier to allowing family witnessed resuscitation in Jordanian critical care settings. CONCLUSION The study provides a unique understanding of Jordanian health professionals' perceptions regarding family witnessed resuscitation. They raised some views that contest some arguments in the broader literature. Further research with patients, family members, health professionals and policy makers is still required. RELEVANCE TO CLINICAL PRACTICE This is the first study about family witnessed resuscitation in Jordan. Considering multi-disciplinary healthcare professionals' views would be helpful when starting to implement this practice in Jordanian hospitals.
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Affiliation(s)
| | - Ahmad Saifan
- School of Nursing, Applied Science Private University, Amman, Jordan
| | | | - Stephen Timmons
- School of Health Science, University of Nottingham, Nottingham, UK
| | - Stuart Nairn
- School of Nursing, Midwifery & Physiotherapy, Royal Derby Hospital, University of Nottingham, Derby, UK
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Al Mutair A, Plummer V, O'Brien AP, Clerehan R. Attitudes of healthcare providers towards family involvement and presence in adult critical care units in Saudi Arabia: a quantitative study. J Clin Nurs 2015; 23:744-55. [PMID: 24734275 DOI: 10.1111/jocn.12520] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To describe healthcare providers' attitudes to family involvement during routine care and family presence during resuscitation or other invasive procedures in adult intensive care units in Saudi Arabia. BACKGROUND Previous research has shown that healthcare professionals have revealed a diversity of opinions on family involvement during routine care and family presence during resuscitation or other invasive procedures. Attitude assessment can provide an indication of staff acceptance or rejection of the practice and also help identify key potential barriers that will need to be addressed. It has also been evident that participation in the care has potential benefits for patients and families as well as healthcare providers. DESIGN A quantitative descriptive design. METHODS A questionnaire was used with a convenience sample of 468 healthcare providers who were recruited from eight intensive care units. RESULTS The analysis found that healthcare providers had positive attitudes towards family involvement during routine care, but negative attitudes towards family presence during resuscitation or other invasive procedures. Physicians expressed more opposition to the practice than did nurses and respiratory therapists. Staff indicated a need to develop written guidelines and policies, as well as educational programmes, to address this sensitive issue in clinical practice. CONCLUSION Family is an important resource in patient care in the context of the critical care environment. Clinical barriers including resources, hospital policies and guidelines, staff and public education should be taken into account to facilitate family integration to the care model. RELEVANCE TO CLINICAL PRACTICE The findings can help to develop policies and guidelines for safe implementation of the practice. They can also encourage those who design nursing and other medical curricula to place more emphasis on the role of the family especially in critical care settings.
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Goldberger ZD, Nallamothu BK, Nichol G, Chan PS, Curtis JR, Cooke CR. Policies allowing family presence during resuscitation and patterns of care during in-hospital cardiac arrest. Circ Cardiovasc Qual Outcomes 2015; 8:226-34. [PMID: 25805646 DOI: 10.1161/circoutcomes.114.001272] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Accepted: 02/12/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND A growing number of hospitals have begun to implement policies allowing for family presence during resuscitation (FPDR). However, the overall safety of these policies and their effect on resuscitation care is unknown. METHODS AND RESULTS We conducted an observational cohort study of 252 hospitals in the United States with 41,568 adults with cardiac arrest. Multivariable hierarchical regression models were used to evaluate patterns of care at hospitals with and without an FPDR policy. Primary outcomes included return of spontaneous circulation and survival to discharge. Secondary outcomes included resuscitation quality, interventions, and facility-reported potential resuscitation systems errors. There were no significant differences in facility characteristics between hospitals with and without an FPDR policy, nor were there significant differences in return of spontaneous circulation (adjusted risk ratio, 1.02; 95% confidence interval, 0.95-1.06) or survival to discharge (adjusted risk ratio, 1.05; 95% confidence interval, 0.95-1.15). There was a small, borderline significant decrease in the mean time to defibrillation at hospitals with an FPDR policy compared with hospitals without the policy (mean difference, 0.32 minutes; 95% confidence interval, -0.01 to 0.64). Resuscitation quality, interventions, and facility-reported potential resuscitation systems errors did not meaningfully differ between hospitals with and without an FPDR policy. CONCLUSIONS Hospitals with an FPDR policy generally have no statistically significant differences in outcomes and processes of care as hospitals without this policy, suggesting such policies may not negatively affect resuscitation care. Further study is warranted about the direct effect of FPDR attempts on adult patients with an in-hospital cardiac arrest and their families.
