Family presence during cardiopulmonary resuscitation: Using evidence-based knowledge to guide the advanced practice nurse in developing formal policy and practice guidelines

Abstract

With this evidence-based knowledge the APN will be able to disseminate information to facilitate collaborative change in current practices surrounding staff education, decision making, and self-governance. The APN can then address controversial changes when developing formal policies and procedures, which will increase patient satisfaction and outcomes.

Nurses’ Perceptions of Family Presence during Resuscitation

“…Survey results and guidelines provided by the American Association of Critical-Care Nurses were considered in updating existing policy on FPDR within the health care system. A primary barrier to FPDR, identified in our study, and in other research, [4][5][6] was fear of interference by a family member during resuscitation and a need for someone to attend to the family. Although chaplains already responded to codes and were able to tend to and be responsible for a patient's family members during resuscitation events, chaplains were not always available, especially at night.…”

“…In addition, FPDR helps a patient's family members understand that everything possible was done for their loved one. The review 4 indicated that families thought that FPDR was their right and that they were more at ease when able to view resuscitation efforts firsthand. Family members reported that FPDR provided closure and helped in the grieving process.…”

“…These barriers include fear that a patient's family might interfere with the patient's care, care providers' performance anxiety, lack of support for family members, fear of emotional trauma to family members, and fear of lawsuits. [4][5][6] Nurses have acknowledged that caring for patients' families during and after resuscitation events is part of a nurse's duty, but the event was emotionally challenging and the nurses felt unprepared. 7 Like the Emergency Nurses Association, the American Association of Critical-Care Nurses recommends that health care organizations have an approved written policy for presenting the option of FPDR, although only 5% of nurses surveyed reported having such written policies.…”

“…A position statement 3 of the Emergency Nurses Association on family presence during invasive procedures and resuscitation in the emergency department states that FPDR should be offered to appropriate family members as an option and should be based on institutional policy. Doolin et al 4 reviewed 38 articles on attitudes and beliefs of health care providers, patients' families, and patients regarding FPDR. The findings revealed that FPDR does not adversely affect communication between members of the health care team, does not interfere with decision making or care, promotes a more professional atmosphere, and upholds the dignity of the patient.…”

Being There: Inpatients' Perceptions of Family Presence During Resuscitation and Invasive Cardiac Procedures

“…29,30 The family facilitator role holds much promise for reducing (a) the risk of families getting in the way, (b) patients' anxiety about families' responses, and (c) families' misunderstanding of events. 28,46 The AACN Practice Alert 28 also recommends the formation of institutional policies and procedures in support of family presence (Table 3). Patients' preferences for family presence might be different and concerns might be fewer if this study were replicated at a site where family facilitators and policies are in place.…”