Family presence during cardiopulmonary resuscitation and invasive procedures in children

Objective: To identify literature evidences related to actions to promote family's presence during cardiopulmonary resuscitation and invasive procedures in children hospitalized in pediatric and neonatal critical care units. Data sources : Integrative literature review in PubMed, SciELO and Lilacs databases, from 2002 to 2012, with the following inclusion criteria: research article in Medicine, or Nursing, published in Portuguese, English or Spanish, using the keywords "family", "invasive procedures", "cardiopulmonary resuscitation", "health staff", and "Pediatrics". Articles that did not refer to the presence of the family in cardiopulmonary resuscitation and invasive procedures were excluded. Therefore, 15 articles were analyzed. Data synthesis : Most articles were published in the United States (80%), in Medicine and Nursing (46%), and were surveys (72%) with healthcare team members (67%) as participants. From the critical analysis, four themes related to the actions to promote family's presence in invasive procedures and cardiopulmonary resuscitation were obtained: a) to develop a sensitizing program for healthcare team; b) to educate the healthcare team to include the family in these circumstances; c) to develop a written institutional policy; d) to ensure the attendance of family's needs. Conclusions: Researches on these issues must be encouraged in order to help healthcare team to modify their practice, implementing the principles of the Patient and Family Centered Care model, especially during critical episodes.

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Validation of instruments about family presence on invasive procedures and cardiopulmonary resuscitation in pediatrics

Revista Latino-Americana de Enfermagem ◽

10.1590/1518-8345.2368.3046 ◽

2018 ◽

Vol 26 (0) ◽

Author(s):

Cristiana Araújo Guiller Ferreira ◽

Flávia Simphronio Balbino ◽

Maria Magda Ferreira Gomes Balieiro ◽

Myriam Aparecida Mandetta

Keyword(s):

Cardiopulmonary Resuscitation ◽

Professional Practice ◽

Health Professionals ◽

Family Care ◽

University Hospital ◽

Invasive Procedures ◽

Family Presence ◽

The Family ◽

Good Internal Consistency

ABSTRACT Objective: to develop and validate instruments to identify health professionals’ beliefs related to the presence of the child’s family in invasive procedures and in cardiopulmonary resuscitation. Method: study based on Psychometrics to conduct the theoretical, empirical and analytical stages, developed in a neonatal unit of a university hospital. The two instruments were constructed based on the literature and applied to 96 health professionals. Results: the Cronbach’s Alpha of the instrument related to the professionals’ beliefson invasive procedures was 0.863 and the instrument on cardiopulmonary resuscitation was 0.882. In both instruments, the tests performed indicated a correlation between the items. From the factorial analysis, four factors were generated: (1) benefits of the presence of the family; (2) impairment for professional practice; (3) strategies for the inclusion of the family; and (4) limitation of learning and decision making by the professional. Conclusion: the instruments analyzed obtained a good internal consistency and are indicators of the professionals’ beliefs with the potential to evaluate the quality of family care in this context.

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Family witnessed resuscitation and invasive procedures: Patient and family opinions

Nursing Ethics ◽

10.1177/0969733020968171 ◽

2020 ◽

pp. 096973302096817

Author(s):

Eva de Mingo Fernández ◽

Guillermina Medina Martín ◽

María Jiménez Herrera

Keyword(s):