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Affiliation(s)
- Zachary D Goldberger
- From the Department of Internal Medicine, University of Washington, Seattle (Z.D.G., G.N., J.R.C.); Divisions of Cardiology (Z.D.G.) and Pulmonary and Critical Care Medicine (J.R.C.), Harborview Medical Center, University of Washington, Seattle; Harborview Center for Prehospital Emergency Care, University of Washington, Seattle (G.N.); Department of Internal Medicine (B.K.N., C.R.C.), Divisions of Cardiovascular Medicine (B.K.N.), Pulmonary and Critical Care Medicine (C.R.C.), and Center for Healthcare Outcomes and Policy, Institute for Healthcare Policy and Innovation (B.K.N., C.R.C.), University of Michigan, Ann Arbor; VA Ann Arbor Center for Clinical Management Research, MI (B.K.N.); and Saint Luke's Mid-America Heart Institute, Kansas City, MO (P.S.C.).
| | - Brahmajee K Nallamothu
- From the Department of Internal Medicine, University of Washington, Seattle (Z.D.G., G.N., J.R.C.); Divisions of Cardiology (Z.D.G.) and Pulmonary and Critical Care Medicine (J.R.C.), Harborview Medical Center, University of Washington, Seattle; Harborview Center for Prehospital Emergency Care, University of Washington, Seattle (G.N.); Department of Internal Medicine (B.K.N., C.R.C.), Divisions of Cardiovascular Medicine (B.K.N.), Pulmonary and Critical Care Medicine (C.R.C.), and Center for Healthcare Outcomes and Policy, Institute for Healthcare Policy and Innovation (B.K.N., C.R.C.), University of Michigan, Ann Arbor; VA Ann Arbor Center for Clinical Management Research, MI (B.K.N.); and Saint Luke's Mid-America Heart Institute, Kansas City, MO (P.S.C.)
| | - Graham Nichol
- From the Department of Internal Medicine, University of Washington, Seattle (Z.D.G., G.N., J.R.C.); Divisions of Cardiology (Z.D.G.) and Pulmonary and Critical Care Medicine (J.R.C.), Harborview Medical Center, University of Washington, Seattle; Harborview Center for Prehospital Emergency Care, University of Washington, Seattle (G.N.); Department of Internal Medicine (B.K.N., C.R.C.), Divisions of Cardiovascular Medicine (B.K.N.), Pulmonary and Critical Care Medicine (C.R.C.), and Center for Healthcare Outcomes and Policy, Institute for Healthcare Policy and Innovation (B.K.N., C.R.C.), University of Michigan, Ann Arbor; VA Ann Arbor Center for Clinical Management Research, MI (B.K.N.); and Saint Luke's Mid-America Heart Institute, Kansas City, MO (P.S.C.)
| | - Paul S Chan
- From the Department of Internal Medicine, University of Washington, Seattle (Z.D.G., G.N., J.R.C.); Divisions of Cardiology (Z.D.G.) and Pulmonary and Critical Care Medicine (J.R.C.), Harborview Medical Center, University of Washington, Seattle; Harborview Center for Prehospital Emergency Care, University of Washington, Seattle (G.N.); Department of Internal Medicine (B.K.N., C.R.C.), Divisions of Cardiovascular Medicine (B.K.N.), Pulmonary and Critical Care Medicine (C.R.C.), and Center for Healthcare Outcomes and Policy, Institute for Healthcare Policy and Innovation (B.K.N., C.R.C.), University of Michigan, Ann Arbor; VA Ann Arbor Center for Clinical Management Research, MI (B.K.N.); and Saint Luke's Mid-America Heart Institute, Kansas City, MO (P.S.C.)
