Family Presence During Invasive Procedures in the Pediatric Intensive Care Unit

Powers, Karen S.; Rubenstein, Jeffrey S.

doi:10.1001/archpedi.153.9.955

Cited by 120 publications

(59 citation statements)

References 4 publications

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“…9,15 Presence was acknowledged as being beneficial to parents, patients, and health care providers. 9,[14][15][16][17] Many parents who were not present wished to be, or at least wished to be given the option. 9,15,16 Parents were more satisfied with care if they were present with their child.…”

Section: Discussionmentioning

confidence: 99%

“…They expressed desires to repeat their choice to be present and would recommend being present to others, also suggesting satisfaction. 9,14,16,17 Of note, significantly more parents who were present would not have changed anything about the presence experience compared with parents who were not present. 16 In addition, coping was noted to be much better when parents were present, especially if the child died.…”

Section: Discussionmentioning

confidence: 99%

“…Parents also commented that being present was beneficial for them, 14,15,17 specifically noting that physical contact with their child was valuable. 9,16,17 Additionally, 81% of parents felt that their presence was beneficial to the medical staff.…”

Section: Methodsmentioning

confidence: 99%

“…If given the option, 94% of parents would choose to be present again for invasive procedures 14 and 100% would choose to be present again for resuscitation. 17 Parents would also recommend presence to others.…”

Section: Satisfactionmentioning

confidence: 99%

See 3 more Smart Citations

Family Presence During Resuscitation and Invasive Procedures in Pediatric Critical Care: A Systematic Review

McAlvin¹,

Carew-Lyons²

2014

American Journal of Critical Care

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Satisfactionmentioning

confidence: 99%

See 2 more Smart Citations

Family Presence During Resuscitation and Invasive Procedures in Pediatric Critical Care: A Systematic Review

McAlvin¹,

Carew-Lyons²

2014

American Journal of Critical Care

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“…[11][12][13] Recent reviews and studies promote providing the option of parental presence even for very invasive procedures. [14][15][16][17] Yet, some parents may not be emotionally capable of remaining present for certain procedures and should not be forced to stay. 17 Health care workers must be prepared to initiate discussions regarding parental presence for pediatric procedures.…”

mentioning

confidence: 99%

Ethnic Differences in Parent Preference to Be Present for Painful Medical Procedures

2005

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ABSTRACT. Objective. To examine ethnic differences between white, black, and Hispanic (Englishspeaking and Spanish-speaking) parents in their desire to remain present during their children's painful medical procedures.Methods. A convenience sample of parents from each of 4 ethnic groups (black, white, and Hispanic [divided into English-speaking Hispanic and Spanish-speaking Hispanic]) was surveyed regarding their preferences for remaining present for 5 hypothetical painful procedures: venipuncture, laceration repair, lumbar puncture, fracture reduction, and critical resuscitation. For each procedure, a short description of the procedure was read to the parent, and a picture of the procedure was shown. The effect of ethnicity on parental desire to stay was examined by using the 2 test and multivariate logistic regression.Results. Complete data on 300 parents, 72 to 79 from each ethnic group, were obtained. There were no significant demographic differences between groups except that English-speaking Hispanic parents were younger, and black parents were relatively well educated, whereas Spanish-speaking Hispanic parents were relatively less well educated. Overall, the percentages of those who would wish to remain with their child during the procedures were 94% (venipuncture), 88% (laceration repair), 81% (lumbar puncture), 81% (fracture reduction), and 81% (critical resuscitation). The only significant ethnic difference was that English-speaking Hispanic parents were less likely to want to remain present during a critical resuscitation (P ‫؍‬ .01). Black parents were less likely, and English-speaking Hispanic parents were more likely, to want physicians to decide for them whether they should remain present. Parents generally preferred to actively participate during the procedure by coaching and soothing their child rather than to just observe.Conclusions. We found few ethnic differences in parents' desire to be present during their child's painful medical procedures. Overall, the vast majority of parents would prefer to remain present even for highly invasive procedures. Pediatrics 2005;116:e191-e197. URL: www. pediatrics.org/cgi

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Family Presence During Pediatric Tracheal Intubations

Sanders¹,

Nett²,

Davis³

et al. 2016

JAMA Pediatr

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IMPORTANCE Family-centered care, which supports family presence (FP) during procedures, is now a widely accepted standard at health care facilities that care for children. However, there is a paucity of data regarding the practice of FP during tracheal intubation (TI) in pediatric intensive care units (PICUs). Family presence during procedures in PICUs has been advocated.OBJECTIVE To describe the current practice of FP during TI and evaluate the association with procedural and clinician (including physician, respiratory therapist, and nurse practitioner) outcomes across multiple PICUs. DESIGN, SETTING, AND PARTICIPANTS Prospective cohort study in which all TIs from July 2010 to March 2014 in the multicenter TI database (National Emergency Airway Registry for Children [NEAR4KIDS]) were analyzed. Family presence was defined as a family member present during TI. This study included all TIs in patients younger than 18 years in 22 international PICUs.EXPOSURES Family presence and no FP during TI in the PICU. MAIN OUTCOMES AND MEASURESThe percentage of FP during TIs. First attempt success rate, adverse TI-associated events, multiple attempts (Ն3), oxygen desaturation (oxygen saturation as measured by pulse oximetry <80%), and self-reported team stress level.RESULTS A total of 4969 TI encounters were reported. Among those, 81% (n = 4030) of TIs had documented FP status (with/without). The median age of participants with FP was 2 years and 1 year for those without FP. The average percentage of TIs with FP was 19% and varied widely across sites (0%-43%; P < .001). Tracheal intubations with FP (vs without FP) were associated with older patients (median, 2 years vs 1 year; P = .04), lower Paediatric Index of Mortality 2 score, and pediatric resident as the first airway clinician (23%, n = 179 vs 18%, n = 584; odds ratio [OR], 1.4; 95% CI, 1.2-1.7). Tracheal intubations with FP and without FP were no different in the first attempt success rate (OR, 1.00; 95% CI, 0.85-1.18), adverse TI-associated events (any events: OR, 1.06; 95% CI, 0.85-1.30 and severe events: OR, 1.04; 95% CI, 0.75-1.43), multiple attempts (Ն3) (OR, 1.03; 95% CI, 0.82-1.28), oxygen desaturation (oxygen saturation <80%) (OR, 0.97; 95% CI, 0.80-1.18), or self-reported team stress level (OR, 1.09; 95% CI, 0.92-1.31). This result persisted after adjusting for patient and clinician confounders.CONCLUSIONS AND RELEVANCE Wide variability exists in FP during TIs across PICUs. Family presence was not associated with first attempt success, adverse TI-associated events, oxygen desaturation (<80%), or higher team stress level. Our data suggest that FP during TI can safely be implemented as part of a family-centered care model in the PICU.

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Family Presence During Invasive Procedures in the Pediatric Intensive Care Unit

Cited by 120 publications

References 4 publications

Family Presence During Resuscitation and Invasive Procedures in Pediatric Critical Care: A Systematic Review

Family Presence During Resuscitation and Invasive Procedures in Pediatric Critical Care: A Systematic Review

Ethnic Differences in Parent Preference to Be Present for Painful Medical Procedures

Family Presence During Pediatric Tracheal Intubations

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