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Abstract
BACKGROUND Patients and their relatives often expect to be actively involved in decisions of treatment. Even during resuscitation and acute medical care, patients may want to have their relatives nearby, and relatives may want to be present if offered the possibility. The principle of family presence during resuscitation (FPDR) is a triangular relationship where the intervention of family presence affects the healthcare professionals, the relatives present, and the care of the patient involved. All needs and well-being must be balanced in the context of FPDR as the actions involving all three groups can impact the others. OBJECTIVES The primary aim of this review was to investigate how offering relatives the option to be present during resuscitation of patients affects the occurrence of post-traumatic stress disorder (PTSD)-related symptoms in the relatives. The secondary aim was to investigate how offering relatives the option to be present during resuscitation of patients affects the occurrence of other psychological outcomes in the relatives and what effect family presence compared to no family presence during resuscitation of patients has on patient morbidity and mortality. We also wanted to investigate the effect of FPDR on medical treatment and care during resuscitation. Furthermore, we wanted to investigate and report the personal stress seen in healthcare professionals and if possible describe their attitudes toward the FPDR initiative. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, PsycINFO, and CINAHL from inception to 22 March 2022 without any language limits. We also checked references and citations of eligible studies using Scopus, and searched for relevant systematic reviews using Epistomonikos. Furthermore, we searched ClinicalTrials.gov, WHO ICTRP, and ISRCTN registry for ongoing trials; OpenGrey for grey literature; and Google Scholar for additional trials (all on 22 March 2022). SELECTION CRITERIA We included randomized controlled trials of adults who have witnessed a resuscitation attempt of a patient (who was their relative) at the emergency department or in the pre-hospital emergency medical service. The participants of this review included relatives, patients, and healthcare professionals during resuscitation. We included relatives aged 18 years or older who have witnessed a resuscitation attempt of a patient (who is their relative) in the emergency department or pre-hospital. We defined relatives as siblings, parents, spouses, children, or close friends of the patient, or any other descriptions used by the study authors. There were no limitations on adult age or gender. We defined patient as a patient with cardiac arrest in need of cardiopulmonary resuscitation (CPR), a patient with a critical medical or traumatic life-threatening condition, an unconscious patient, or a patient in any other way at risk of sudden death. We included all types of healthcare professionals as described in the included studies. There were no limitations on age or gender. DATA COLLECTION AND ANALYSIS We checked titles and abstracts of studies identified by the search, and obtained the full reports of those studies deemed potentially relevant. Two review authors independently extracted data. As it was not possible to conduct meta-analyses, we synthesized data narratively. MAIN RESULTS The electronic searches yielded a total of 7292 records after deduplication. We included 2 trials (3 papers) involving a total of 595 participants: a cluster-randomized trial from 2013 involving pre-hospital emergency medical services units in France, comparing systematic offer for a relative to witness CPR with the traditional practice, and its 1-year assessment; and a small pilot study from 1998 of FPDR in an emergency department in the UK. Participants were 19 to 78 years old, and between 56% and 64% were women. PTSD was measured with the Impact of Event Scale, and the median score ranged from 0 to 21 (range 0 to 75; higher scores correspond to more severe disease). In the trial that accounted for most of the included participants (570/595), the frequency of PTSD-related symptoms was significantly higher in the control group after 3 and 12 months, and in the per-protocol analyses a significant statistical difference was found in favor of FPDR when looking at PTSD, anxiety and depression, and complicated grief after 1 year. One of the included studies also measured duration of patient resuscitation and personal stress in healthcare professionals during FPDR and found no difference between groups. Both studies had high risk of bias, and the evidence for all outcomes except one was assessed as very low certainty. AUTHORS' CONCLUSIONS There was insufficient evidence to draw any firm conclusions on the effects of FPDR on relatives' psychological outcomes. Sufficiently powered and well-designed randomized controlled trials may change the conclusions of the review in future.
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Affiliation(s)
- Monika Afzali Rubin
- Department of Anaesthesiology and Herlev ACES, Herlev Anaesthesia Critical and Emergency Care Science Unit, Copenhagen University Hospital, Herlev-Gentofte, Copenhagen, Denmark
| | | | - Suzanne Forsyth Herling
- The Neuroscience Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- University of Copenhagen, Copenhagen, Denmark
| | - Patricia Jabre
- Assistance Publique-Hôpitaux de Paris (AP-HP), SAMU (Service d'Aide Médicale Urgente) de Paris, Hôpital Universitaire Necker-Enfants Malades, Paris, France
- Cochrane Pre-hospital and Emergency Care Field, Paris, France
- Université Paris Cité, Paris Cardiovascular Research Centre (PARCC), INSERM, Integrative Epidemiology of Cardiovascular Diseases Team, Paris, France
| | - Ann Merete Møller
- Department of Anaesthesiology and Herlev ACES, Herlev Anaesthesia Critical and Emergency Care Science Unit, Copenhagen University Hospital, Herlev-Gentofte, Copenhagen, Denmark
- University of Copenhagen, Copenhagen, Denmark
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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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Bordessoule A, Felice-Civitillo C, Grazioli S, Barcos F, Haddad K, Rimensberger PC, Polito A. In situ simulation training for parental presence during critical situations in PICU: an observational study. Eur J Pediatr 2022; 181:2409-2414. [PMID: 35277736 PMCID: PMC9110492 DOI: 10.1007/s00431-022-04425-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 02/02/2022] [Accepted: 02/18/2022] [Indexed: 02/02/2023]
Abstract
Family presence during invasive procedures or cardiopulmonary resuscitation (CPR) is a part of the family-centered approach in pediatric intensive care units (PICUs). We established a simulation program aiming at providing communication tools to healthcare professionals. The goal of this study was to evaluate the impact of this program on the stress of PICU professionals and its acceptance. An observational study of a simulation program, with questionnaire, was used to measure pre- and post-simulation stress and the degree of satisfaction of the participants. PICU of Geneva Children's Hospital, Switzerland. Forty simulations with four different simulation scenarios and various types of parental behavior, as imitated by professional actors, were completed during a 1-year period. Primary outcomes were the difference in perceived stress level before and after the simulation and the degree of satisfaction of healthcare professionals (nursing assistants, nurses, physicians). The impact of previous experience with family members during critical situations or CPR was evaluated by variation in perceived stress level. Overall, 201 questionnaires were analyzed. Perceived stress associated with parental presence decreased from a pre-simulation value of 6 (IQR, 4-7) to 4 (IQR, 2-5) post-simulation on a scale of 1-10. However, in 25.7% of cases, the individually perceived post-simulation stress level was higher than the pre-simulation one. Satisfaction of the participants was high with a median of 10 (IQR, 9-10) out of 10. CONCLUSIONS A simulation program helps reduce PICU team emotional stress associated with the presence of family members during critical situations or CPR, and is welcomed by PICU team members. WHAT IS KNOWN • Family presence during cardiopulmonary resuscitation (CPR) or critical situations is a part of the family-centered approach in pediatric intensive care. • The benefits for the family have been already demonstrated. However, this policy is still controversy among healthcare professionals. WHAT IS NEW • A simulation program seeking to provide skills focused on family presence management in the PICU is useful to reduce stress and was well accepted by participants. • It might become an indispensable training intervention for the implementation of a PICU policy to allow family presence during CPR or other critical situations.
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Affiliation(s)
- Alice Bordessoule
- Pediatric and Neonatal Intensive Care Unit, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, University of Geneva, Rue Willy Donze 6, 1205 Geneva, Switzerland
| | - Cristina Felice-Civitillo
- Pediatric and Neonatal Intensive Care Unit, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, University of Geneva, Rue Willy Donze 6, 1205 Geneva, Switzerland
| | - Serge Grazioli
- Pediatric and Neonatal Intensive Care Unit, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, University of Geneva, Rue Willy Donze 6, 1205 Geneva, Switzerland
| | - Francisca Barcos
- Pediatric and Neonatal Intensive Care Unit, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, University of Geneva, Rue Willy Donze 6, 1205 Geneva, Switzerland
| | - Kevin Haddad
- Pediatric and Neonatal Intensive Care Unit, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, University of Geneva, Rue Willy Donze 6, 1205 Geneva, Switzerland
| | - Peter C. Rimensberger
- Pediatric and Neonatal Intensive Care Unit, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, University of Geneva, Rue Willy Donze 6, 1205 Geneva, Switzerland
| | - Angelo Polito
- Pediatric and Neonatal Intensive Care Unit, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, University of Geneva, Rue Willy Donze 6, 1205 Geneva, Switzerland
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What are the care needs of families experiencing cardiac arrest?: A survivor and family led scoping review. Resuscitation 2021; 168:119-141. [PMID: 34592400 DOI: 10.1016/j.resuscitation.2021.09.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 08/30/2021] [Accepted: 09/16/2021] [Indexed: 11/20/2022]
Abstract
AIM The sudden and unexpected cardiac arrest of a family member can be a grief-filled and life-altering event. Every year many hundreds of thousands of families experience the cardiac arrest of a family member. However, care of the family during the cardiac arrest and afteris poorly understood and incompletely described. This review has been performed with persons with lived experience of cardiac arrest to describe, "What are the needs of families experiencing cardiac arrest?" from the moment of collapse until the outcome is known. METHODS This review was guided by specific methodological framework and reporting items (PRISMA-ScR) as well as best practices in patient and public involvement in research and reporting (GRIPP2). A search strategy was developed for eight online databases and a grey literature review. Two reviewers independently assessed all articles for inclusion and extracted relevant study information. RESULTS We included 47 articles examining the experience and care needs of families experiencing cardiac arrest of a family member. Forty one articles were analysed as six represented duplicate data. Ten family care need themes were identified across five domains. The domains and themes transcended cardiac arrest setting, aetiology, family-member age and family composition. The five domains were i) focus on the family member in cardiac arrest, ii) collaboration of the resuscitation team and family, iii) consideration of family context, iv) family post-resuscitation needs, and v) dedicated policies and procedures. We propose a conceptual model of family centred cardiac arrest. CONCLUSION Our review provides a comprehensive mapping and description of the experience of families and their care needs during the cardiac arrest of a family-member. Furthermore, our review was conducted with co-investigators and collaborators with lived experience of cardiac arrest (survivors and family members of survivors and non-survivors alike). The conceptual framework of family centred cardiac arrest care presented may aid resuscitation scientists and providers in adopting greater family centeredness to their work.