Cardiopulmonary Resuscitation ◽

Clinical Evidence ◽

Invasive Procedures ◽

Structured Interviews ◽

Ethical Considerations ◽

Patient Centered ◽

Family Presence ◽

Divergence Of Opinion ◽

Centered Care ◽

Qualitative Descriptive

Background: Family presence during invasive procedures and cardiopulmonary resuscitation (FPDR) is a highly controversial issue, with divergence of opinion among health professionals, with clinical evidence in favor, and with barriers to its implementation in comprehensive patient care. Many international organizations support health policies for its implementation, but it is not a widespread practice. Little research has been conducted on this subject from the perspective of patients and families. Objective: To learn opinions, perceptions, and desires of family members and patients in terms of family presence during invasive procedures and cardiopulmonary resuscitation. Method: Qualitative descriptive study, using semi-structured interviews with relatives and patients regarding their experiences and perceptions about FPDR (n = 18) from 8 October 2017 to 8 March 2018. The interviews were recorded and transcribed verbatim for later analysis using the method of content analysis. Ethical considerations: This study has the approval of the Clinical Research Ethics Committee of the Fundació Unió Catalana d’Hospitals and ethical considerations were carefully regarded throughout the study. Results: Three significant categories were identified: knowledge, respect for rights, and accompaniment of the patient, relating FPDR to courage, emotional support, and trust in professionals. Conclusion: FPDR is an unusual practice; it is not offered to patients or their families, and it is not considered a patient’s right, although most of the interviewees support it. The desire for accompaniment is conditioned by the courage and knowledge of the accompanying persons, as well as the degree of invasiveness of the procedures. The results of this study provide information for a change of vision in patient-centered care.

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Family Presence During Cardiopulmonary Resuscitation and Invasive Procedures: Practices of Critical Care and Emergency Nurses

American Journal of Critical Care ◽

10.4037/ajcc2003.12.3.246 ◽

2003 ◽

Vol 12 (3) ◽

pp. 246-257 ◽

Cited By ~ 82

Author(s):

Susan L. MacLean ◽

Cathie E. Guzzetta ◽

Cheri White ◽

Dorrie Fontaine ◽

Dezra J. Eichhorn ◽

...

Keyword(s):

Critical Care ◽

Cardiopulmonary Resuscitation ◽

American Association ◽

Family Members ◽

Invasive Procedure ◽

Critical Care Nurses ◽

Invasive Procedures ◽

Emergency Nurses ◽

Family Presence ◽

Do So

• Background Increasingly, patients’ families are remaining with them during cardiopulmonary resuscitation and invasive procedures, but this practice remains controversial and little is known about the practices of critical care and emergency nurses related to family presence. • Objective To identify the policies, preferences, and practices of critical care and emergency nurses for having patients’ families present during resuscitation and invasive procedures. • Methods A 30-item survey was mailed to a random sample of 1500 members of the American Association of Critical-Care Nurses and 1500 members of the Emergency Nurses Association. • Results Among the 984 respondents, 5% worked on units with written policies allowing family presence during both resuscitation and invasive procedures and 45% and 51%, respectively, worked on units that allowed it without written policies during resuscitation or during invasive procedures. Some respondents preferred written policies allowing family presence (37% for resuscitation, 35% for invasive procedures), whereas others preferred unwritten policies allowing it (39% for resuscitation, 41% for invasive procedures). Many respondents had taken family members to the bedside (36% for resuscitation, 44% for invasive procedure) or would do so in the future (21% for resuscitation, 18% for invasive procedures), and family members often asked to be present (31% for resuscitation, 61% for invasive procedures). • Conclusions Nearly all respondents have no written policies for family presence yet most have done (or would do) it, prefer it be allowed, and are confronted with requests from family members to be present. Written policies or guidelines for family presence during resuscitation and invasive procedures are recommended.

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Family presence during cardiopulmonary resuscitation and invasive procedures: Practices of critical care and emergency nurses

Journal of Emergency Nursing ◽

10.1067/men.2003.100 ◽

2003 ◽

Vol 29 (3) ◽

pp. 208-221 ◽

Cited By ~ 65

Author(s):

Susan L. MacLean ◽

Cathie E. Guzzetta ◽

Cheri White ◽

Dorrie Fontaine ◽

Dezra J. Eichhorn ◽

...