| | - J Randall Curtis
- From the Department of Internal Medicine, University of Washington, Seattle (Z.D.G., G.N., J.R.C.); Divisions of Cardiology (Z.D.G.) and Pulmonary and Critical Care Medicine (J.R.C.), Harborview Medical Center, University of Washington, Seattle; Harborview Center for Prehospital Emergency Care, University of Washington, Seattle (G.N.); Department of Internal Medicine (B.K.N., C.R.C.), Divisions of Cardiovascular Medicine (B.K.N.), Pulmonary and Critical Care Medicine (C.R.C.), and Center for Healthcare Outcomes and Policy, Institute for Healthcare Policy and Innovation (B.K.N., C.R.C.), University of Michigan, Ann Arbor; VA Ann Arbor Center for Clinical Management Research, MI (B.K.N.); and Saint Luke's Mid-America Heart Institute, Kansas City, MO (P.S.C.)
| | - Colin R Cooke
- From the Department of Internal Medicine, University of Washington, Seattle (Z.D.G., G.N., J.R.C.); Divisions of Cardiology (Z.D.G.) and Pulmonary and Critical Care Medicine (J.R.C.), Harborview Medical Center, University of Washington, Seattle; Harborview Center for Prehospital Emergency Care, University of Washington, Seattle (G.N.); Department of Internal Medicine (B.K.N., C.R.C.), Divisions of Cardiovascular Medicine (B.K.N.), Pulmonary and Critical Care Medicine (C.R.C.), and Center for Healthcare Outcomes and Policy, Institute for Healthcare Policy and Innovation (B.K.N., C.R.C.), University of Michigan, Ann Arbor; VA Ann Arbor Center for Clinical Management Research, MI (B.K.N.); and Saint Luke's Mid-America Heart Institute, Kansas City, MO (P.S.C.)
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Experiences of families when present during resuscitation in the emergency department after trauma. J Trauma Nurs 2014; 20:77-85. [PMID: 23722216 DOI: 10.1097/jtn.0b013e31829600a8] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Several organizations have published national guidelines on providing the option of family presence during resuscitation (FPDR). Although FPDR is being offered in clinical practice, there is limited description of family experiences after FPDR. The aim of this study was to describe family experiences of the FPDR option after trauma from motor vehicle crashes and gunshot wounds. A descriptive, qualitative design based on content analysis was used to describe family experiences of the FPDR option. Family members (N = 28) were recruited from a major level 1 adult trauma center in the Midwest. Participants in this study were 1 family member per patient who were 18 years or older, visited the patient in the surgical intensive care unit, spoke and understood English, and had only one critically injured patient in the family. Family interview data on experiences during FPDR after trauma were used to identify themes. Two main categories were found. Families view the role of health care professionals (HCPs) to "fix" the patient, whereas they as family members have an important role to protect and support the patient. Subcategories related to the role of the HCP include the following: multiple people treating the patient, completion of many tasks with "assessment of the damages," and professionalism/teamwork. Important subcategories related to the family member role include the following: providing information to the HCP, ensuring that the medical team is doing its job, and remaining close to provide physical and emotional comfort to the patient. Health care professionals are viewed positively by the family, and the role of the family is viewed as important. Families wanted to be present and would recommend the choice to other family members. The findings of this study support that the FPDR option is an intervention that helps family members build trust in HCPs, fulfills informational needs, allows family members to gain close proximity to the patient, and support their family member emotionally.
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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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Belpomme V, Adnet F, Mazariegos I, Beardmore M, Duchateau FX, Mantz J, Ricard-Hibon A. Family witnessed resuscitation: nationwide survey of 337 prehospital emergency teams in France. Emerg Med J 2012; 30:1038-42. [PMID: 23221456 DOI: 10.1136/emermed-2012-201626] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To assess the practices and opinions of prehospital emergency medical services (EMS) with regard to family witnessed resuscitation (FWR) and to analyse the differences between physicians' and nurses' responses. DESIGN An anonymous questionnaire (30 yes/no questions on demographics and FWR) was sent to all prehospital emergency staff (physicians, nurses and support staff) working for the 377 Mobile Intensive Care Units in France. RESULTS Of the 2689 responses received 2664 were analysed. Mean respondent age was 38 ± 8 years, the male to female ratio was 1:2. 87% of respondents had already performed FWR and 38% had offered relatives the option to be present during resuscitation. Most respondents (90%) felt that FWR might cause psychological trauma to the family; 70% thought that FWR might impact on the duration of resuscitation and 68% on EMS team concentration. In the 28% of cases when relatives had asked to be present, 59% of respondents had acquiesced but only 27% were willing to invite relatives to be routinely present. CONCLUSIONS Prehospital EMS teams in France seems to support FWR but are not yet ready to offer it systematically to relatives. Following our survey, written guidelines are currently in development in our department. These guidelines could be the first step of a national strategy for developing FWR in France. We await results from other studies of family members' opinions to compare prehospital practitioners' and family members' views to further develop our practice.
