Advertisement

The Impact of Education on Provider Attitudes Toward Family-Witnessed Resuscitation

Published:April 08, 2010DOI:https://doi.org/10.1016/j.jen.2010.02.023

      Introduction

      The majority of acute care facilities have not developed policies or guidelines to facilitate family presence during cardiopulmonary resuscitation. Prior studies have shown that the personal beliefs and attitudes of hospital personnel involved in resuscitation efforts are the primary reasons family presence is not offered.

      Methods

      This 2-phase, before/after study was conducted in a 388-bed academic trauma center, and in a 143-bed community hospital in eastern Washington State in 2008. In phase I, a convenience sample of physicians and registered nurses from both facilities were surveyed about their opinions and beliefs regarding family-witnessed resuscitation (FWR). Spearman’s rho and independent t-tests were used to compare support of FWR between and within roles and practice location subgroups. In phase II of the study, clinician subgroups in the community hospital were re-surveyed following an educational program that used evidence-based information. Independent t-test and one-way ANOVA were used to compare pre and post-education mean scores of subgroups on indicators of effective teaching strategies and improved FWR support.

      Results

      Opinions on FWR vary within and between practice roles and locations, with the strongest variable of support being prior experience with FWR. Following FWR education, mean scores improved for survey variables chosen as indicators of FWR support and teaching effectiveness.

      Discussion

      When CPR providers are presented with FWR education, their opinion-based beliefs may be modified, decreasing barriers to family witnessed resuscitation and improving overall support of FWR as an extension of family-centered care.

      Keywords

      To read this article in full you will need to make a payment

      References

        • Emergency Nurses Association
        Position statement; family presence at the bedside during invasive procedures and cardiopulmonary resuscitation.
        (Emergency Nurses Association Web site) (Revised October 2005. Accessed November 28, 2007)
        • American Association of Critical-Care Nurses
        Practice alert: family presence during CPR and invasive procedures.
        (American Association of Critical Care Nurses Web site) (Issued November 2004. Accessed November 23, 2007)
        • American College of Critical Care Medicine Task Force
        Clinical practice guidelines for support of the family in the patient-centered intensive care unit: American College of Critical Care Medicine Task Force 2004-2005.
        Crit Care Med. 2007; 35: 605-622
        • American Academy of Pediatrics Committee on Pediatric Emergency Medicine
        • American College of Emergency Medicine
        Patient and family-centered care and the role of the emergency physician providing care to a child in the emergency department.
        Pediatrics. 2006; 118: 2242-2244
        • American Heart Association
        American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care, part 2: ethical issues.
        Circulation. 2005; 112 (Accessed November 23, 2007): IV-6-IV-11
        • MacLean SL
        • Guzzetta CE
        • White C
        • et al.
        Family presence during cardiopulmonary resuscitation and invasive procedures: practices of critical care and emergency nurses.
        Am J Crit Care. 2003; 12: 246-255
        • Lewin K
        Group decisions and social change.
        in: Maccoby EE Newcomb TM Hartley EL Readings in Social Psychology. Holt, Rhinehart and Winston, New York1958: 197-211
        • Belanger MA
        • Reed S
        A rural community hospital's experience with family-witnessed resuscitation.
        J Emerg Nurs. 1997; 23: 238-239
        • Duran CR
        • Oman KS
        • Abel JJ
        • Koziel VM
        • Szymanski D
        Attitudes toward and beliefs about family presence: a survey of healthcare providers, patients' families, and patients.
        Am J Crit Care. 2007; 16: 270-279
        • Ellison S
        Nurses' attitudes toward family presence during resuscitative efforts and invasive procedures.
        J Emerg Nurs. 2003; 29: 515-521
        • McClenathan BM
        • Torrington KG
        • Uyehara CFT
        Family member presence during cardiopulmonary resuscitation: a survey of US and international critical care professionals.
        Chest. 2002; 122: 2204-2211
        • Meyers TA
        • Eichhorn DJ
        • Guzzetta CE
        • et al.
        Family presence during invasive procedures and resuscitation: the experience of family members, nurses, and physicians.
        Am J Nurs. 2000; 100: 32-34
        • Mian P
        • Warchal S
        • Whitney S
        • Fitzmaurice J
        • Tancredi D
        Impact of a multifaceted intervention on nurses' and physicians' attitudes and behaviors toward family presence during resuscitation.
        Crit Care Nurse. 2007; 27: 52-61
        • Hanson C
        • Strawser D
        Family presence during cardiopulmonary resuscitation: Foote Hospital emergency department's nine-year perspective.
        JEmerg Nurs. 1992; 18: 104-106
        • Barratt F
        • Wallis DN
        Relatives in the resuscitation room: their point of view.
        J Accid Emerg Med. 1998; 15: 109-111
        • Meyers TA
        • Eichhorn DJ
        • Guzzetta CE
        Do families want to be present during CPR? A retrospective survey..
        J Emerg Nurs. 1998; 24: 400-405
        • Doyle CJ
        • Post H
        • Burney RE
        • Maino J
        • Keefe M
        • Rhee KJ
        Family participation during resuscitation: an option.
        Ann Emerg Med. 1987; 16: 673-675
        • Robinson SM
        • Mackenzie-Ross S
        • Campbell Hewson GL
        • Egleston CV
        • Prevost AT
        Psychological effect of witnessed resuscitation on bereaved relatives.
        Lancet. 1998; 352: 614-617
        • Eichhorn DJ
        • Meyers TA
        • Guzzetta CE
        • et al.
        Family presence during invasive procedures and resuscitation: hearing the voice of the patient.
        Am J Nurs. 2001; 101: 48-55
      1. Emergency Nurses Association. Presenting the Option for Family Presence. 3rd ed. Des Plains, IL: Emergency Nurses Association; 2007:1-16, 29, 77-99.

        • Jonsen AR
        • Siegler M
        • Winslade WJ
        Clinical Ethics. 5th ed. McGraw-Hill, New York2002: 84-85
        • Benner P
        Honoring the good behind rights and justice in healthcare when more than justice is needed.
        Am J Crit Care. 2005; 14: 152-157
        • Day L
        Family involvement in critical care: short comings of a utilitarian justification.
        Am J Crit Care. 2006; 15: 223-225
        • Henderson DP
        • Knapp JF
        Report of the national consensus conference on family presence during pediatric cardiopulmonary resuscitation and procedures.
        Pediatr Emerg Care. 2005; 21: 787-791
        • Knapp J
        • Mulligan-Smith D
        The death of a child in the emergency department.
        Pediatrics. 2005; 115: 1432-1437

      Biography

      Lori M. Feagan is Advanced Registered Nurse Practitioner, Spokane Internal Medicine, Spokane Valley, WA.

      Biography

      Nancy J. Fisher is Clinical Educator, Valley Hospital and Medical Center, Spokane Valley, WA.