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Mentzelopoulos SD, Couper K, Van de Voorde P, Druwé P, Blom M, Perkins GD, Lulic I, Djakow J, Raffay V, Lilja G, Bossaert L. [Ethics of resuscitation and end of life decisions]. Notf Rett Med 2021; 24:720-749. [PMID: 34093076 PMCID: PMC8170633 DOI: 10.1007/s10049-021-00888-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 12/14/2022]
Abstract
These European Resuscitation Council Ethics guidelines provide evidence-based recommendations for the ethical, routine practice of resuscitation and end-of-life care of adults and children. The guideline primarily focus on major ethical practice interventions (i.e. advance directives, advance care planning, and shared decision making), decision making regarding resuscitation, education, and research. These areas are tightly related to the application of the principles of bioethics in the practice of resuscitation and end-of-life care.
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Affiliation(s)
- Spyros D. Mentzelopoulos
- Evaggelismos Allgemeines Krankenhaus, Abteilung für Intensivmedizin, Medizinische Fakultät der Nationalen und Kapodistrischen Universität Athen, 45–47 Ipsilandou Street, 10675 Athen, Griechenland
| | - Keith Couper
- Universitätskliniken Birmingham NHS Foundation Trust, UK Critical Care Unit, Birmingham, Großbritannien
- Medizinische Fakultät Warwick, Universität Warwick, Coventry, Großbritannien
| | - Patrick Van de Voorde
- Universitätsklinikum und Universität Gent, Gent, Belgien
- staatliches Gesundheitsministerium, Brüssel, Belgien
| | - Patrick Druwé
- Abteilung für Intensivmedizin, Universitätsklinikum Gent, Gent, Belgien
| | - Marieke Blom
- Medizinisches Zentrum der Universität Amsterdam, Amsterdam, Niederlande
| | - Gavin D. Perkins
- Medizinische Fakultät Warwick, Universität Warwick, Coventry, Großbritannien
| | | | - Jana Djakow
- Intensivstation für Kinder, NH Hospital, Hořovice, Tschechien
- Abteilung für Kinderanästhesiologie und Intensivmedizin, Universitätsklinikum und Medizinische Fakultät der Masaryk-Universität, Brno, Tschechien
| | - Violetta Raffay
- School of Medicine, Europäische Universität Zypern, Nikosia, Zypern
- Serbischer Wiederbelebungsrat, Novi Sad, Serbien
| | - Gisela Lilja
- Universitätsklinikum Skane, Abteilung für klinische Wissenschaften Lund, Neurologie, Universität Lund, Lund, Schweden
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Mentzelopoulos SD, Couper K, Voorde PVD, Druwé P, Blom M, Perkins GD, Lulic I, Djakow J, Raffay V, Lilja G, Bossaert L. European Resuscitation Council Guidelines 2021: Ethics of resuscitation and end of life decisions. Resuscitation 2021; 161:408-432. [PMID: 33773832 DOI: 10.1016/j.resuscitation.2021.02.017] [Citation(s) in RCA: 106] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
These European Resuscitation Council Ethics guidelines provide evidence-based recommendations for the ethical, routine practice of resuscitation and end-of-life care of adults and children. The guideline primarily focus on major ethical practice interventions (i.e. advance directives, advance care planning, and shared decision making), decision making regarding resuscitation, education, and research. These areas are tightly related to the application of the principles of bioethics in the practice of resuscitation and end-of-life care.
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Affiliation(s)
| | - Keith Couper
- UK Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; Warwick Medical School, University of Warwick, Coventry, UK
| | - Patrick Van de Voorde
- University Hospital and University Ghent, Belgium; Federal Department Health, Belgium
| | - Patrick Druwé
- Ghent University Hospital, Department of Intensive Care Medicine, Ghent, Belgium
| | - Marieke Blom
- Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Gavin D Perkins
- UK Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | | | - Jana Djakow
- Paediatric Intensive Care Unit, NH Hospital, Hořovice, Czech Republic; Department of Paediatric Anaesthesiology and Intensive Care Medicine, University Hospital and Medical Faculty of Masaryk University, Brno, Czech Republic
| | - Violetta Raffay
- European University Cyprus, School of Medicine, Nicosia, Cyprus; Serbian Resuscitation Council, Novi Sad, Serbia
| | - Gisela Lilja
- Lund University, Skane University Hospital, Department of Clinical Sciences Lund, Neurology, Lund, Sweden
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Meghani S. Witnessed resuscitation: A concept analysis. Intensive Crit Care Nurs 2021; 64:103003. [PMID: 33451915 DOI: 10.1016/j.iccn.2020.103003] [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: 06/05/2020] [Revised: 11/18/2020] [Accepted: 12/06/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The advance in the practice of resuscitation is globally recognised and fully sanctioned in scientific world. However, practicing family presence during resuscitation, also known as witnessed resuscitation, is yet to be endorsed by healthcare professionals. Many professional nursing and physician organisations have endorsed the practice of witnessed resuscitation by issuing guidelines. These organisations support family presence during resuscitation due to the research proving its benefit for patients and families. PURPOSE The purpose of this paper is to analyse the concept of witnessed resuscitation. METHOD A concept analysis was undertaken using Rodger's (2000) evolutionary method. FINDINGS The concept analysis suggests that witnessed resuscitation refers to the presence of a family member or relative during a resuscitation procedure, mostly in emergency and complex critical care areas. The defining attributes are family centred care approach, exercising patients and family rights and autonomy in end of life care decisions and involvement of family as active and passive observers during a resuscitation event. CONCLUSION Clarity surrounding witnessed resuscitation will guide the development of a conceptual framework, expand nursing knowledge and identify the research required to advance understanding of witnessed resuscitation in practice.
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Factors Associated With Emergency Department Health Professionals' Attitudes Toward Family Presence During Adult Resuscitation in 9 Greek Hospitals. Dimens Crit Care Nurs 2020; 39:269-277. [DOI: 10.1097/dcc.0000000000000417] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Erogul M, Likourezos A, Meddy J, Terentiev V, Davydkina D, Monfort R, Pushkar I, Vu T, Achalla M, Fromm C, Marshall J. Post-traumatic Stress Disorder in Family-witnessed Resuscitation of Emergency Department Patients. West J Emerg Med 2020; 21:1182-1187. [PMID: 32970573 PMCID: PMC7514396 DOI: 10.5811/westjem.2020.6.46300] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 06/22/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction Family presence during emergency resuscitations is increasingly common, but the question remains whether the practice results in psychological harm to the witness. We examine whether family members who witness resuscitations have increased post-traumatic stress disorder (PTSD) symptoms at one month following the event. Methods We identified family members of critically ill patients via our emergency department (ED) electronic health record. Patients were selected based on their geographic triage to an ED critical care room. Family members were called a median of one month post-event and administered the Impact of Event Scale-Revised (IES-R), a 22-item validated scale that measures post-traumatic distress symptoms and correlates closely with Diagnostic and Statistical Manual of Mental Disorders-IV criteria for post-traumatic stress disorder (PTSD). Family members were placed into two groups based on whether they stated they had witnessed the resuscitation (FWR group) or not witnessed the resuscitation (FNWR group). Data analyses included chi-square test, independent sample t-test, and linear regression controlling for gender and age. Results A convenience sample of 423 family members responded to the phone interview: 250 FWR and 173 FNWR. The FWR group had significantly higher mean total IES-R scores: 30.4 vs 25.6 (95% confidence interval [CI], −8.73 to −0.75; P<.05). Additionally, the FWR group had significantly higher mean score for the subscales of avoidance (10.6 vs 8.1; 95% CI, −4.25 to −0.94; P<.005) and a trend toward higher score for the subscale of intrusion (13.0 vs 11.4; 95% CI, −3.38 to .028; P = .054). No statistical significant difference was noted between the groups in the subscale of hyperarousal (6.95 vs 6.02; 95% CI, −2.08 to 0.22; P=.121). All findings were consistent after controlling for age, gender, and immediate family member (spouse, parent, children, and grandchildren). Conclusion Our results suggest that family members who witness ED resuscitations may be at increased risk of PTSD symptoms at one month. This is the first study that examines the effects of family visitation for an unsorted population of very sick patients who would typically be seen in the critical care section of a busy ED.
