Review of evidence about family presence during resuscitation.

Family presence during resuscitation (FPDR) has not been implemented consistently as standard practice across health care settings despite the availability of supporting research and recommendations from professional organizations. Health care providers, patients, families, and the public have divergent attitudes about FPDR. Inconsistencies in if, when, and how FPDR is offered can lead to inequities in care. This article presents relevant research on attitudes about FPDR and interventions to help change practice. The authors also share their experience with a project to implement FPDR in a medical intensive care unit.

Flanders SA ，Strasen JH 《-》

Intensive care nurses' perspectives of family-centered care and their attitudes toward family presence during resuscitation.

Ganz FD ，Yoffe F 《-》

Attitudes of healthcare staff and patients' family members towards family presence during resuscitation in adult critical care units.

This study examines the attitudes of healthcare staff and patients' family members towards family presence during resuscitation (FPDR) in critical care units in Hong Kong. A wealth of literature is available on FPDR in various hospital and healthcare settings. The findings include many anecdotal accounts of both the positive and the negative effects of family presence. There is little documentation on the comparisons of staff and family members' perceptions and the predictors of staff attitudes towards FPDR practice. Cross-sectional survey design. A convenience sample of 163 healthcare staff and 69 family members was recruited from the intensive care units. There was significant difference in the attitudes of healthcare staff and patients' families towards FPDR. The regression analysis showed that the healthcare staff would be more supportive to FPDR if family members could share the dying moments with patients, family members were accompanied by a bereavement team member, there was adequate staff to support the family and staff members were adequately trained. If healthcare staff feel that family members may have the impression that the resuscitation is chaotic, witness resuscitation is traumatic experience for the family, family presence will increase risk of litigation and colleagues will not allow family members to stay during resuscitation making them less supportive of FPDR. Nurses were more supportive to FPDR than doctors. The results provide information for healthcare professionals on the development of FPDR programmes for patients and their family members. Through multi-disciplinary collaborations, the effective and safe implementation of FPDR practice can be enhanced. The results could help the clinical staff to develop written guidelines to produce an integrated and consistent approach to this sensitive issue in clinical practice.

Leung NY ，Chow SK 《-》

Family presence during resuscitation: a survey of Canadian critical care nurses' practices and perceptions.

Fallis WM ，McClement S ，Pereira A 《-》

Family perception of and experience with family presence during cardiopulmonary resuscitation: An integrative review.

The objective was to consider family presence during resuscitation (FPDR) from the perspective of the family member. FPDR has been a topic of interest internationally since the first report of this practice more than 25 years ago. Worldwide, many studies have provided insight into the perspective of healthcare professionals (HCPs); however, there is limited research on the perspective and experiences of family members. An integrative review was conducted. An electronic database search was conducted for the years from 1994-2017. The Cumulative Index of Nursing and Allied Health Literature (CINAHL), PyschINFO, Academic Search, SocINDEX, PubMed, ProQuest databases and Google Scholar were searched. Search terms were family perceptions, family presence and resuscitation. Twelve reviews met inclusion criteria. Findings suggest that family members view family presence as a fundamental right. Family members involved in a FPDR experience reported that their presence benefitted the patient and healthcare team. In an international sample of studies, family presence overall was viewed positively by family members and they voiced wanting to be given an option to be present during a loved one's resuscitation. Findings support that family members' desire for FPDR; however, the literature reflects that HCPs do not always embrace the practice of FPDR. Stronger educational preparation of nurses and other HCPs related to FPDR is warranted. Policy initiatives include the formulation of policies that allow family presence during resuscitation of a family member. The findings are relevant for a clinical practice that promotes a more family-centred approach to allowing FPDR. Creating policy and providing FPDR education for HCPs based on evidence provide more consistency in clinical practice and help to eliminate the moral distress experienced by clinical nurses forced to make difficult decisions during a stressful event.

Toronto CE ，LaRocco SA 《-》