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Affiliation(s)
- Vanessa Belpomme
- AP-HP, SMUR et DAR, Hôpital Beaujon, Université Paris 7, , Clichy, France
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Snowdon C, Elbourne D, Forsey M, Alfirevic Z. Information-hungry and disempowered: A qualitative study of women and their partners' experiences of severe postpartum haemorrhage. Midwifery 2012; 28:791-9. [DOI: 10.1016/j.midw.2011.12.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Revised: 12/14/2011] [Accepted: 12/29/2011] [Indexed: 10/28/2022]
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Beckstrand RL, Wood RD, Callister LC, Luthy KE, Heaston S. Emergency Nurses' Suggestions for Improving End-of-Life Care Obstacles. J Emerg Nurs 2012; 38:e7-14. [DOI: 10.1016/j.jen.2012.03.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Revised: 01/13/2012] [Accepted: 03/17/2012] [Indexed: 10/28/2022]
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Intensive Care Nurses’ Perspectives of Family-Centered Care and Their Attitudes Toward Family Presence During Resuscitation. J Cardiovasc Nurs 2012; 27:220-7. [DOI: 10.1097/jcn.0b013e31821888b4] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Al-Mutair AS, Plummer V, Copnell B. Family presence during resuscitation: a descriptive study of nurses' attitudes from two Saudi hospitals. Nurs Crit Care 2012; 17:90-8. [PMID: 22335350 DOI: 10.1111/j.1478-5153.2011.00479.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The presence of family in the patient care area during resuscitation events is a matter of current debate among health care professionals in many communities. Family presence is highly recommended by many health organizations worldwide for several reasons including patient and family rights. There are no policies or guidelines in Saudi Arabia to guide health professionals in their practice regarding the option of family being present during resuscitations. The purpose of this study was to identify the attitudes of nurses towards family presence during resuscitation in the Muslim community of Saudi Arabia. DESIGN This is a descriptive survey using data from a convenience sample of 132 nurses using a self-administered questionnaire. The study took place in two major trauma centres in the eastern region of Saudi Arabia. RESULTS The analysis of the data revealed that nurses (n = 132) had negative attitudes towards family presence during resuscitation. A high percentage (77·2%) agreed that witnessing resuscitation is a traumatic experience for the family members. Almost all participants (92·3%) disagreed with the statement that the practice of allowing family members to be present during the resuscitation of a loved one would benefit the patient and 78% disagreed with the statement that it would benefit families. The majority of the participants (65%) revealed that the presence of family would negatively affect the performance of the resuscitation team. However, almost half of the sample (43·8%) would prefer a written policy allowing the option of family presence during resuscitation in Saudi Arabia. CONCLUSION The findings of the study strongly suggest the need for the development of written policies offering families the option to remain with patients during resuscitation in Saudi Arabia. The study further recommends the development of education programs for staff and public for the safe implementation of the practice.
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Affiliation(s)
- Abbas S Al-Mutair
- Ministry of Health & Ministry of Higher Education, Riyadh, Saudi Arabia.