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Affiliation(s)
- Mert Erogul
- Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York
| | - Antonios Likourezos
- Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York
| | - Jodee Meddy
- Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York
| | - Victoria Terentiev
- Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York
| | - D'anna Davydkina
- Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York
| | - Ralph Monfort
- Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York
| | - Illya Pushkar
- Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York
| | - Thomas Vu
- Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York
| | - Madhu Achalla
- Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York
| | - Christian Fromm
- Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York
| | - John Marshall
- Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York
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Tíscar-González V, Gea-Sánchez M, Blanco-Blanco J, Pastells-Peiró R, De Ríos-Briz N, Moreno-Casbas MT. Witnessed resuscitation of adult and paediatric hospital patients: An umbrella review of the evidence. Int J Nurs Stud 2020; 113:103740. [PMID: 33099179 DOI: 10.1016/j.ijnurstu.2020.103740] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine the research evidence about whether families were allowed to witness cardiopulmonary resuscitation on hospitalised adult and paediatric patients; and the views of patients, families and health professionals, about witnessed cardiopulmonary resuscitation. DESIGN An umbrella review methodology of systematic reviews with sufficient methodological quality. REVIEW METHODS Papers published in Spanish and English between, 1 January 2009 and 31 December 2018 were considered. The following databases were searched: PubMed, CINAHL, Web of Science, Scopus, Cochrane Central Register of Controlled Trials, PsycInfo, Embase, the Central Supplier Database and the Joanna Briggs Institute, Evidence-based Practice Database. Two independent reviewers assessed the papers for methodological quality employing instruments from the Joanna Briggs Institute. Critical appraisal, extraction and synthesis were carried out, employing the established methods for umbrella reviews and the protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO number CRD42019145610). RESULTS The search identified 12 systematic reviews with moderate-to-high quality, which covered 110 original papers. Habitually, health professionals expressed controversial views and showed some reluctance to let families be present during cardiopulmonary resuscitation. In contrast, family members felt strongly that they should be present and patients agreed. Key factors that facilitated witnessed cardiopulmonary were a formal institutional policy, educating health professionals, and designating a health professional to support the family. Educational and cultural backgrounds influenced healthcare professionals' experiences and their attitudes towards witnessed cardiopulmonary resuscitation. In general, Anglo-Saxon countries showed greater support for this practice. These included the United States, which was the country that dominated the literature on this subject. CONCLUSIONS The best available evidence supports allowing the family to be present during cardiopulmonary resuscitation. It is necessary to include this practice in educational curricula and to train emergency personnel in its implementation. Culturally sensitive policies need to be designed, and the public to be aware of their right to be present.
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Affiliation(s)
- Verónica Tíscar-González
- Nursing teaching Unit, OSI Araba (Osakidetza), Vitoria, Spain; Clinical nursing and community health group. BioAraba Health Research Institute, Vitoria, Spain
| | - Montserrat Gea-Sánchez
- Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain; Group for the Study of Society Health Education and Culture (GESEC), University of Lleida, Lleida, Spain; Health Care Research Group (GRECS) Biomedical Research Institute of Lleida, IRBLleida, Lleida, Spain
| | - Joan Blanco-Blanco
- Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain; Group for the Study of Society Health Education and Culture (GESEC), University of Lleida, Lleida, Spain; Health Care Research Group (GRECS) Biomedical Research Institute of Lleida, IRBLleida, Lleida, Spain.
| | - Roland Pastells-Peiró
- Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain; Group for the Study of Society Health Education and Culture (GESEC), University of Lleida, Lleida, Spain; Health Care Research Group (GRECS) Biomedical Research Institute of Lleida, IRBLleida, Lleida, Spain
| | - Nuria De Ríos-Briz
- OSI Ezkerraldea-Enkarterri-Cruces (Osakidetza), Bizkaia, Spain; Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Maria Teresa Moreno-Casbas
- Nursing and Healthcare Research Unit (Investén-isciii), Madrid, Spain; CIBERFES, Institute of Health Carlos III, Madrid, Spain
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Goldfarb M, Bibas L, Burns K. Patient and Family Engagement in Care in the Cardiac Intensive Care Unit. Can J Cardiol 2020; 36:1032-1040. [PMID: 32533931 DOI: 10.1016/j.cjca.2020.03.037] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 03/06/2020] [Accepted: 03/14/2020] [Indexed: 12/26/2022] Open
Abstract
Hospitalization in the cardiac intensive care unit can be a stressful experience for patients and families. Family members often feel overwhelmed by the severity of their loved one's illness, powerless to affect their care, and struggle to comprehend information regarding their loved one's current health status and treatment plan. Consequently, up to half of family members might develop psychological symptoms (depression, generalized anxiety, and post-traumatic stress disorder) and a syndrome of enduring psychological, cognitive, or emotional disturbances. Patient and family engagement (PFE) is an emerging approach that empowers family members to become essential and active partners in care delivery and research. In the patient care context, the goal of PFE is to improve the care experience and achieve better outcomes for patients and family members. As a result of societal trends, family members increasingly wish to directly participate in their relative's care and be informed and involved in decision-making. There is growing evidence that engaging family members in care improves patient- and family-important outcomes after acute and critical illness. Although the role for PFE in care and research has been explored in the general critical care context, efforts to inform clinicians who manage patients with acute cardiovascular disease about the relevance of PFE are limited. In this review, we describe opportunities for PFE in the cardiac intensive care unit, outline the current evidence base for PFE in patient care, identify barriers to PFE and how to overcome them, and highlight knowledge gaps and areas for future investigations.
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Affiliation(s)
- Michael Goldfarb
- Division of Cardiology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
| | - Lior Bibas
- Division of Cardiology, Pierre-Boucher Hospital, Longueuil, Quebec, Canada
| | - Karen Burns
- Division of Critical Care Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
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Tennyson CD. Family presence during resuscitation: Updated review and clinical pearls. Geriatr Nurs 2019; 40:645-647. [DOI: 10.1016/j.gerinurse.2019.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Family presence during resuscitation: A narrative review of the practices and views of critical care nurses. Intensive Crit Care Nurs 2019; 53:15-22. [PMID: 31053336 DOI: 10.1016/j.iccn.2019.04.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 04/16/2019] [Accepted: 04/18/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND The option of family presence during resuscitation was first presented in the late 1980s. Discussion and debate about the pros and cons of this practice has led to an abundant body of international research. AIM To determine critical care nurses' experiences of, and support for family presence during adult and paediatric resuscitation and their views on the positive and negative effects of this practice. METHODS A narrative literature review of primary research published 2005 onwards. The search strategy comprised an electronic search of three bibliographic databases, supplemented by exploration of a web-based search engine and hand-searching. RESULTS Twelve studies formed the review. Research primarily originated from Europe. The findings were obtained from a moderately small number of nurses, and their views were mostly based on conjecture. Among the factors influencing family presence during resuscitation were dominant concerns about harmful effects. There was a noticeable absence of compliance with recommended guidelines for practice, and the provision of a unit protocol or policy to assist decision-making. CONCLUSION A commitment to family-centred care, educational intervention and the uptake of professional guidance are recommended evidence-informed strategies to enhance nurses' support for this practice in critical care.
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Family Presence During Resuscitation: The Education Needs of Critical Care Nurses. Dimens Crit Care Nurs 2018; 37:210-216. [PMID: 29847433 DOI: 10.1097/dcc.0000000000000304] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Education on family presence during resuscitation (FPDR) has been shown to improve critical care nurses' support for FPDR; however, there have been limited studies in this area. Exploring nurses' perceived needs related to FPDR education is important to design educational interventions to promote FPDR in practice. OBJECTIVES The aim of this study was to explore the FPDR education needs of critical care nurses to provide recommendations for future educational interventions. METHODS A cross-sectional survey design was used, and descriptive and qualitative data were collected online in 2016. A convenience sample of 395 critical care nurses was obtained. Participants completed online surveys, and descriptive statistics and thematic analysis were conducted. RESULTS One-third of the participants had received FPDR education, and 83% desired to receive education on FPDR. Qualitative data revealed 4 themes: "nurses need education," "team training is important," "focus on implementation of FPDR," and "a variety of preferences." DISCUSSION Critical care nurses' reported needs for FPDR education are currently not being met. It is important for nurse educators and researchers to design and test educational interventions to meet nurses' needs for guidance on implementing FPDR in clinical practice. In particular, online and simulation approaches should be investigated.
