Presentation on theme: "FAMILY PRESENCE DURING RESUSCITATION IRB 014-138 Pamela Green, APRN, MSN, FNP-C, DNP-S Baylor Medical Center at Carrollton."— Presentation transcript:
FAMILY PRESENCE DURING RESUSCITATION IRB 014-138 Pamela Green, APRN, MSN, FNP-C, DNP-S Baylor Medical Center at Carrollton
Family Presence during Resuscitation Purpose Statement: To determine if awareness of the benefits of and guidelines for family presence in the resuscitation room has a positive impact on physician opinion. Although CPR forecasts likely poor outcome, less than five percent of acute care facilities across the United States have policies and protocols to allow for family presence in the resuscitation room. (MacLean et al., 2003)
Healthcare Provider Perception Family presence would interfere with resuscitation efforts. Resuscitation event would be too stressful for family members. Provider stress and performance anxiety when family present. Provider fear of increased litigation.
Guidelines and Position Statements Emergency Nurses Association (ENA) guidelines recommend family members be included during invasive procedures and resuscitation (Emergency Nurses Association [ENA], 2012). The American Heart Association recommended family members be offered the opportunity to be present during resuscitation. (American Heart Association [AHA], 2000) American Association of Critical Care Nurses practice alert in 2010 stated all family members should be given the option of family presence during resuscitation (American Association of Critical Care Nurses [AACN], 2010)
Evidence: Delay in Care No significance difference identified in the number of shocks delivered with family present and appropriate protocol in place versus no family presence No significant difference identified in the minutes to first defibrillation shock with family present and appropriate protocol in place versus no family presence ( Fernandez, R., Compton, S., Jones, K. A. & Velilla, M. A. (2009). The presence of a family witness impacts physician performance during simulated medical codes. Critical Care Medicine, 37:6, 1956-1960)
Evidence: Family Stress No studies indicated decrease in family member satisfaction or increase in stress when present during resuscitation. Many expressed they not only wanted to be present, but felt it was their right. (Tinsley et al., 2008; Mortelmans et al., 2009; Piira, Sugiura, Champion, Donnelly, & Cole, 2005; Dingeman, Mitchell, Meyer, & Curley, 2007; Dudley et al., 2009; McGahey-Oakland, Lieder, Young, & Jefferson, 2007) Family presence creates transparency. Family members who had witnessed a resuscitation event felt everything had been attempted to save their loved one. (McGahey-Oakland et al., 2007; Tinsley et al., 2008; Emergency Nurses Association [ENA], 2007)
Evidence: Provider Stress Providers in the emergency and critical care areas revealed providers were 82% in favor of family presence during resuscitation. (Demir, 2008) Healthcare providers identify family presence allows the family the opportunity to say goodbye when resuscitation efforts are unsuccessful, promotes family acceptance of their loved one’s death, and facilitates grieving. (Dingeman et al., 2007; Demir, 2008; McClement, Fallis, & Pereira, 2009; Walker, 2008).
Evidence: Litigation No evidence to support providers fear of increased litigation when family members are present in the resuscitation room. (Walker, 2008; Madden & Condon, 2007; McClement et al., 2009; Dingeman et al., 2007; Demir, 2008; Fernandez et al., 2009)
Consumer Opinion Family members perceive the experience to have a positive effect on grieving and adjusting to loss. (Doyle et al., 1987; Meyers et al., 2000; Meyers, Eichhorn, & Guzzetta, 1998) Of those survivors, all were content with family presence during resuscitation. (Robinson, Mackenzie-Ross, Hewson, Egleston, & Prevost, 1998). Hospitalized patients with life threatening illness indicated they would prefer family to be present during CPR. (Mortelmans et al., 2009).
Next Steps Baylor Health Care System, like most other acute care facilities, does not have policies in place to support family presence during resuscitation. (MacLean et al., 2003) Three studies indicated hospital policy surrounding family presence would have a positive impact on provider attitude regarding family presence during resuscitation. (Basol et al., 2009; Madden & Condon, 2007; Howlett, Alexander, & Tsuchiya, 2010) ENA recommends that institutional policy should be written to support the recommendation of family presence during resuscitation. (Emergency Nurses Association [ENA], 2012)
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