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Rittenmeyer L, Huffman D. How Families and Health Care Practitioners Experience Family Presence during Resuscitation and Invasive Procedures. ACTA ACUST UNITED AC 2012; 10:1785-1882. [PMID: 27820214 DOI: 10.11124/01938924-201210310-00001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND The presence of family members during resuscitation and invasive procedures has been, and continues to be debated in the literature. OBJECTIVE To synthesize the best available research evidence on how families and health care practitioners experience family presence during resuscitation and invasive procedures. INCLUSION CRITERIA Studies about families and health care practitioners experiencing family presence during resuscitation and invasive procedures were considered.This review considered family members and health care practitioners who had experienced the phenomena of family presence during resuscitation or invasive procedures.Family members and health care practitioners experience of family presence during resuscitation or invasive procedures.Qualitative evidence consisting of, but not limited to, designs such as interpretive, descriptive-exploratory, observational, phenomenology, ethnography, grounded theory, hermeneutics, participatory action research, and critical theory were included in the review. SEARCH STRATEGY The search strategy sought to find both published and unpublished research articles from 1985 to 2009. The review was limited to papers written in English. METHODOLOGICAL QUALITY Each paper was assessed by two independent reviewers for methodological quality prior to inclusion in the review using the standardised tools developed by the Joanna Briggs Institute. DATA COLLECTION Data were using standardized data extraction tools developed by the Joanna Briggs Institute. DATA SYNTHESIS The Joanna Briggs Institute' approach for meta-synthesis by meta-aggregation was used. RESULTS 25 studies were included in the review. 154 findings were extracted and synthesized into 14 categories and 5 synthesized findings. CONCLUSIONS A tension is created between the belief of most family members that being present is a right and health care practitioners who believe they should have control over the circumstances of the practice. Although healthcare practitioners express concern that the practice will cause the family to experience psychological trauma the data does not suggest that this is the case. Most family members describe their presence as an opportunity to comfort and to gain closure. IMPLICATIONS FOR PRACTICE IMPLICATIONS FOR RESEARCH.
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Affiliation(s)
- Leslie Rittenmeyer
- 1. Indiana Center For Evidence-Based Nursing Practice: An affiliating centre of the Joanna Briggs Collaborative at Purdue University Calumet School of Nursing
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Rittenmeyer L, Huffman D. How Families and Health Care Practitioners Experience Family Presence during Resuscitation and Invasive Procedures. ACTA ACUST UNITED AC 2012. [DOI: 10.11124/jbisrir-2012-40] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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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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Bradley C, Lensky M, Brasel K. Family Presence during Resuscitation #232. J Palliat Med 2011; 14:97-8. [DOI: 10.1089/jpm.2010.9743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Doolin CT, Quinn LD, Bryant LG, Lyons AA, Kleinpell RM. Family presence during cardiopulmonary resuscitation: Using evidence-based knowledge to guide the advanced practice nurse in developing formal policy and practice guidelines. ACTA ACUST UNITED AC 2010; 23:8-14. [DOI: 10.1111/j.1745-7599.2010.00569.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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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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Feagan LM, Fisher NJ. The impact of education on provider attitudes toward family-witnessed resuscitation. J Emerg Nurs 2010; 37:231-9. [PMID: 21550455 DOI: 10.1016/j.jen.2010.02.023] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2009] [Revised: 02/23/2010] [Accepted: 02/28/2010] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The majority of acute care facilities have not developed policies or guidelines to facilitate family presence during cardiopulmonary resuscitation. Prior studies have shown that the personal beliefs and attitudes of hospital personnel involved in resuscitation efforts are the primary reasons family presence is not offered. METHODS This 2-phase, before/after study was conducted in a 388-bed academic trauma center, and in a 143-bed community hospital in eastern Washington State in 2008. In phase I, a convenience sample of physicians and registered nurses from both facilities were surveyed about their opinions and beliefs regarding family-witnessed resuscitation (FWR). Spearman's rho and independent t-tests were used to compare support of FWR between and within roles and practice location subgroups. In phase II of the study, clinician subgroups in the community hospital were re-surveyed following an educational program that used evidence-based information. Independent t-test and one-way ANOVA were used to compare pre and post-education mean scores of subgroups on indicators of effective teaching strategies and improved FWR support. RESULTS Opinions on FWR vary within and between practice roles and locations, with the strongest variable of support being prior experience with FWR. Following FWR education, mean scores improved for survey variables chosen as indicators of FWR support and teaching effectiveness. DISCUSSION When CPR providers are presented with FWR education, their opinion-based beliefs may be modified, decreasing barriers to family witnessed resuscitation and improving overall support of FWR as an extension of family-centered care.