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Family Presence During Resuscitation: Physicians' Perceptions of Risk, Benefit, and Self-Confidence. Dimens Crit Care Nurs 2018; 37:167-179. [PMID: 29596294 DOI: 10.1097/dcc.0000000000000297] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Families often desire proximity to loved ones during life-threatening resuscitations and perceive clear benefits to being present. However, critical care nurses and physicians perceive risks and benefits. Whereas research is accumulating on nurses' perceptions of family presence, physicians' perspectives have not been clearly explicated. Psychometrically sound measures of physicians' perceptions are needed to create new knowledge and enhance collaboration among critical care nurses and physicians during resuscitation events. OBJECTIVE This study tests 2 new instruments that measure physicians' perceived risks, benefits, and self-confidence related to family presence during resuscitation. METHODS By a correlational design, a convenience sample of physicians (N = 195) from diverse clinical specialties in 1 hospital in the United States completed the Physicians' Family Presence Risk-Benefit Scale and Physicians' Family Presence Self-confidence Scale. RESULTS Findings supported the internal consistency reliability and construct validity of both new scales. Mean scale scores indicated that physicians perceived more risk than benefit and were confident in managing resuscitations with families present, although more than two-thirds reported feeling anxious. Higher self-confidence was significantly related to more perceived benefit and less perceived risk (P = .001). Younger physicians, family practice physicians, and physicians who previously had invited family presence expressed more positive perceptions (P = .05-.001). DISCUSSION These 2 new scales offer a means to assess key perceptions of physicians related to family presence. Further testing in diverse physician populations may further validate the scales and yield knowledge that can strengthen collaboration among critical care nurses and physicians and improve patient and family outcomes.
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Mureau-Haines RM, Boes-Rossi M, Casperson SC, Çoruh B, Furth AM, Haverland A, Herrera F, Hirai-Seaton T, Kummet C, Ngo H, Shushan S, Kritek PA, Greco SA. Family Support During Resuscitation: A Quality Improvement Initiative. Crit Care Nurse 2018; 37:14-23. [PMID: 29196584 DOI: 10.4037/ccn2017347] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Despite increasing support for family presence during cardiopulmonary resuscitation, a review of the literature revealed no published protocols or training curricula to guide hospitals in implementing a family support provider role. OBJECTIVES To develop a curriculum and train dedicated resuscitation team members whose role is to provide family support during in-hospital resuscitation events. METHODS An interdisciplinary team developed a 4-hour training session for the family support staff. The session included an introduction to the evidence for family presence during resuscitation and local data on resuscitations. The training was composed of 4 sections: (1) clinical aspects of resuscitation, (2) integration into the resuscitation team and steps for providing family support during resuscitation, (3) responding to families in distress, and (4) self-care practices. Before and after the training session, the participants completed surveys of self-rated knowledge and attitudes toward family presence during resuscitation. RESULTS Fifty-nine social workers and 8 spiritual care providers were trained in 2015. There was a significant increase in all rated aspects of knowledge of the family support role and self-care strategies. CONCLUSION Through the creation of an interdisciplinary curriculum, an institution can effectively train health care providers in a new resuscitation team role: the family support provider.
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Affiliation(s)
- Rache Marie Mureau-Haines
- Rache Marie Mureau-Haines is an adult-gerontology nurse practitioner and critical care clinical nurse specialist at the University of Washington School of Nursing, Seattle, Washington. She works both in the United States and East Africa. .,Mandy Boes-Rossi is a social worker in the medical intensive care unit at University of Washington Medical Center, Seattle, Washington. .,Susan Christine Casperson is a clinical instructor at the University of Washington School of Nursing and nurse manager at the Regional Hospital for Respiratory and Complex Care, Burien, Washington, Washington. .,Basak Çoruh is an assistant professor of pulmonary and critical care medicine at the University of Washington, Seattle, Washington. .,Amy M. Furth is an ordained minister in the United Church of Christ and has served in East Harlem, San Francisco, Southern California, and Seattle, Seattle, Washington. .,Amy Haverland is the nurse manager of the surgical intensive care unit at University of Washington Medical Center, Seattle, Washington. .,Farah Herrera is a registered nurse in the surgical intensive care unit at University of Washington Medical Center, Seattle, Washington. .,Tracy Hirai-Seaton is a social worker at University of Washington Medical Center and at Harborview Medical Center, Seattle, Washington. .,Carol Kummet is a palliative care social worker at University of Washington Medical Center. .,Hkori Ngo is a social worker at Harborview Medical Center and University of Washington Medical Center. .,Stephanie Shushan is a program operations specialist at University of Washington Medical Center and the University of Washington School of Medicine. .,Patricia A. Kritek is an associate medical director for critical care at University of Washington Medical Center. She is also the co-chair of the Medical Emergency Response Committee. .,Sheryl A. Greco is a critical care clinical nurse specialist at University of Washington Medical Center.
| | - Mandy Boes-Rossi
- Rache Marie Mureau-Haines is an adult-gerontology nurse practitioner and critical care clinical nurse specialist at the University of Washington School of Nursing, Seattle, Washington. She works both in the United States and East Africa.,Mandy Boes-Rossi is a social worker in the medical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Susan Christine Casperson is a clinical instructor at the University of Washington School of Nursing and nurse manager at the Regional Hospital for Respiratory and Complex Care, Burien, Washington, Washington.,Basak Çoruh is an assistant professor of pulmonary and critical care medicine at the University of Washington, Seattle, Washington.,Amy M. Furth is an ordained minister in the United Church of Christ and has served in East Harlem, San Francisco, Southern California, and Seattle, Seattle, Washington.,Amy Haverland is the nurse manager of the surgical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Farah Herrera is a registered nurse in the surgical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Tracy Hirai-Seaton is a social worker at University of Washington Medical Center and at Harborview Medical Center, Seattle, Washington.,Carol Kummet is a palliative care social worker at University of Washington Medical Center.,Hkori Ngo is a social worker at Harborview Medical Center and University of Washington Medical Center.,Stephanie Shushan is a program operations specialist at University of Washington Medical Center and the University of Washington School of Medicine.,Patricia A. Kritek is an associate medical director for critical care at University of Washington Medical Center. She is also the co-chair of the Medical Emergency Response Committee.,Sheryl A. Greco is a critical care clinical nurse specialist at University of Washington Medical Center
| | - Susan Christine Casperson
- Rache Marie Mureau-Haines is an adult-gerontology nurse practitioner and critical care clinical nurse specialist at the University of Washington School of Nursing, Seattle, Washington. She works both in the United States and East Africa.,Mandy Boes-Rossi is a social worker in the medical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Susan Christine Casperson is a clinical instructor at the University of Washington School of Nursing and nurse manager at the Regional Hospital for Respiratory and Complex Care, Burien, Washington, Washington.,Basak Çoruh is an assistant professor of pulmonary and critical care medicine at the University of Washington, Seattle, Washington.,Amy M. Furth is an ordained minister in the United Church of Christ and has served in East Harlem, San Francisco, Southern California, and Seattle, Seattle, Washington.,Amy Haverland is the nurse manager of the surgical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Farah Herrera is a registered nurse in the surgical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Tracy Hirai-Seaton is a social worker at University of Washington Medical Center and at Harborview Medical Center, Seattle, Washington.,Carol Kummet is a palliative care social worker at University of Washington Medical Center.,Hkori Ngo is a social worker at Harborview Medical Center and University of Washington Medical Center.,Stephanie Shushan is a program operations specialist at University of Washington Medical Center and the University of Washington School of Medicine.,Patricia A. Kritek is an associate medical director for critical care at University of Washington Medical Center. She is also the co-chair of the Medical Emergency Response Committee.,Sheryl A. Greco is a critical care clinical nurse specialist at University of Washington Medical Center
| | - Basak Çoruh
- Rache Marie Mureau-Haines is an adult-gerontology nurse practitioner and critical care clinical nurse specialist at the University of Washington School of Nursing, Seattle, Washington. She works both in the United States and East Africa.,Mandy Boes-Rossi is a social worker in the medical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Susan Christine Casperson is a clinical instructor at the University of Washington School of Nursing and nurse manager at the Regional Hospital for Respiratory and Complex Care, Burien, Washington, Washington.,Basak Çoruh is an assistant professor of pulmonary and critical care medicine at the University of Washington, Seattle, Washington.,Amy M. Furth is an ordained minister in the United Church of Christ and has served in East Harlem, San Francisco, Southern California, and Seattle, Seattle, Washington.,Amy Haverland is the nurse manager of the surgical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Farah Herrera is a registered nurse in the surgical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Tracy Hirai-Seaton is a social worker at University of Washington Medical Center and at Harborview Medical Center, Seattle, Washington.,Carol Kummet is a palliative care social worker at University of Washington Medical Center.,Hkori Ngo is a social worker at Harborview Medical Center and University of Washington Medical Center.,Stephanie Shushan is a program operations specialist at University of Washington Medical Center and the University of Washington School of Medicine.,Patricia A. Kritek is an associate medical director for critical care at University of Washington Medical Center. She is also the co-chair of the Medical Emergency Response Committee.,Sheryl A. Greco is a critical care clinical nurse specialist at University of Washington Medical Center
| | - Amy M Furth