Keyword(s):

Critical Care ◽

Cardiopulmonary Resuscitation ◽

Invasive Procedures ◽

Emergency Nurses ◽

Family Presence

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Family Witnessed Resuscitation: Staff Opinion

10.21203/rs.3.rs-31012/v1 ◽

2020 ◽

Author(s):

Eva de Mingo-Fernández ◽

Ángel Belzunegui-Eraso ◽

María Jiménez-Herrera

Keyword(s):

Cardiopulmonary Resuscitation ◽

Health Care Providers ◽

Health Personnel ◽

Health Workers ◽

Likelihood Method ◽

Moderate Intensity ◽

Care Providers ◽

Family Presence ◽

Self Confidence ◽

The Family

Abstract BACKGROUNDSince the 1980s, the controversial issue of family presence during cardiopulmonary resuscitation has been studied, as well as to identify the perceptions, opinions and beliefs of health professionals, patients and family members, as well as to identify benefits, barriers and design training and protocols for its implementation. In 2008, Twibell et al. designed a questionnaire that measured nurses’ perceptions of Risks-Benefits and Self-Confidence in the face of Family Presence during Cardiopulmonary Resuscitation.MethodsThe objective is to adapt and validate into Spanish the Family Presence Risk-Benefit scale and Family Presence Self-Confidence scale (FPRB-FPSC) instrument by Twibell et al. For this purpose were used a questionnaire on paper and online self-administered, semi-structured, translated cross-culturally. Statistical tests were performed for the validity of the questionnaire. 541 health workers were invited to answer. The results were analysed by factor analysis with varimax rotation (maximum likelihood method), in addition to ANOVA, contingency tables and Student’s t-test to observe associations between different variables. The study was approved by the institutional review board of the Consorci Sanitari del Garraf, and by the Ethic Comitee clinical research of the Fundació Unió Catalana Hospitals.Results 237 health workers answered the survey (69% women), of whom 167 were nurses. Health care providers who have experienced CPR barely reach 13%, with the majority being men and the elderly. Regarding the invitation to the FPDR, it barely reaches 5% and regarding the willingness to include the FP in the advance directives, 66% of the health workers are in favour. Health personnel identify similar barriers and factors that favour Family Presence.The correlation between the two measured scales, FPRB-FPSC, is significant and has a moderate intensity of the relationship (r = 0.65 and α <0.001).ConclusionsThe Family Presence during Cardiopulmonary Resuscitation generates controversy in health personnel, observing a trend along with generational change, as younger professionals tend to accept the Family Presence more. The psychometric properties of the questionnaire indicate high validity and reliability. Risk-Benefit perception and trust are related to healthcare staff who consider the Family Presence beneficial.

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Enhancing Lactation Support in the NICU During the COVID-19 Pandemic by Implementing a Primary Care Model

Clinical Lactation ◽

10.1891/clinlact-d-20-00016 ◽

2020 ◽

Vol 11 (4) ◽

pp. 192-196

Author(s):

Jennie Wagner ◽

Carolyn Delaney ◽

Sharron Baines

Keyword(s):

Primary Care ◽

Healthcare Team ◽

Lactation Consultant ◽

Supportive Environment ◽

Lactation Consultants ◽

The Family ◽

Centered Care ◽

Family Centered ◽

Care Nursing ◽

Primary Care Nursing

ObjectiveMeet the needs for additional lactation support in the NICU during the Covid-19 pandemic due to restriction in visitors, hours, and other stressors impacting the Mother and infant dyad.MethodDuring the Covid-19 pandemic, a large southeast U.S. research hospital implemented a new model of providing Lactation Consultation in a Level IV NICU. The Primary Care nursing model utilized in the NICU focuses on the infant and mother's individual needs and assists in the development of a caring and supportive environment.ResultsThe response to the Primary Care Lactation Consultant has well received and has resulted in the early identification of any Lactation concerns. Parents are reassured, knowing whom to contact with questions. The Lactation Consultant can set mutually agreed upon goals with the mother and include input from the other family members and the healthcare team.ConclusionsIn the future, the model and outcomes of Primary Care by Lactation Consultants in the NICU will focus on additional study and evaluation. In the interim, the parents at this facility have benefited from the family-centered care that focuses on the infant and parents.

