Family presence during resuscitation: attitudes of Yale-New Haven Hospital staff (original) (raw)
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Health Care Providers' Evaluations of Family Presence During Resuscitation
Journal of Emergency Nursing, 2010
Introduction: The benefits of family presence (FP) during resuscitation are well documented in the literature, and it is becoming an accepted practice in many hospitals. There is sufficient evidence about health care provider (HCP) and family attitudes and beliefs about FP and little about the actual outcomes after family witnessed resuscitation. The purpose of this study was to evaluate FP at resuscitations. Methods: A descriptive design was used to collect data at an academic medical center in the western U.S. There were 106 resuscitations during the study period. Family presence was documented on 31 (29%) records. One hundred and seventy-four health care provider names were listed on the resuscitation records, and 40 names (23%) were illegible or incomplete. The convenience sample of 134 HCPs was invited to complete an electronic survey and 65 (49%) responded. Results: Respondents indicated that family members were able to emotionally tolerate the situation (59%), did not interfere with the care being provided to the patient (88%). In addition, team communication was not negatively affected (88%). A family facilitator was present 70% of the time, and it was usually a registered nurse (41%). Twenty-one narrative comments were summarized to reflect the following themes: 1) family presence is beneficial; 2) family presence is emotional; 3) a family facilitator is necessary. Discussion: These study findings demonstrate that having families present during resuscitations does not negatively impact patient care, is perceived to benefit family members and that a dedicated family facilitator is an integral part of the process.
Health Care Providers' Attitudes Regarding Family Presence During Resuscitation of Adults
Clinical Nurse Specialist, 2010
P urpose: Family presence (FP) during resuscitation is a controversial practice that leads to disagreement among health care professionals. A systematic review of the literature was performed to answer the question: What are the attitudes of health care providers regarding family presence during resuscitation of adults? Methods: MEDLINE, PubMed, and CINAHL databases were searched using the following terms: family, family presence, family witnessed, cardiopulmonary resuscitation, nurses, personnel, patient, attitudes, attitude of health personnel, and ethics. Criteria for inclusion consisted of research studies addressing health care providers' attitudes toward family presence during adult resuscitation conducted in the United States that were published between 1998 and 2008. Results: The literature search produced 480 titles. Thirteen full-text articles met criteria for inclusion in the evidence tables. Findings of this integrated literature indicate that: between and within discipline differences in attitudes, perceived burden on staff, perceived effects on family, lack of medical knowledge of family, and existence of a hospital policy influence provider attitudes toward FP. Conclusions and Implications: More research is needed to determine if FP is evidence based; however, there is sufficient evidence to consider implementing FP. There is wide variation in support for FP among health care professionals, although nurses generally are more favorable. If an institution elects to implement an FP policy or evidence-based practice guideline, it must carefully consider the many provider, patient, family, and system-level factors that can hinder or promote the success of this initiative.
Attitudes of emergency department staff toward family presence during resuscitation
The Israel Medical Association journal : IMAJ, 2010
BACKGROUND While family presence during resuscitation has been researched extensively in the international and especially American medical literature, in Israel this subject has rarely been researched. Because such policies have become common practice in many countries, it is important to investigate the attitudes of health care staff in Israeli emergency departments to better understand the potential implication of adopting such policies. OBJECTIVES To examine the attitudes of the physicians and nurses in the ED of Soroka Medical Center to FPDR. METHODS The methods we used were both qualitative (partly structured open interviews of 10 ED staff members from various medical professions) and quantitative (an anonymous questionnaire that collected sociodemographic, professional, and attitude data). RESULTS The qualitative and quantitative results showed that most staff members opposed FPDR. The main reasons for objecting to FPDR were concern about family criticism, the added pressure t...
Australasian Emergency Nursing Journal, 2008
Background: In March 2007 part of a staff attitudes to Family Presence during resuscitation project were presented as part of a 3-year research project examining the relatives and staff attitudes to family presence during resuscitation (Holzhauser K, Finucane J, De Vries SM. Family presence during resuscitation: a randomised controlled trial of the impact of family presence. Australas Emerg Nurs J 2006;8(4):139-147). This article presents the results of staff attitudes immediately post-resuscitation.