- Rache Marie Mureau-Haines is an adult-gerontology nurse practitioner and critical care clinical nurse specialist at the University of Washington School of Nursing, Seattle, Washington. She works both in the United States and East Africa.,Mandy Boes-Rossi is a social worker in the medical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Susan Christine Casperson is a clinical instructor at the University of Washington School of Nursing and nurse manager at the Regional Hospital for Respiratory and Complex Care, Burien, Washington, Washington.,Basak Çoruh is an assistant professor of pulmonary and critical care medicine at the University of Washington, Seattle, Washington.,Amy M. Furth is an ordained minister in the United Church of Christ and has served in East Harlem, San Francisco, Southern California, and Seattle, Seattle, Washington.,Amy Haverland is the nurse manager of the surgical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Farah Herrera is a registered nurse in the surgical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Tracy Hirai-Seaton is a social worker at University of Washington Medical Center and at Harborview Medical Center, Seattle, Washington.,Carol Kummet is a palliative care social worker at University of Washington Medical Center.,Hkori Ngo is a social worker at Harborview Medical Center and University of Washington Medical Center.,Stephanie Shushan is a program operations specialist at University of Washington Medical Center and the University of Washington School of Medicine.,Patricia A. Kritek is an associate medical director for critical care at University of Washington Medical Center. She is also the co-chair of the Medical Emergency Response Committee.,Sheryl A. Greco is a critical care clinical nurse specialist at University of Washington Medical Center
| | - Amy Haverland
- Rache Marie Mureau-Haines is an adult-gerontology nurse practitioner and critical care clinical nurse specialist at the University of Washington School of Nursing, Seattle, Washington. She works both in the United States and East Africa.,Mandy Boes-Rossi is a social worker in the medical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Susan Christine Casperson is a clinical instructor at the University of Washington School of Nursing and nurse manager at the Regional Hospital for Respiratory and Complex Care, Burien, Washington, Washington.,Basak Çoruh is an assistant professor of pulmonary and critical care medicine at the University of Washington, Seattle, Washington.,Amy M. Furth is an ordained minister in the United Church of Christ and has served in East Harlem, San Francisco, Southern California, and Seattle, Seattle, Washington.,Amy Haverland is the nurse manager of the surgical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Farah Herrera is a registered nurse in the surgical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Tracy Hirai-Seaton is a social worker at University of Washington Medical Center and at Harborview Medical Center, Seattle, Washington.,Carol Kummet is a palliative care social worker at University of Washington Medical Center.,Hkori Ngo is a social worker at Harborview Medical Center and University of Washington Medical Center.,Stephanie Shushan is a program operations specialist at University of Washington Medical Center and the University of Washington School of Medicine.,Patricia A. Kritek is an associate medical director for critical care at University of Washington Medical Center. She is also the co-chair of the Medical Emergency Response Committee.,Sheryl A. Greco is a critical care clinical nurse specialist at University of Washington Medical Center
| | - Farah Herrera
- Rache Marie Mureau-Haines is an adult-gerontology nurse practitioner and critical care clinical nurse specialist at the University of Washington School of Nursing, Seattle, Washington. She works both in the United States and East Africa.,Mandy Boes-Rossi is a social worker in the medical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Susan Christine Casperson is a clinical instructor at the University of Washington School of Nursing and nurse manager at the Regional Hospital for Respiratory and Complex Care, Burien, Washington, Washington.,Basak Çoruh is an assistant professor of pulmonary and critical care medicine at the University of Washington, Seattle, Washington.,Amy M. Furth is an ordained minister in the United Church of Christ and has served in East Harlem, San Francisco, Southern California, and Seattle, Seattle, Washington.,Amy Haverland is the nurse manager of the surgical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Farah Herrera is a registered nurse in the surgical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Tracy Hirai-Seaton is a social worker at University of Washington Medical Center and at Harborview Medical Center, Seattle, Washington.,Carol Kummet is a palliative care social worker at University of Washington Medical Center.,Hkori Ngo is a social worker at Harborview Medical Center and University of Washington Medical Center.,Stephanie Shushan is a program operations specialist at University of Washington Medical Center and the University of Washington School of Medicine.,Patricia A. Kritek is an associate medical director for critical care at University of Washington Medical Center. She is also the co-chair of the Medical Emergency Response Committee.,Sheryl A. Greco is a critical care clinical nurse specialist at University of Washington Medical Center
| | - Tracy Hirai-Seaton
- Rache Marie Mureau-Haines is an adult-gerontology nurse practitioner and critical care clinical nurse specialist at the University of Washington School of Nursing, Seattle, Washington. She works both in the United States and East Africa.,Mandy Boes-Rossi is a social worker in the medical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Susan Christine Casperson is a clinical instructor at the University of Washington School of Nursing and nurse manager at the Regional Hospital for Respiratory and Complex Care, Burien, Washington, Washington.,Basak Çoruh is an assistant professor of pulmonary and critical care medicine at the University of Washington, Seattle, Washington.,Amy M. Furth is an ordained minister in the United Church of Christ and has served in East Harlem, San Francisco, Southern California, and Seattle, Seattle, Washington.,Amy Haverland is the nurse manager of the surgical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Farah Herrera is a registered nurse in the surgical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Tracy Hirai-Seaton is a social worker at University of Washington Medical Center and at Harborview Medical Center, Seattle, Washington.,Carol Kummet is a palliative care social worker at University of Washington Medical Center.,Hkori Ngo is a social worker at Harborview Medical Center and University of Washington Medical Center.,Stephanie Shushan is a program operations specialist at University of Washington Medical Center and the University of Washington School of Medicine.,Patricia A. Kritek is an associate medical director for critical care at University of Washington Medical Center. She is also the co-chair of the Medical Emergency Response Committee.,Sheryl A. Greco is a critical care clinical nurse specialist at University of Washington Medical Center
| | - Carol Kummet
- Rache Marie Mureau-Haines is an adult-gerontology nurse practitioner and critical care clinical nurse specialist at the University of Washington School of Nursing, Seattle, Washington. She works both in the United States and East Africa.,Mandy Boes-Rossi is a social worker in the medical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Susan Christine Casperson is a clinical instructor at the University of Washington School of Nursing and nurse manager at the Regional Hospital for Respiratory and Complex Care, Burien, Washington, Washington.,Basak Çoruh is an assistant professor of pulmonary and critical care medicine at the University of Washington, Seattle, Washington.,Amy M. Furth is an ordained minister in the United Church of Christ and has served in East Harlem, San Francisco, Southern California, and Seattle, Seattle, Washington.,Amy Haverland is the nurse manager of the surgical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Farah Herrera is a registered nurse in the surgical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Tracy Hirai-Seaton is a social worker at University of Washington Medical Center and at Harborview Medical Center, Seattle, Washington.,Carol Kummet is a palliative care social worker at University of Washington Medical Center.,Hkori Ngo is a social worker at Harborview Medical Center and University of Washington Medical Center.,Stephanie Shushan is a program operations specialist at University of Washington Medical Center and the University of Washington School of Medicine.,Patricia A. Kritek is an associate medical director for critical care at University of Washington Medical Center. She is also the co-chair of the Medical Emergency Response Committee.,Sheryl A. Greco is a critical care clinical nurse specialist at University of Washington Medical Center
| | - Hkori Ngo
- Rache Marie Mureau-Haines is an adult-gerontology nurse practitioner and critical care clinical nurse specialist at the University of Washington School of Nursing, Seattle, Washington. She works both in the United States and East Africa.,Mandy Boes-Rossi is a social worker in the medical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Susan Christine Casperson is a clinical instructor at the University of Washington School of Nursing and nurse manager at the Regional Hospital for Respiratory and Complex Care, Burien, Washington, Washington.,Basak Çoruh is an assistant professor of pulmonary and critical care medicine at the University of Washington, Seattle, Washington.,Amy M. Furth is an ordained minister in the United Church of Christ and has served in East Harlem, San Francisco, Southern California, and Seattle, Seattle, Washington.,Amy Haverland is the nurse manager of the surgical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Farah Herrera is a registered nurse in the surgical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Tracy Hirai-Seaton is a social worker at University of Washington Medical Center and at Harborview Medical Center, Seattle, Washington.,Carol Kummet is a palliative care social worker at University of Washington Medical Center.,Hkori Ngo is a social worker at Harborview Medical Center and University of Washington Medical Center.,Stephanie Shushan is a program operations specialist at University of Washington Medical Center and the University of Washington School of Medicine.,Patricia A. Kritek is an associate medical director for critical care at University of Washington Medical Center. She is also the co-chair of the Medical Emergency Response Committee.,Sheryl A. Greco is a critical care clinical nurse specialist at University of Washington Medical Center
| | - Stephanie Shushan
