Impact of family presence during cardiopulmonary resuscitation on team performance and perceived task load: a prospective randomised simulator-based trial

Willmes, Mareike; Sellmann, Timur; Semmer, Norbert K.; Tschan, Franziska; Wetzchewald, Dietmar; Schwager, Heidrun; Russo, Sebastian G.; Marsch, Stephan

doi:10.1136/bmjopen-2021-056798

Cited by 9 publications

(11 citation statements)

References 39 publications

(55 reference statements)

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“…Almost two-thirds of the participants (65%) revealed that the presence of family would negatively affect the performance of the resuscitation team. In reality, it was discovered that the attitudes of healthcare professionals varied greatly with between 15-85% in favor of FPDR [21]. The difference between the present study and that conducted by Al-Mutair et al could be attributed to variation in the demographic characteristics of the participants; we included consultants, the majority of whom were men whereas the Al-Mutair study included nurses, mostly women.…”

Section: Discussionmentioning

confidence: 60%

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The attitudes of Emergency Department consultants toward family presence during resuscitation

Aljohani¹,

Binmuhainy²,

Aljarbou³

et al. 2022

IJASR

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Objectives: We assessed the attitudes of emergency department (ED) consultants toward family presence during resuscitation (FPDR), to elucidate and provide proof of the benefits of allowing FPDR in Kingdom of Saudi Arabia. Methods: A cross-sectional descriptive study using a questionnaire electronically sent to all ED consultants from five major government hospitals in Riyadh, Saudi Arabia. The survey examined the consultants' beliefs and perception of FPDR, legalities, policies and the effects and outcomes of FPDR on the patient, family, and themselves. Results: The survey received 172 responses, 55.0% were 36â€“45 years old and 144 (83.7%) were men. Most respondents (91.36%) had experienced FPDR. Less than half (40.1%) believed that FPDR is beneficial to the patient, and 58.7% believed that FPDR could cause difficulties for the resuscitation team. A written policy for FPDR was preferred by 42% of respondents. Significantly more respondents 36-45 years old recommend allowing FPDR compared to other age groups, and significantly more male consultants in this age group believe there is a positive outcome of FPDR. Conclusion: The attitude and perception of emergency consultants towards the practice of FPDR was less positive than expected. Many consultants did not favor the advantages of FPDR, and were worried about negative outcomes, potential medico-legal repercussions, and the unpleasant experience for the family members, especially female consultants. However, a larger proportion of consultants nevertheless recommend FPDR. The ability of ED doctors to manage FPDR and their understanding of the benefits of FPDR needs to be strengthened.

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Section: Discussionmentioning

confidence: 60%

“…The research also discovered that while there was no apparent detrimental impact on the standard of CPR, FPDR was linked to an increase in frustration and perceived temporal and mental demands [20]. Another recent study revealed that, especially in pediatric situations, parents and family members desire the opportunity to be present [21].…”

Section: Discussionmentioning

confidence: 99%

The attitudes of Emergency Department consultants toward family presence during resuscitation

Aljohani¹,

Binmuhainy²,

Aljarbou³

et al. 2022

IJASR

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“…It seems that FPDR does not affect adult resuscitation outcomes 59 or increase stress levels of HCP during FPDR 60,61 . However, simulation studies of student nurses and physicians indicate that FPDR may negatively impact the quality of acute medical care 41,42,59 . In a simulation study with paramedics, it was observed that the presence of socioemotional stress, in this case from the presence of an upset friend, increased the subjective workload and frustration of HCP 62 .…”

Section: Discussionmentioning

confidence: 97%

“…Elevated stress levels may impede performance on tasks which requires divided attention, working memory, retrieval of information from memory, and decision making 58 . It seems that FPDR does not affect adult resuscitation outcomes 59 or increase stress levels of HCP during FPDR 60,61 . However, simulation studies of student nurses and physicians indicate that FPDR may negatively impact the quality of acute medical care 41,42,59 .…”

Section: Discussionmentioning

confidence: 99%

The healthcare professionals' perspectives and experiences with family presence during resuscitation: A qualitative evidence synthesis