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Family presence during cardiopulmonary resuscitation and invasive procedures: a meta-synthesis

Revista da Escola de Enfermagem da USP ◽

10.1590/s1980-220x2018001303435 ◽

2019 ◽

Vol 53 ◽

Cited By ~ 2

Author(s):

Mayckel da Silva Barreto ◽

Hellen Emília Peruzzo ◽

Cristina Garcia-Vivar ◽

Sonia Silva Marcon

Keyword(s):

Cardiopulmonary Resuscitation ◽

Qualitative Data ◽

Web Of Science ◽

Data Extraction ◽

Family Members ◽

Limiting Factors ◽

Invasive Procedures ◽

Family Presence ◽

Factors Influencing ◽

Qualitative Evidence

ABSTRACT Objective: To synthesize the best qualitative evidence regarding the perception of family members, patients and health professionals about family presence during cardiopulmonary resuscitation and invasive procedures. Method: Systematic review with meta-synthesis performed in the databases of Web of Science, Scopus, CINAHL, PsycINFO, LILACS, MEDLINE, Embase and VHL. Articles published between 2010 and 2017 were included and evaluated with use of the Qualitative Data Extraction Instrument. Results: In total, were found 2,391 articles, out of which 26 were selected, and 24 were analyzed. The identified meta-theme was ‘A pendular perspective: different views on family presence during cardiopulmonary resuscitation and invasive procedures’, which is supported by the following themes: Benefits resulting from family presence; Disadvantages and/or limiting factors of family presence; and Context: environmental, sociocultural and care factors influencing the perception of family presence. Conclusion: The perception of family members, patients and professionals about family presence is still controversial. The sensitization of these subjects can potentiate the practice by making it more systematized and qualified.

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Family Presence During Resuscitation: Adaptation and Validation into Spanish of the Family Presence Risk-Benefit Scale and the Self-Confidence Scale Instrument

10.21203/rs.3.rs-31012/v2 ◽

2020 ◽

Author(s):

Eva de Mingo-Fernández ◽

Ángel Belzunegui-Eraso ◽

María Jiménez-Herrera

Keyword(s):

Cardiopulmonary Resuscitation ◽

Health Professionals ◽

Healthcare Professionals ◽

Healthcare Providers ◽

Likelihood Method ◽

Moderate Intensity ◽

Family Presence ◽

Self Confidence ◽

The Family ◽

Confidence Scale

Abstract Background Since the 1980s, the controversial issue of family presence during cardiopulmonary resuscitation has been studied both to identify the perceptions, opinions and beliefs of health professionals, patients and family members, and to identify benefits and barriers, as well as to design training programs and protocols for its implementation. In 2008, Twibell et al designed a questionnaire that measured nurses’ perceptions of Risks-Benefits and Self-Confidence regarding Family Presence during Resuscitation. There are few studies in Spain on this practice, and therefore, this study is carried out using the same instrument, so that a comparison can be made.Methods The objective is to adapt and validate into Spanish the Family Presence Risk-Benefit scale and Family Presence Self-Confidence scale (FPRB-FPSC) instrument by Twibell et al. and thus, know the opinions of our healthcare professionals. For this purpose, a paper and online questionnaire was used. It was self-administered, semi-structured and translated cross-culturally. Statistical tests were carried out for the validity of the questionnaire. 541 healthcare professionals were invited to respond. The results were analyzed by means of factorial analysis with varimax rotation (maximum likelihood method), in addition to ANOVA and Student’s t-test to observe associations between different variables. The study was approved by the institutional review board of the Consorci Sanitari del Garraf, and by the clinical research Ethic Committee of the Fundació Unió Catalana Hospitals.Results 237 healthcare professionals answered the survey (69% women), of whom 167 were nurses. Healthcare providers who have experienced Cardiopulmonary Resuscitation barely reach 13%, with the majority being men and older people. As for the invitation to the FPDR, it barely reaches 5%, and regarding the willingness to include FP in the advance directives, 66% of the healthcare providers are in favor. Health professionals identify similar barriers to Family Presence and factors in its favor.The correlation between the two measured scales, FPRB-FPSC, is significant and has a moderate intensity of the relationship (r = 0.65 and α <0.001).Conclusions The Family Presence During Resuscitation (FPDR) generates controversy among health professionals, with a trend observed along with generational change, since younger professionals tend to accept the Family Presence better. The psychometric properties of the questionnaire indicate high validity and reliability. Risk-Benefit perception and self-confidence are related to the healthcare professionals who consider the Family Presence to be beneficial.