- Rache Marie Mureau-Haines is an adult-gerontology nurse practitioner and critical care clinical nurse specialist at the University of Washington School of Nursing, Seattle, Washington. She works both in the United States and East Africa.,Mandy Boes-Rossi is a social worker in the medical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Susan Christine Casperson is a clinical instructor at the University of Washington School of Nursing and nurse manager at the Regional Hospital for Respiratory and Complex Care, Burien, Washington, Washington.,Basak Çoruh is an assistant professor of pulmonary and critical care medicine at the University of Washington, Seattle, Washington.,Amy M. Furth is an ordained minister in the United Church of Christ and has served in East Harlem, San Francisco, Southern California, and Seattle, Seattle, Washington.,Amy Haverland is the nurse manager of the surgical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Farah Herrera is a registered nurse in the surgical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Tracy Hirai-Seaton is a social worker at University of Washington Medical Center and at Harborview Medical Center, Seattle, Washington.,Carol Kummet is a palliative care social worker at University of Washington Medical Center.,Hkori Ngo is a social worker at Harborview Medical Center and University of Washington Medical Center.,Stephanie Shushan is a program operations specialist at University of Washington Medical Center and the University of Washington School of Medicine.,Patricia A. Kritek is an associate medical director for critical care at University of Washington Medical Center. She is also the co-chair of the Medical Emergency Response Committee.,Sheryl A. Greco is a critical care clinical nurse specialist at University of Washington Medical Center
| | - Patricia A Kritek
- Rache Marie Mureau-Haines is an adult-gerontology nurse practitioner and critical care clinical nurse specialist at the University of Washington School of Nursing, Seattle, Washington. She works both in the United States and East Africa.,Mandy Boes-Rossi is a social worker in the medical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Susan Christine Casperson is a clinical instructor at the University of Washington School of Nursing and nurse manager at the Regional Hospital for Respiratory and Complex Care, Burien, Washington, Washington.,Basak Çoruh is an assistant professor of pulmonary and critical care medicine at the University of Washington, Seattle, Washington.,Amy M. Furth is an ordained minister in the United Church of Christ and has served in East Harlem, San Francisco, Southern California, and Seattle, Seattle, Washington.,Amy Haverland is the nurse manager of the surgical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Farah Herrera is a registered nurse in the surgical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Tracy Hirai-Seaton is a social worker at University of Washington Medical Center and at Harborview Medical Center, Seattle, Washington.,Carol Kummet is a palliative care social worker at University of Washington Medical Center.,Hkori Ngo is a social worker at Harborview Medical Center and University of Washington Medical Center.,Stephanie Shushan is a program operations specialist at University of Washington Medical Center and the University of Washington School of Medicine.,Patricia A. Kritek is an associate medical director for critical care at University of Washington Medical Center. She is also the co-chair of the Medical Emergency Response Committee.,Sheryl A. Greco is a critical care clinical nurse specialist at University of Washington Medical Center
| | - Sheryl A Greco
- Rache Marie Mureau-Haines is an adult-gerontology nurse practitioner and critical care clinical nurse specialist at the University of Washington School of Nursing, Seattle, Washington. She works both in the United States and East Africa.,Mandy Boes-Rossi is a social worker in the medical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Susan Christine Casperson is a clinical instructor at the University of Washington School of Nursing and nurse manager at the Regional Hospital for Respiratory and Complex Care, Burien, Washington, Washington.,Basak Çoruh is an assistant professor of pulmonary and critical care medicine at the University of Washington, Seattle, Washington.,Amy M. Furth is an ordained minister in the United Church of Christ and has served in East Harlem, San Francisco, Southern California, and Seattle, Seattle, Washington.,Amy Haverland is the nurse manager of the surgical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Farah Herrera is a registered nurse in the surgical intensive care unit at University of Washington Medical Center, Seattle, Washington.,Tracy Hirai-Seaton is a social worker at University of Washington Medical Center and at Harborview Medical Center, Seattle, Washington.,Carol Kummet is a palliative care social worker at University of Washington Medical Center.,Hkori Ngo is a social worker at Harborview Medical Center and University of Washington Medical Center.,Stephanie Shushan is a program operations specialist at University of Washington Medical Center and the University of Washington School of Medicine.,Patricia A. Kritek is an associate medical director for critical care at University of Washington Medical Center. She is also the co-chair of the Medical Emergency Response Committee.,Sheryl A. Greco is a critical care clinical nurse specialist at University of Washington Medical Center
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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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Breach J. Exploring the implementation of family-witnessed resuscitation. Nurs Stand 2018; 33:76-81. [PMID: 29583168 DOI: 10.7748/ns.2018.e11003] [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] [Accepted: 01/16/2018] [Indexed: 06/08/2023]
Abstract
Cardiac arrest is a traumatic event, both for patients and their family members. Traditionally, healthcare professionals have often been reluctant to offer family members the opportunity to witness cardiopulmonary resuscitation (CPR) attempts. However, professional bodies globally have begun to recommend the use of family-witnessed resuscitation (FWR) during CPR, identifying a range of potential benefits including supporting the patient, increasing family members' confidence in healthcare professionals and, in some cases, promoting acceptance of the patient's death. This article explores the benefits of, and barriers to, the implementation of FWR during CPR. Despite the perceived benefits of FWR identified by professional bodies, healthcare professionals, and patients and their families, the evidence indicates there is ongoing reluctance among some healthcare professionals to incorporate FWR in practice. Therefore, standardised global policies aimed at the multidisciplinary implementation of FWR are required. Additionally, multidisciplinary training and education in CPR should be readily available, particularly in areas where CPR is frequently used, such as emergency departments.
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Psychosocial Care Models for Families of Critically Ill Children in Pediatric Emergency Department Settings: A Scoping Review. J Pediatr Nurs 2018; 38:46-52. [PMID: 29167080 DOI: 10.1016/j.pedn.2017.10.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 10/21/2017] [Accepted: 10/22/2017] [Indexed: 11/23/2022]
Abstract
PROBLEM Critical illness in children is a significant and stressful life event for families. Within pediatric emergency department (ED) settings it is acknowledged that these crises are challenging for both the families of these children, and for the clinical staff treating the child. Literature recommends routine care should include an offer to the family to be present with their critically ill child, however there is a lack of clarity regarding specific family care models or evidence-based interventions to guide clinical practice. ELIGIBILITY CRITERIA Peer reviewed articles written in English, published between 2006 and 2016, proposing or testing psychosocial care models in pediatric (or mixed) emergency settings. SAMPLE Nine articles met inclusion criteria. RESULTS Search results showed limited evidence available in the literature at this time. Thematic analysis of article content and proposed model showed strong support for the benefit of family presence, including shifting the family role from passive to active, needing to be inclusive of the psychological impact of critical health events, importance of multidisciplinary education, and the need for additional exploratory and empirical research to evaluate and refine proposed care models. CONCLUSIONS Pediatric emergency health events are challenging for both families and staff, and care models provide staff with a consistent, evidence-informed approach to caring for families in challenging situations. IMPLICATIONS There is a need to find common ground from specific discipline guidelines into a multidisciplinary team approach for the care of families within emergency care.
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Sade RM, Kavarana MN. Surgical ethics: today and tomorrow. Future Cardiol 2017; 13:567-578. [PMID: 29052454 PMCID: PMC6219449 DOI: 10.2217/fca-2017-0057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 09/26/2017] [Indexed: 11/21/2022] Open
Abstract
Ethical behavior has always been deeply ingrained in surgical culture, but ethical deliberation has only recently become an important component of cardiac surgical practice. In our earlier review, we covered a range of issues including several related to informed consent, conflict of interest, professional self-regulation and innovation, among many others. This update covers several topics of interest to cardiac surgeons and cardiologists, focusing on controversial issues specific to the practice of cardiothoracic surgery: informed consent, relations with hospitals and euthanasia and physician-assisted suicide. The future holds much uncertainty for cardiac surgical practice, research and culture, and we provide an update on ethical issues to serve as a platform for envisioning what is to come.
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Affiliation(s)
- Robert M Sade
- Department of Surgery, Institute of Human Values in Health Care, Medical University of South Carolina, 114 Doughty Street, STB 277, MSC 295, Charleston, SC 29425, USA
| | - Minoo N Kavarana
- Section of Pediatric Cardiothoracic Surgery, Department of Surgery, 96 Jonathan Lucas Street, CSB 424, MSC 613, Charleston, SC 29425, USA
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Zali M, Hassankhani H, Powers KA, Dadashzadeh A, Rajaei Ghafouri R. Family presence during resuscitation: A descriptive study with Iranian nurses and patients' family members. Int Emerg Nurs 2017; 34:11-16. [PMID: 28528270 DOI: 10.1016/j.ienj.2017.05.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 04/29/2017] [Accepted: 05/01/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Family presence during resuscitation (FPDR) has advantages for the patients' family member to be present at the bedside. However, FPDR is not regularly practiced by nurses, especially in low to middle income countries. The purpose of this study was to determine Iranian nurses' and family members' attitudes towards FPDR. METHOD In a descriptive study, data was collected from the random sample of 178 nurses and 136 family members in four hospitals located in Iran. A 27-item questionnaire was used to collect data on attitudes towards FPDR, and descriptive and correlational analyses were conducted. RESULTS Of family members, particularly the women, 57.2% (n=78) felt it is their right to experience FPDR and that it has many advantages for the family; including the ability to see that everything was done and worry less. However, 62.5% (n=111) of the nurses disagreed with an adult implementation of FPDR. Nurses perceived FPDR to have many disadvantages. Family members becoming distressed and interfering with the patient which may prolong the resuscitation effort. Nurses with prior education on FPDR were more willing to implement it. CONCLUSION FPDR was desired by the majority of family members. To meet their needs, it is important to improve Iranian nurses' views about the advantages of the implementation of FPDR. Education on FPDR is recommended to improve Iranian nurses' views about the advantages of the implementation of FPDR.
