Nurses’ Perceptions of Family Presence during Resuscitation

Abstract

Background 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. Objectives 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. Methods 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. Results Nurses' self-confidence and perceived benefit of family presence were significantly related (r = 0.54; P < .001). Self-confidence was significantly greater in nurses who had completed training in Advanced Cardiac Life Support, had experienced 10 or more resuscitation events, were specialty certified, or were members of nurses' professional organizations. Barriers to family presence included fear of interference by the patient's family, lack of space, lack of support for the family members, fear of trauma to family members, and performance anxiety. Conclusions Changing the practice of family presence will require strengthening current policy, identifying a team member to attend to the patient's family during resuscitation, and requiring nurses to complete education on evidence that supports family presence and changes in clinical practice. (American Journal of Critical Care. 2014;23:e88-e96)

Family Presence During Resuscitation: Impact of Online Learning on Nurses’ Perception and Self-confidence

“…Yet, recent research continues to demonstrate unfavorable or mixed views of FPDR (9) 32 (94) 0 (0) 1 (3) 2 (6) 1 (3) 1 (3) 0 (0) 12 (35) 6 (18) 8 (24) 7 (21) 1 (3) 3 (9) 3 (9) 18 (53) 9 (26) 1 (3) 1 (3) 3 (9) 11 (32) 4 (12) 3 (9) 12 (35) 24 (71) 0 (0) 9 (26) 1 (3) 0 (0) 22 (65) 11 (32) 1 (3) 32 (94) 2 (6) 0 (0) 38 (95) 2 (5) 34 (85) 3 (8) 2 (5) 1 (2) 0 (0) 1 (2) 0 (0) 8 (20) 9 (22) 11 (28) 11 (28) 1 (3) 1 (2) 12 (30) 18 (45) 8 (21) 1 (2) 0 ( www.ajcconline.org among nurses. 2,26 Consequently, the need for creation of policies and programs and an increase in education 1,29,44,45 to facilitate acceptance and implementation of FPDR continues to be emphasized. Yet, among our total sample of critical care nurses who are frequently exposed to resuscitative care, we found that only 29.7% worked in a facility or unit that had an FPDR policy and only 41.9% had received any prior education on FPDR.…”

“…25 Research has repeatedly shown that nurses are not uniformly supportive of FPDR with adult patients, 2,26-28 and thus FPDR is not commonly implemented at the bedside. In fact, only approximately one-third of nurses from across practice settings implement FPDR in their bedside care, 2,27,28 and recent research suggests an even lower implementation rate in critical care, 26 despite frequent opportunities for implementation owing to the fact that 45% of in-hospital cardiac arrests occur in a critical care setting. 17 Without nursing support, it is highly likely that FPDR will not be implemented and family-centered care will not be upheld.…”

“…2,28 Commonly cited risks include potential for interference with patient care, emotional distress and psychological trauma of the family, and increased risk for litigation. 1,21,22,29 Research has disproven these perceived risks, yet nurses' negative perceptions persist and are viewed as an obstacle to support and implementation of FPDR.…”

“…It is a shift from the traditional practice norm of separating families during resuscitative care and aims to promote family-centered care during acute health crises. 1,2 FPDR is supported by 94% to 100% of patients' family members, [3][4][5] and patients and their family members view FPDR as their right. 6 FPDR is also supported by multiple professional nursing and interdisciplinary organizations.…”

Recent Advances in Multidisciplinary Critical Care

“…Although the evidence for its positive effects on patients' families continues to increase, the practice is still under debate and its implementation remains inconsistent. 102,103 Using a 63-item survey, Tudor et al 104 conducted a monocentric study among a convenience sample of 154 nurses working in both inpatient and outpatient units to explore their experiences with resuscitation, perceptions of benefits and risks of family presence, and self-confidence in family presence at the workplace. The latter was significantly related (P < .001) to the perceived benefits, and was significantly greater in participants who had completed an advanced training program, were highly experienced in resuscitation, specialty certified, or a member of a professional organization.…”