Rubin,

Meulengracht,

Frederiksen

et al. 2023

Acta Anaesthesiol Scand

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IntroductionFamily presence during resuscitation (FPDR) is a growing hospital praxis despite lack of high‐quality evidence. The aim of this qualitative evidence synthesis review was to synthesize current evidence regarding healthcare professionals (HCP) perspectives on barriers and facilitating factors of FPDR and the potential impact of FPDR on HCP performance.MethodsWe conducted a systematic literature search May 17, 2023 including primary studies with qualitative study designs. We applied NVivo for data analysis. Data was coded with line‐by‐line coding and organized into themes and categories following the method for thematic synthesis described by Thomas and Harden to analyse data. The studies underwent quality appraisal by Critical Appraisal Skills Program. We used GRADE CERQual to assess the confidence in the evidence.ResultsWe identified 8241 articles suitable for screening, 141 articles were full text screened, and nine studies included from Australia, UK and USA. In total, 134 HCP participated, between 2005 and 2019. Most studies lacked sufficiently rigorous data analysis and findings were appraised to have moderate GRADE CERQual confidence.We identified three analytical themes (“Facilitating factors for FPDR”, “Barriers for FPDR” and “How staff are affected by FPDR”) with eight descriptive subthemes. One finding was of high GRADE CERQual confidence: a belief that FPDR is “the right thing to do” which was a “Facilitating factor of FPDR.”ConclusionThe evidence on HCP perspectives is of low to moderate confidence. The interviewed consent that FPDR is the “right thing to do”, and an ethical principle of beneficence is dominant, especially regarding children.

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“…This is a prospective comparative trial of two cohorts: during the pandemic years 2020 and 2021, all participants of our workshops performed CPR with PPE (PPE group), while a cohort of participants of pre-pandemic workshops of 2016 to 2019 [ 23 , 24 , 25 ] served as the control group. Apart from the need to wear PPE, the conditions and settings for both cohorts were identical.…”

Section: Methodsmentioning

confidence: 99%

COVID-19 CPR—Impact of Personal Protective Equipment during a Simulated Cardiac Arrest in Times of the COVID-19 Pandemic: A Prospective Comparative Trial

Sellmann

Nur

Wetzchewald

et al. 2022

JCM

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Background: Guidelines of cardiopulmonary resuscitation (CPR) recommend the use of personal protective equipment (PPE) during the resuscitation of COVID-19 patients. Data on the effects of PPE on rescuers’ stress level and quality of CPR are sparse and conflicting. This trial investigated the effects of PPE on team performance in simulated cardiac arrests. Methods: During the pandemic period, 198 teams (689 participants) performed CPR with PPE in simulated cardiac arrests (PPE group) and were compared with 423 (1451 participants) performing in identical scenarios in the pre-pandemic period (control group). Video recordings were used for data analysis. The primary endpoint was hands-on time. Secondary endpoints included a further performance of CPR and the perceived task load assessed by the NASA task-load index. Results: Hands-on times were lower in PPE teams than in the control group (86% (83–89) vs. 90% (87–93); difference 3, 95% CI for difference 3–4, p < 0.0001). Moreover, PPE teams made fewer change-overs and delayed defibrillation and administration of drugs. PPE teams perceived higher task loads (57 (44–67) vs. 63 (53–71); difference 6, 95% CI for difference 5–8, p < 0.0001) and scored higher in the domains physical and temporal demand, performance, and effort. Leadership allocation had no effect on primary and secondary endpoints. Conclusions: Having to wear PPE during CPR is an additional burden in an already demanding task. PPE is associated with an increase in perceived task load, lower hands-on times, fewer change-overs, and delays in defibrillation and the administration of drugs. (German study register number DRKS00023184).

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Impact of family presence during cardiopulmonary resuscitation on team performance and perceived task load: a prospective randomised simulator-based trial

Cited by 9 publications

References 39 publications

The attitudes of Emergency Department consultants toward family presence during resuscitation

The attitudes of Emergency Department consultants toward family presence during resuscitation

The healthcare professionals' perspectives and experiences with family presence during resuscitation: A qualitative evidence synthesis

COVID-19 CPR—Impact of Personal Protective Equipment during a Simulated Cardiac Arrest in Times of the COVID-19 Pandemic: A Prospective Comparative Trial

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