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Affiliation(s)
- Mahnaz Zali
- Student's Research Committee, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Hadi Hassankhani
- Center of Qualitative Studies, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Kelly A Powers
- School of Nursing, UNC Charlotte, College of Health and Human Services 428, 9201 University City Blvd., Charlotte, NC 28223, United States.
| | - Abbas Dadashzadeh
- Road Traffic Injury Research Center, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
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Jakab M, Day AZ, Kraguljac A, Brown M, Mehta S. Family Presence in the Adult ICU During Bedside Procedures. J Intensive Care Med 2017; 34:587-593. [PMID: 28502236 DOI: 10.1177/0885066617705857] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To understand perspectives of family members of adult patients admitted to the medical-surgical intensive care unit (ICU) regarding their presence during procedures. METHODS Respondents completed a questionnaire about procedures the patient had undergone, their desire to be present, and their experience. Procedures of interest were endotracheal intubation; chest compressions; vascular catheter insertion; and gastric, chest, and rectal tubes. Impact of Events Scale-Revised (IES-R) was completed at the time of questionnaire completion and again 1 month later to evaluate the psychological impact of witnessing a procedure. RESULTS Ninety-seven respondents completed the questionnaire on behalf of 72 patients. More than 90% patients had at least 1 procedure. Only 29 (30%) family members were present for at least 1 procedure, and 44% to 100% wished to be present. Of the 68 respondents not present for a procedure, 18 (26.5%) wanted to be present. The IES-R was completed by 52 (95%) of 55 respondents who witnessed any procedure at time 1 and 28 (51%) of 55 respondents at time 2; mean IES-R scores were 8.0 and 8.8 ( P = .68), respectively. Only 2 participants had IES-R >33, signifying the likely presence of posttraumatic stress disorder. CONCLUSION Family members wish to be present for ICU procedures, and there are no adverse psychological effects.
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Affiliation(s)
- Marnie Jakab
- 1 Department of Medicine, Mount Sinai Hospital, Interdepartmental Division of Critical Care Medicine, Toronto, Ontario, Canada
| | - Alex Z Day
- 1 Department of Medicine, Mount Sinai Hospital, Interdepartmental Division of Critical Care Medicine, Toronto, Ontario, Canada
| | - Alan Kraguljac
- 1 Department of Medicine, Mount Sinai Hospital, Interdepartmental Division of Critical Care Medicine, Toronto, Ontario, Canada.,2 University of Toronto, Toronto, Ontario, Canada
| | - Maedean Brown
- 1 Department of Medicine, Mount Sinai Hospital, Interdepartmental Division of Critical Care Medicine, Toronto, Ontario, Canada
| | - Sangeeta Mehta
- 1 Department of Medicine, Mount Sinai Hospital, Interdepartmental Division of Critical Care Medicine, Toronto, Ontario, Canada.,2 University of Toronto, Toronto, Ontario, Canada
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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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Chen CL, Tang JS, Lai MK, Hung CH, Hsieh HM, Yang HL, Chuang CC. Factors influencing medical staff’s intentions to implement family-witnessed cardiopulmonary resuscitation: A cross-sectional, multihospital survey. Eur J Cardiovasc Nurs 2017; 16:492-501. [DOI: 10.1177/1474515117692663] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Chien-Liang Chen
- Department of Physical Therapy, I-Shou University, Kaohsiung, Taiwan
| | - Jing-Shia Tang
- Department of Nursing, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Meng-Kuan Lai
- Department of Business Administration, National Cheng Kung University, Tainan, Taiwan
| | - Chiu-Hsia Hung
- Department of Nursing, Tainan Municipal Hospital, Taiwan
| | | | - Hui-Lin Yang
- Department of Nursing, Kuo General Hospital, Tainan, Taiwan
| | - Chia-Chang Chuang
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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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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Brasel KJ, Entwistle JW, Sade RM. Should Family Presence Be Allowed During Cardiopulmonary Resuscitation? Ann Thorac Surg 2016; 102:1438-1443. [PMID: 27772571 PMCID: PMC5094278 DOI: 10.1016/j.athoracsur.2016.02.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 01/29/2016] [Accepted: 02/01/2016] [Indexed: 11/21/2022]
Affiliation(s)
- Karen J Brasel
- Department of Surgery, Oregon Health & Science University, Portland, Oregon
| | - John W Entwistle
- Department of Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Robert M Sade
- Department of Surgery, Institute of Human Values in Health Care, Medical University of South Carolina, Charleston, South Carolina.
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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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Erbay H. Some Ethical Issues in Prehospital Emergency Medicine. Turk J Emerg Med 2016; 14:193-8. [PMID: 27437517 PMCID: PMC4909960 DOI: 10.5505/1304.7361.2014.32656] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 08/27/2014] [Indexed: 11/13/2022] Open
Abstract
Prehospital emergency medical care has many challenges including unpredictable patient profiles, emergency conditions, and administration of care in a non-medical area. Many conflicts occur in a prehospital setting that require ethical decisions to be made. An overview of the some of ethical issues in prehospital emergency care settings is given in this article. Ethical aspects of prehospital emergency medicine are classified into four groups: the process before medical interventions, including justice, stigmatization, dangerous situations, and safe driving; the treatment process, including triage, refusal of treatment or transport, and informed consent; the end of life and care, including life-sustaining treatments, prehospital cardiopulmonary resuscitation (CPR), withholding or withdrawal of CPR, and family presence during resuscitation; and some ambulance perception issues, including ambulance misuse, care of minors, and telling of bad news. Prehospital emergency medicine is quite different from emergency medicine in hospitals, and all patients and situations are unique. Consequently, there are no quick formulas for the right action and emotion. It is important to recognize the ethical conflicts that occur in prehospital emergency medicine and then act to provide the appropriate care that is of optimal value.
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Affiliation(s)
- Hasan Erbay
- Department of History of Medicine And Ethics, Afyon Kocatepe University Faculty of Medicine, Afyonkarahisar
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Inviting family to be present during cardiopulmonary resuscitation: Impact of education. Nurse Educ Pract 2016; 16:274-9. [DOI: 10.1016/j.nepr.2015.10.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 10/01/2015] [Accepted: 10/06/2015] [Indexed: 11/23/2022]
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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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Rippin AS, Zimring C, Samuels O, Denham ME. Finding a Middle Ground: Exploring the Impact of Patient- and Family-Centered Design on Nurse-Family Interactions in the Neuro ICU. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2015; 9:80-98. [PMID: 26187793 DOI: 10.1177/1937586715593551] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This comparative study of two adult neuro critical care units examined the impact of patient- and family-centered design on nurse-family interactions in a unit designed to increase family involvement. BACKGROUND A growing evidence base suggests that the built environment can facilitate the delivery of patient- and family-centered care (PFCC). However, few studies examine how the PFCC model impacts the delivery of care, specifically the role of design in nurse-family interactions in the adult intensive care unit (ICU) from the perspective of the bedside nurse. METHODS Two neuro ICUs with the same patient population and staff, but with different layouts, were compared. Structured observations were conducted to assess changes in the frequency, location, and content of interactions between the two units. Discussions with staff provided additional insights into nurse attitudes, perceptions, and experiences caring for families. RESULTS Nurses reported challenges balancing the needs of many stakeholders in a complex clinical environment, regardless of unit layout. However, differences in communication patterns between the clinician- and family-centered units were observed. More interactions were observed in nurse workstations in the PFCC unit, with most initiated by family. While the new unit was seen as more conducive to the delivery of PFCC, some nurses reported a loss of workspace control. CONCLUSIONS Patient- and family-centered design created new spatial and temporal opportunities for nurse-family interactions in the adult ICU, thus supporting PFCC goals. However, greater exposure to unplanned family encounters may increase nurse stress without adequate spatial and organizational support.
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Affiliation(s)
| | | | - Owen Samuels
- Neuroscience Critical Care, Emory Healthcare, Atlanta, GA, USA
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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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Dwyer TA. Predictors of public support for family presence during cardiopulmonary resuscitation: A population based study. Int J Nurs Stud 2015; 52:1064-70. [PMID: 25814044 DOI: 10.1016/j.ijnurstu.2015.03.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 03/04/2015] [Accepted: 03/05/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND The debate on whether individuals want their family to be present during cardiopulmonary resuscitation continues to be a contentious issue, but there is little analysis of the predictors of the general public's opinion. The aim of this population based study was to identify factors that predict public support for having family present during cardiopulmonary resuscitation. DESIGN Data for this cross-sectional population based study were collected via computer-assisted-telephone-interviews of people (n=1208) residing in Central Queensland, Australia. RESULTS Participants supported family members being present should their child (75%), an adult relative (52%) or they themselves (51%) require cardiopulmonary resuscitation. Reasons cited for not wanting to be present were; distraction for the medical team (30.4%), too distressing (30%) or not known/not considered the option (19%). Sex and prior exposure to being present during the resuscitation of adults and children were both predictors of support (p<0.05). Reasons for not wanting to be present differed significantly for males and females (p=0.001). CONCLUSION Individual support for being present during cardiopulmonary resuscitation varies according to; sex, prior exposure and if the family member who is being resuscitated is a family member, their child or the person themselves. A considerable proportion of the public have not considered nor planned for the option of being present during a cardiac arrest of an adult relative. Clinicians may find it useful to explain the experiences of other people who have been present when supporting families to make informed decisions about their involvement in emergency interventions.
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Affiliation(s)
- Trudy A Dwyer
- Central Queensland University Australia, Building 18 Rockhampton, Bruce Highway, Rockhampton, QLD 4702 Australia.