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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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Sim SH, Lee EN. Perception of Physicians and Nurses on Presence of Family during Invasive Procedures. J Korean Acad Nurs 2010; 40:326-35. [DOI: 10.4040/jkan.2010.40.3.326] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Sang-Hee Sim
- RN, Intensive Care Unit, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Eun-Nam Lee
- Professor, Department of Nursing, Dong-A University, Busan, Korea
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Abstract
The practice of allowing family to be present during patient resuscitation or invasive procedures (Family Presence) is gaining acceptance in North America and the United Kingdom in controlled circumstances. Research into Family Presence has demonstrated multiple benefits for the patient, family and health care team. These advantages include helping the family to understand the severity of the illness/trauma and to see that appropriate attempts were undertaken to save their loved one. Family Presence can also facilitate improved communication between the health care team and family. In spite of evidence supporting Family Presence as a useful practice for patient, family and health care team, the use of Family Presence is uncommon within Australian emergency departments and hospitals. Clear expectations at organisational, governmental and professional levels are essential to effectively implement this approach. To be supported in the clinical area, the success of a Family Presence program requires an inclusive approach to program development. A critical component of a successful Family Presence program is a family facilitator who is adequately prepared for the role and committed to supporting the family during resuscitation or invasive procedures. Research exploring Family Presence in Australia is lacking and highlights the need for context specific research in this area.
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Affiliation(s)
- Alister N Hodge
- Emergency Services, Blacktown and Mt Druitt Hospital, 19 Flora Street, Arncliffe 2205, Australia.
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Impact of the presence of parents on cardiopulmonary resuscitation and invasive procedures. Crit Care Med 2009; 37:3189; author reply 3189-90. [DOI: 10.1097/ccm.0b013e3181b77eb7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Using research to determine support for a policy on family presence during resuscitation. Dimens Crit Care Nurs 2009; 28:237-47; quiz 248-9. [PMID: 19700973 DOI: 10.1097/dcc.0b013e3181ac4bf4] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
National guidelines and professional organizations have recommended allowing family presence during resuscitation and bedside invasive procedures. Studies found that only 5% of critical care units have written policies. Periodic requests by family members prompted the creation of a task force, including nurses, physicians, and respiratory therapists, to develop this controversial policy. Before development, a research study of healthcare personnel attitudes, concerns, and beliefs toward family presence during cardiopulmonary resuscitation and bedside invasive procedures was done. This descriptive and correlational study showed support for family presence by critical care and emergency department nurses. Findings revealed both support and non-support for families to be present during resuscitative efforts. Providing family presence as an option offers an opportunity for reluctant healthcare team members to refuse their presence and an opportunity for those who support family presence to welcome the family.
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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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Baumhover N, Hughes L. Spirituality and support for family presence during invasive procedures and resuscitations in adults. Am J Crit Care 2009; 18:357-66; quiz 367. [PMID: 19556414 DOI: 10.4037/ajcc2009759] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Many health care professionals believe that they provide holistic care. The role of spirituality, a known variable of holism, has not been explored in relation to the support among health care professionals for family presence during invasive procedures and resuscitative efforts in adults. OBJECTIVE To determine the relationship between spirituality of health care professionals and their support for family presence during invasive procedures and resuscitative efforts in adults. METHODS In this descriptive correlational study, 108 participants (physicians, physician assistants, and nurses) completed the Howden Spirituality Assessment Scale and a survey to measure their support for family presence. RESULTS A significant positive relationship was found between spirituality and support for family presence during resuscitative efforts in adults (r = 0.24, P = .05) and a significant negative correlation was found between support for family presence and the age of the health care professional (r = - 0.27, P = .01). No significant correlations were found between any of the study variables and invasive procedures in adults. CONCLUSIONS Adopting a more holistic perspective may support family presence, especially during resuscitative efforts in adults. Allowing the option for patients' families to remain present promotes holistic family-centered care.
