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Family Presence During Trauma Activations and Medical Resuscitations in a Pediatric Emergency Department: An Evidence-based Practice Project

Published:February 01, 2010DOI:https://doi.org/10.1016/j.jen.2009.12.023

      Introduction

      The existing family presence literature indicates that implementation of a family presence policy can result in positive outcomes. The purpose of our evidence-based practice project was to evaluate a family presence intervention using the 6 A's of the evidence cycle (ask, acquire, appraise, apply, analyze, and adopt/adapt). For step 1 (ask), we propose the following question: Is it feasible to implement a family presence intervention during trauma team activations and medical resuscitations in a pediatric emergency department using national guidelines to ensure appropriate family member behavior and uninterrupted patient care?

      Methods

      Regarding steps 2 through 4 (acquire, appraise, and apply), our demonstration project was conducted in a pediatric emergency department during the implementation of a new family presence policy. Our family presence intervention incorporated current appraisal of literature and national guidelines including family screening, family preparation, and use of family presence facilitators. We evaluated whether it was feasible to implement the steps of our intervention and whether the intervention was safe in ensuring uninterrupted patient care.

      Results

      With regard to step 5 (analyze), family presence was evaluated in 106 events, in which 96 families were deemed appropriate and chose to be present. Nearly all families (96%) were screened before entering the room, and all were deemed appropriate candidates. Facilitators guided the family during all events. One family presence event was terminated. In all cases patient care was not interrupted.

      Discussion

      Regarding step 6 (adopt/adapt), our findings document the feasibility of implementing a family presence intervention in a pediatric emergency department while ensuring uninterrupted patient care. We have adopted family presence as a standard practice. This project can serve as the prototype for others.

      Key words

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      Biography

      Jennifer Kingsnorth is Emergency Medicine and Trauma Center Nurse Manager, Children's National Medical Center, Washington, DC.

      Biography

      Karen O'Connell is Assistant Professor of Pediatrics and Emergency Medicine, George Washington University School of Medicine and Health Sciences, and Children's National Medical Center, Washington, DC.

      Biography

      Cathie E. Guzzetta is Nursing Research Consultant, Children's National Medical Center, Washington, DC.

      Biography

      Jacki Curreri Edens is Staff Nurse, Children's National Medical Center, Washington, DC.

      Biography

      Shireen Atabaki is Assistant Professor of Pediatrics and Emergency Medicine, George Washington University School of Medicine and Health Sciences, and Children's National Medical Center, Washington, DC.

      Biography

      Anne Mecherikunnel is Social Worker, Children's National Medical Center, Washington, DC.

      Biography

      Kathleen Brown is Associate Professor of Pediatrics and Emergency Medicine, George Washington University School of Medicine and Health Sciences, and Medical Director, Emergency Medicine and Trauma Center, Children's National Medical Center, Washington, DC.