Nurses' perceptions of family presence during resuscitation
American journal of critical care : an official publication, American Association of Critical-Care Nurses, 2014
Although strong evidence indicates that the presence of a patient's family during resuscitation has a positive effect on the family, the practice is still controversial and is not consistently implemented. To explore nurses' experience with resuscitation, perceptions of the benefits and risks of having a patient's family members present, and self-confidence in having family presence at their workplace. Differences in demographic characteristics and relationships between nurses' perceptions of self-confidence and perceived risks and benefits of family presence were evaluated. The study was descriptive, with a cross-sectional survey design. A convenience sample of 154 nurses working in inpatient and outpatient units at an urban hospital were surveyed. The 63-item survey included 2 previously validated scales, demographic questions, and opinion questions. Nurses' self-confidence and perceived benefit of family presence were significantly related (r = 0.54; P < .0...
Family presence during resuscitation: a critical review of the literature
American journal of critical care : an official publication, American Association of Critical-Care Nurses, 2005
Presence of patients' families during resuscitation has emerged as an important practice issue, sparking considerable controversy worldwide. Early advocates of allowing patients' families to be present during resuscitation faced more resistance than did current advocates because the former had little or no scientific research results to support their ideas. In the past 15 years, a number of quantitative studies, especially descriptive surveys, have been conducted. Qualitative researchers have also explored the lived experience of family members present during resuscitation and less commonly the perspectives of patients and health care providers. In this review of the literature, the current state of the science is critically reviewed and the ethical-theoretical perspectives of respective researchers and staff participants in the reviewed studies are discussed. Surveys were used to collect data in most studies to date. Limitations of these designs include small convenience sa...
Understanding Health Care Professionals' Views of Family Presence During Pediatric Resuscitation
American Journal of Critical Care, 2011
Objective To examine the conflicting perceptions that health care professionals hold regarding family presence during pediatric resuscitation. Methods In phase 1, 137 health care professionals completed a 23-item questionnaire about their views on family presence and their perceptions of their opponents' views on family presence. In phase 2, 12 phase 1 respondents were interviewed about the effects that family presence may have on patients' families and on trauma teams. Results All respondents indicated that legal concerns and risks were important factors during family presence; however, respondents in favor of family presence believed that legal concerns and risks were minimized when patients' families were present whereas respondents who were opposed believed the opposite. Respondents who were opposed assumed that respondents who were in favor of family presence were less sympathetic and concerned about families, trauma teams, and health care providers; respondents in favor of family presence assumed that respondents who were opposed were overly preoccupied with legal concerns and potential risks involved with family presence during pediatric resuscitations. All respondents believed that patients' families and trauma teams are affected by family presence. Specifically, respondents in favor of family presence believed that families and trauma team members are positively affected whereas opponents believed the opposite. Conclusions These findings provide a deeper understanding of the views of health care professionals and how these views might affect the delivery of family-centered care.
Family Presence During Resuscitation: A Double-Edged Sword
Purpose: To illuminate the meaning of the lived experiences of resuscitation team members with the presence of the patient's family during resuscitation in the cultural context of Iran. Design: An interpretative phenomenology was used to discover the lived experiences of the nurses and physicians of Tabriz hospitals, Iran, with family presence during resuscitation (FPDR). A total of 12 nurses and 9 physicians were interviewed over a 6-month period. Methods: The interviews were audio recorded and semistructured, and were transcribed verbatim. Van Manen's technique was used for data analysis. Findings: Two major themes and 10 subthemes emerged, including destructive presence (cessation of resuscitation, interference in resuscitation, disruption to the resuscitation team's focus, argument with the resuscitation team, and adverse mental image in the family) and supportive presence (trust in the resuscitation team, collaboration with the resuscitation team, alleviating the family's concern and settling their nerves, increasing the family's satisfaction, and reducing conflict with resuscitation team members). Conclusions: Participants stated that FPDR may work as a double-edged sword for the family and resuscitation team, hurting or preserving quality. It is thus recommended that guidelines be created to protect patients' and families' rights, while considering the positive aspects of the phenomenon for hospitals. Clinical Relevance: A liaison support person would act to decrease family anxiety levels and would be able to de-escalate any potentially aggressive or confrontational events during resuscitation. Well-trained and expert car-diopulmonary resuscitation team members do not have any stress in the presence of family during resuscitation. Resuscitation events tend to be prolonged when family members are allowed to be present.