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Family Presence During Resuscitation: Adaptation and Validation into Spanish of the Family Presence Risk-Benefit Scale and the Self-Confidence Scale Instrument

10.21203/rs.3.rs-31012/v3 ◽

2021 ◽

Author(s):

Eva de Mingo-Fernández ◽

Ángel Belzunegui-Eraso ◽

María Jiménez-Herrera

Keyword(s):

Cardiopulmonary Resuscitation ◽

Healthcare Professionals ◽

Statistical Tests ◽

National Standards ◽

Moderate Intensity ◽

Validity And Reliability ◽

Family Presence ◽

Self Confidence ◽

The Family ◽

Confidence Scale

Abstract BACKGROUNDFamily Presence during Cardiopulmonary Resuscitation has been studied both to identify the opinions of health professionals, patients, and family members, and to identify benefits and barriers, as well as to design protocols for its implementation. R.Twibell and her team designed an instrument that measured nurses’ perceptions of Risks-Benefits and Self-Confidence regarding Family Presence during Resuscitation. There are few studies in Spain on this practice. MethodsThe aim is to adapt and validate into Spanish the Family Presence Risk-Benefit scale and Family Presence Self-Confidence scale instrument. For this purpose, this instrument was translated cross-culturally, and administered in paper and online version. Statistical tests were carried out for the validity of the questionnaire. 541 healthcare professionals were invited to respond. The results were analyzed by the same statistical procedures as in the original scale. Ethical approvals and research permissions were obtained according to national standards.Results 237 healthcare professionals (43.8%) answered the survey (69% women), of whom 167 were nurses. Validation of instruments: Cronbach’s α in Family Presence Risk-Benefit scale was 0.94. Cronbach’s α in Family Presence Self-Confidence scale was 0.96. Factor Analysis Kaiser, Meyer and Olkin (KMO) was greater than 0.9. The correlation between the two measured scales, is significant and has a moderate intensity of the relationship (r = 0.65 and α <0.001). A lower predisposition to Family Presence during Cardiopulmonary Resuscitation is observed, but the pure detractors are only 12%. Doctors are more reluctant than nurses.ConclusionsThe psychometric properties of the questionnaire in Spanish indicate high validity and reliability. Risk-Benefit perception and Self-Confidence are related to the healthcare professionals who consider the Family Presence to be beneficial. More studies in different contexts are necessary to confirm the psychometric results and validity of this instrument in Spanish.

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Implementing Family-Centered Care Through Facilitated Sensemaking

AACN Advanced Critical Care ◽

10.4037/aacnacc2017102 ◽

2017 ◽

Vol 28 (2) ◽

pp. 200-209 ◽

Cited By ~ 11

Author(s):

Judy E. Davidson ◽

Sidney Zisook

Keyword(s):

Decision Making ◽

Critical Care ◽

Family Engagement ◽

Information Gathering ◽

Family Presence ◽

Engagement Strategies ◽

The Family ◽

Centered Care ◽

Range Theory ◽

Family Centered

The Society of Critical Care Medicine has released updated recommendations for care of the family in neonatal, pediatric, and adult intensive care units. Translation of the recommendations into practice may benefit from a supporting theoretical framework. Facilitated sensemaking is a mid-range theory built from the same literature that formed the basis for recommendations within the guidelines. The process of facilitated sensemaking may be used to help nurses adopt the SCCM recommendations into practice through the development of caring relationships, promoting family presence, teaching family engagement strategies, and supporting families with communication, information gathering, and participation in decision-making.

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