Should Parents Be Present during Emergency Department Procedures on Children, and Who Should Make That Decision? A Survey of Emergency Physician and Nurse Attitudes

Beckman, Andrew; Sloan, Brian K.; Moore, Gregory P.; Cordell, William H.; Brizendine, Edward J.; Boie, Eric T.; Knoop, Kevin J.; Goldman, Michael A.; Geninatti, Marilyn

doi:10.1111/j.1553-2712.2002.tb00234.x

Cited by 57 publications

(33 citation statements)

References 6 publications

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“…It has been noted that as procedures become more invasive, both physicians and nurses are less likely to allow parent presence. 10 Fewer than half of nurses and physicians support parent presence during resuscitation; however, nurses were more likely to support parent presence than were physicians. 10 Education of the health care team may help providers to understand the benefits of family presence as well as the detrimental effects to parents if they are not present.…”

Section: Being Present Coping Satisfactionmentioning

confidence: 99%

“…10 Fewer than half of nurses and physicians support parent presence during resuscitation; however, nurses were more likely to support parent presence than were physicians. 10 Education of the health care team may help providers to understand the benefits of family presence as well as the detrimental effects to parents if they are not present. In a survey done after the implementation of a presence policy, clinicians reported greater comfort with providing the option for parents to be present during invasive procedures and resuscitation.…”

Section: Being Present Coping Satisfactionmentioning

confidence: 99%

“…2,[7][8][9] Nurses have been noted to oppose parent presence to a lesser extent than their physician colleagues. 10 Family members experience a great deal of stress and anxiety while their child is hospitalized in critical condition. Signs and symptoms of acute stress disorder are prevalent in parents of children who are hospitalized in the intensive care unit 11 and are strong predictors of future symptoms of posttraumatic stress disorder.…”

mentioning

confidence: 99%

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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: Being Present Coping Satisfactionmentioning

confidence: 99%

Section: Being Present Coping Satisfactionmentioning

confidence: 99%

mentioning

confidence: 99%

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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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“…Physicians at other children's hospitals seem to share these views: a survey of 10 pediatric EDs revealed that Ͼ90% of the respondents believed that parents should be present during a peripheral IV start. 8 The ED staff at our hospital observed that children Ͻ2 years of age were less likely to receive a local anesthetic; feedback from nurses in the department indicated that underuse in this age group was based on the belief that a local anesthetic makes the procedure more difficult. A review of the literature showed that subcutaneous lidocaine infiltration does not affect the success of IV access in this age group.…”

Section: Eliminating Road Blocks and Expanding The Programmentioning

confidence: 99%

On the Front Lines: Lessons Learned in Implementing Multidisciplinary Peripheral Venous Access Pain-Management Programs in Pediatric Hospitals

et al. 2008

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Venipuncture and intravenous cannulation are among the most common and widespread medical procedures performed on children today. Therefore, effective treatment of venous access pain can benefit from an integrated systems approach that enlists multiple players in the health care system. By using case studies that analyze this issue from the perspective of the nurse, the physician, the pharmacist, and the child life specialist, this article illustrates how multidisciplinary programs designed to manage needle pain have been developed successfully in several institutions. Common themes that arise from these case studies include the importance of a multidisciplinary evidence-based approach to advocate change; a system-wide protocol for the administration of local anesthetics; convenient access to topical local anesthetics; department and hospital-wide support for educational efforts, including training in nonpharmacologic techniques used by child life specialists; and ongoing quantification of the overall success of any program. Implementation of these strategies can result in significant improvements in the pediatric venous access experience. Pediatrics 2008;122:S161-S170 A TTITUDES ON PREVENTING procedural pain in children are changing as medical centers seek to comply with recent policy statements and clinical guidelines. The American Academy of Pediatrics and the American Pain Society recommend that efforts to soothe and minimize pediatric distress be considered even for minor procedures such as venipunctures. 1 A recent publication by the International Association for the Study of Pain cited humanitarian, ethical, and practical reasons for managing and preventing pediatric pain. 2 It is important to note that the management and prevention of pain in children is not limited to highly painful conditions and procedures but also includes the prevention of pain associated with venous access procedures whenever possible. 1 In this article we review the experiences of 5 children's hospitals in the United States that have well-developed peripheral venous access pain-management programs. The case studies, written by roundtable members integrally involved in the development of these programs, summarize the strategies that were used successfully in implementing systematic and multidisciplinary programs for the management of venous access pain in the individual hospitals.When the case studies are viewed in totality, a number of common strategies are found to be essential in moving the pediatric venous access pain-management programs from theory to practice: (1) assembling a multidisciplinary team to advocate change; (2) using an evidence-based approach to determine which interventions would best suit a particular institution; (3) using a system-wide protocol for the administration of local anesthetics in the hospital setting; (4) storing local anesthetics in patient care areas and using physician standing orders to facilitate access to these agents; (5) securing department and hospital-wide support of the programs ...

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“…1 Surveys of health care workers show that many still do not invite parents to remain present for more invasive procedures such as lumbar punctures. 2,3 The effect of parental presence on children during medical procedures is unclear. Some studies have found that parental presence leads to calmer children, [4][5][6] others have found increased distress, 7,8 and others still have shown no effect.…”

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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Should Parents Be Present during Emergency Department Procedures on Children, and Who Should Make That Decision? A Survey of Emergency Physician and Nurse Attitudes

Abstract: A majority of emergency physicians and nurses indicated parents should be present for some invasive pediatric procedures. However, as the invasiveness of the pediatric procedures increased, fewer physicians and nurses believed that parents should be present.

Cited by 57 publications

References 6 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

On the Front Lines: Lessons Learned in Implementing Multidisciplinary Peripheral Venous Access Pain-Management Programs in Pediatric Hospitals

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

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