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Anwesenheit von Angehörigen während kardiopulmonaler Reanimation. Notf Rett Med 2014. [DOI: 10.1007/s10049-014-1907-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Jabre P, Tazarourte K, Azoulay E, Borron SW, Belpomme V, Jacob L, Bertrand L, Lapostolle F, Combes X, Galinski M, Pinaud V, Destefano C, Normand D, Beltramini A, Assez N, Vivien B, Vicaut E, Adnet F. Offering the opportunity for family to be present during cardiopulmonary resuscitation: 1-year assessment. Intensive Care Med 2014; 40:981-7. [PMID: 24852952 DOI: 10.1007/s00134-014-3337-1] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 05/07/2014] [Indexed: 01/14/2023]
Abstract
PURPOSE To evaluate the psychological consequences among family members given the option to be present during the CPR of a relative, compared with those not routinely offered the option. METHODS Prospective, cluster-randomized, controlled trial involving 15 prehospital emergency medical services units in France, comparing systematic offer for a relative to witness CPR with the traditional practice among 570 family members. Main outcome measure was 1-year assessment included proportion suffering post-traumatic stress disorder (PTSD), anxiety and depression symptoms, and/or complicated grief. RESULTS Among the 570 family members [intention to treat (ITT) population], 408 (72%) were evaluated at 1 year. In the ITT population (N = 570), family members had PTSD-related symptoms significantly more frequently in the control group than in the intervention group [adjusted odds ratio, 1.8; 95% confidence interval (CI) 1.1-3.0; P = 0.02] as did family members to whom physicians did not propose witnessing CPR [adjusted odds ratio, 1.7; 95% CI 1.1-2.6; P = 0.02]. In the observed cases population (N = 408), the proportion of family members experiencing a major depressive episode was significantly higher in the control group (31 vs. 23%; P = 0.02) and among family members to whom physicians did not propose the opportunity to witness CPR (31 vs. 24%; P = 0.03). The presence of complicated grief was significantly greater in the control group (36 vs. 21%; P = 0.005) and among family members to whom physicians did not propose the opportunity to witness resuscitation (37 vs. 23%; P = 0.003). CONCLUSIONS At 1 year after the event, psychological benefits persist for those family members offered the possibility to witness the CPR of a relative in cardiac arrest.
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Affiliation(s)
- Patricia Jabre
- AP-HP, Urgences-Samu 93, Hôpital Avicenne, Université Paris 13, 93000, Bobigny, France
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Tripon C, Defossez G, Ragot S, Ghazali A, Boureau-Voultoury A, Scépi M, Oriot D. Parental presence during cardiopulmonary resuscitation of children: the experience, opinions and moral positions of emergency teams in France. Arch Dis Child 2014; 99:310-5. [PMID: 24395644 DOI: 10.1136/archdischild-2013-304488] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To evaluate the experience, opinions and moral positions of French emergency physicians (EP) who had taken a paediatric university course on parental presence during child cardiopulmonary resuscitation (CPR), and to compare it with the responses of nurses on their teams. METHODS A questionnaire was sent to 550 EPs who had taken the course during the previous 6 years; the EPs were also asked to give a copy of the questionnaire to nurses on their staff. Data were collected on experience of parental presence during child CPR, opinions on the practice, arguments for and against parental presence, and the moral positions of respondents regarding their perception of life and the sharing of medical/parental power in the decision-making process. RESULTS 343 responses were analysed, 47% from EPs (29% response rate) and 53% from nurses. 52% of respondents had experienced parental presence during child CPR, but it had been the physician's wish on only 6% of these occasions. Only 17% of respondents favoured parental presence, with EPs (27%) being favourable more often than nurses (12%). The reasons against parental presence were psychological trauma for the parents, risk of interference with medical management, and care team stress. Respondents not in favour of parental presence expressed this view more for medical reasons than for parent-related reasons. The physicians not in favour of parental presence espoused a moral position predicated on medical power. CONCLUSIONS A majority of EPs and nurses were reluctant to have parents present during child CPR. Their attitude involved medical paternalism.
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Affiliation(s)
- Cédric Tripon
- Pediatric Emergency Department, University Hospital, , Poitiers, France
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Porter JE, Cooper SJ, Sellick K. Family presence during resuscitation (FPDR): Perceived benefits, barriers and enablers to implementation and practice. Int Emerg Nurs 2014; 22:69-74. [DOI: 10.1016/j.ienj.2013.07.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2013] [Revised: 07/11/2013] [Accepted: 07/14/2013] [Indexed: 11/26/2022]
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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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Place des familles pendant la réanimation cardiopulmonaire en préhospitalier. MEDECINE INTENSIVE REANIMATION 2014. [DOI: 10.1007/s13546-013-0821-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Jabre P, Belpomme V, Azoulay E, Jacob L, Bertrand L, Lapostolle F, Tazarourte K, Bouilleau G, Pinaud V, Broche C, Normand D, Baubet T, Ricard-Hibon A, Istria J, Beltramini A, Alheritiere A, Assez N, Nace L, Vivien B, Turi L, Launay S, Desmaizieres M, Borron SW, Vicaut E, Adnet F. Family presence during cardiopulmonary resuscitation. N Engl J Med 2013; 368:1008-18. [PMID: 23484827 DOI: 10.1056/nejmoa1203366] [Citation(s) in RCA: 230] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The effect of family presence during cardiopulmonary resuscitation (CPR) on the family members themselves and the medical team remains controversial. METHODS We enrolled 570 relatives of patients who were in cardiac arrest and were given CPR by 15 prehospital emergency medical service units. The units were randomly assigned either to systematically offer the family member the opportunity to observe CPR (intervention group) or to follow standard practice regarding family presence (control group). The primary end point was the proportion of relatives with post-traumatic stress disorder (PTSD)-related symptoms on day 90. Secondary end points included the presence of anxiety and depression symptoms and the effect of family presence on medical efforts at resuscitation, the well-being of the health care team, and the occurrence of medicolegal claims. RESULTS In the intervention group, 211 of 266 relatives (79%) witnessed CPR, as compared with 131 of 304 relatives (43%) in the control group. In the intention-to-treat analysis, the frequency of PTSD-related symptoms was significantly higher in the control group than in the intervention group (adjusted odds ratio, 1.7; 95% confidence interval [CI], 1.2 to 2.5; P=0.004) and among family members who did not witness CPR than among those who did (adjusted odds ratio, 1.6; 95% CI, 1.1 to 2.5; P=0.02). Relatives who did not witness CPR had symptoms of anxiety and depression more frequently than those who did witness CPR. Family-witnessed CPR did not affect resuscitation characteristics, patient survival, or the level of emotional stress in the medical team and did not result in medicolegal claims. CONCLUSIONS Family presence during CPR was associated with positive results on psychological variables and did not interfere with medical efforts, increase stress in the health care team, or result in medicolegal conflicts. (Funded by Programme Hospitalier de Recherche Clinique 2008 of the French Ministry of Health; ClinicalTrials.gov number, NCT01009606.).
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Affiliation(s)
- Patricia Jabre
- Assistance Publique-Hôpitaux de Paris (AP-HP), Service d'Aide Médicale d'Urgence (SAMU), Hôpital Avicenne, Bobigny, France
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Chapman R, Watkins R, Bushby A, Combs S. Assessing health professionals’ perceptions of family presence during resuscitation: A replication study. Int Emerg Nurs 2013; 21:17-25. [DOI: 10.1016/j.ienj.2011.10.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Revised: 09/28/2011] [Accepted: 10/04/2011] [Indexed: 10/15/2022]
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Chapman R, Watkins R, Bushby A, Combs S. Family-Witnessed Resuscitation: Perceptions of Nurses and Doctors Working in an Australian Emergency Department. ACTA ACUST UNITED AC 2012. [DOI: 10.5402/2012/369423] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Inconsistencies abound in the literature regarding staff attitudes and perceptions toward family-witnessed resuscitation. Our study builds on previous research by using a validated tool to investigate emergency department staff perceptions of family-witnessed resuscitation. A cross-sectional survey was distributed to 221 emergency department doctors' and nurses'. We found few differences between doctors and nurses perceptions toward family-witnessed resuscitation. Both nurses and doctors who held a specialty certification, who were more highly qualified, who had more experience with family presence during resuscitation, and who had a personal preference for having family members present during their own resuscitation perceived more benefits and fewer risks, as well as more confidence in their ability to manage these events. However, nurses more than doctors want patients to provide advanced directives for family presence. The findings will enable clinicians, educators, and hospital management to provide better support to all stakeholders through these events.
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Affiliation(s)
- Rose Chapman
- School of Nursing and Midwifery, Curtin University, GPO Box U1987, Perth, WA 6845, Australia
- Nursing Executive, Joondalup Health Campus, Shenton Avenue, Joondalup, WA 6027, Australia
| | - Rochelle Watkins
- Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, P.O. Box 855, West Perth, WA 6872, Australia
| | - Angela Bushby
- Department of Emergency, Joondalup Health Campus, Shenton Avenue, Joondalup, WA 6027, Australia
| | - Shane Combs
- Nursing Executive, Joondalup Health Campus, Shenton Avenue, Joondalup, WA 6027, Australia
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