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Affiliation(s)
- Nancy Baumhover
- Nancy Baumhover is a clinical assistant professor in adult critical care at Arizona State University in Phoenix. Linda Hughes is a professor and director of undergraduate nursing programs at Nebraska Methodist College at The Josie Harper Campus in Omaha
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- Nancy Baumhover is a clinical assistant professor in adult critical care at Arizona State University in Phoenix. Linda Hughes is a professor and director of undergraduate nursing programs at Nebraska Methodist College at The Josie Harper Campus in Omaha
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Maxton FJC. Parental presence during resuscitation in the PICU: the parents' experience. Sharing and surviving the resuscitation: a phenomenological study. J Clin Nurs 2009; 17:3168-76. [PMID: 19012784 DOI: 10.1111/j.1365-2702.2008.02525.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM AND OBJECTIVE To provide in-depth understanding of the meaning for parents who were present or absent during a resuscitation attempt on their child in the PICU. BACKGROUND Family presence during resuscitation remains a topic of debate with both benefits and disadvantages identified, yet few studies have asked parents of children in PICU to describe their experiences of being present or absent during this resuscitation and what this means to their understanding and coping. Additionally, minimal research has investigated parental presence during a successful resuscitation. DESIGN A qualitative design was used based upon van Manen's interpretative phenomenological approach. METHODS Fourteen parents of critically ill children from one paediatric intensive care unit in Australia, who had either survived or died following a resuscitation attempt were interviewed. RESULTS Four main themes were identified: (1) being only for a child; (2) making sense of a living nightmare; (3) maintaining hope in the face of reality; (4) living in a relationship with staff. CONCLUSIONS The findings underpin the inherent need for parents to choose to be present during resuscitation to make sense of the situation. Memories of the resuscitation were not long-lasting and distress was for the potential death of a child, rather than the resuscitation scene. Parents who did not witness their child's resuscitation were more distressed than those who did. Having the opportunity to make the decision to stay or leave was important for parents. Support during the resuscitation was best provided by experienced clinical nurses. RELEVANCE TO PRACTICE Recognition of the parents' compelling need to stay will improve nurses' understanding of how witnessing this event may assist family coping and functioning. Ways in which parents may be better supported in making the decision to stay or leave during resuscitation are identified.
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Affiliation(s)
- Fiona J C Maxton
- School of Nursing, Midwifery & Social Care, Faculty of Health, Life and Social Sciences, Napier University, Edinburgh, UK.
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Demir F. Presence of patients' families during cardiopulmonary resuscitation: physicians' and nurses' opinions. J Adv Nurs 2008; 63:409-16. [PMID: 18727768 DOI: 10.1111/j.1365-2648.2008.04725.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM This paper is a report of a study to determine the opinions of physicians and nurses who work in a university hospital intensive care unit and emergency department about the presence of patients' families during cardiopulmonary resuscitation in these units. BACKGROUND Healthcare professionals have conflicting opinions about the presence of patients' families during cardiopulmonary resuscitation. Families who are allowed to be present have less fear and worry, feel they have supported their family member and are able to cope more easily. METHOD The data for this descriptive questionnaire study were collected between November 2006 and January 2007. The respondents were 62 physicians and 82 nurses who worked in an emergency department or in cardiology or anaesthesia intensive care units in Turkey. The data were collected using a questionnaire and the responses summarized using frequencies and percentages. The chi-squared test was performed to test for differences in the opinion by profession, educational level, or number of years of working experience in the profession. FINDINGS The response rate was 79%. Of the respondents, 82.6% did not think it was appropriate for patients' families to be present during cardiopulmonary resuscitation. The most common concerns mentioned were that the family would interfere with the team's activities (56.3%) and that resuscitation is a very traumatic procedure (43.6%). CONCLUSION Policies need to be developed regarding this topic because the absence of policy can cause misunderstanding and differences in practice. Further research is needed to determine what public education is needed to facilitate implementation of such policies.
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Affiliation(s)
- Fatma Demir
- School of Nursing, Ege University, Izmir, Turkey.
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Fisher C, Lindhorst H, Matthews T, Munroe DJ, Paulin D, Scott D. Nursing staff attitudes and behaviours regarding family presence in the hospital setting. J Adv Nurs 2008; 64:615-24. [DOI: 10.1111/j.1365-2648.2008.04828.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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