Description:
Aim: To explore the experiences of nurses and doctors on the implementation of family presence during resuscitation (FPDR) in Victorian emergency departments. Methods: An interpretative qualitative study design was utilized which incorporated the open ended responses on a state wide Victorian survey of emergency department nurses and doctors. A thematic analysis of the responses was conducted involving data reduction, identification of key words, phrases and themes. Results: A total of 18 emergency departments consented to participate with a mean participant age of 41 years, made up of 91 (81) nurses and 21(19) doctors. The participants came from both metropolitan (64 (57), hospitals 300 – >500 beds) and regional (48 (43), hospitals <80 – 300 beds) health services. There were four emerging themes from the analysis; Depends on the day, impact family have on staff, organisational considerations and incorporating family centred care. Conclusion: There remain a number of variables which have been identified as continuing to create barriers to implementation of family presence during resuscitation that need to be investigated further in order to ensure emergency personnel have consistency of FPDR practice.
Description:
Aim of study: This study aimed to investigate the attitudes of personnel working in emergency departments on the constitution of a resuscitation team in particular the perceptions of the family liaison role. Methods: A paper base survey on family presence during resuscitation was distributed to emergency personnel working in 18 public departments in the state of Victoria, Australia. Results: A combination of nurses (n = 282) and doctors (n = 65) working in rural and metropolitan emergency departments, identified seven unique resuscitation team roles. Resuscitation teams were identified as comprising of three doctors, three nurses and one other which could be either. Respondents identified seven unique roles as consisting of a team leader, airway doctor, airway nurse, procedure doctor and procedure nurse, drugs nurse and a scribe. The respondents identified the following components as key to discussions with family members; emergency personnel, reassurance, diagnosis, regular updates, intervention, and prognosis (ER-DRIP). Conclusion: The acronym ER-DRIP can be used as a reminder to emergency staff when speaking with family members during resuscitation events ensuring they receive all the necessary information and support.
Description:
Aim of study: This study aimed to investigate the attitudes of personnel working in emergency departments on the constitution of a resuscitation team in particular the perceptions of the family liaison role. Methods: A paper base survey on family presence during resuscitation was distributed to emergency personnel working in 18 public departments in the state of Victoria, Australia. Results: A combination of nurses (n = 282) and doctors (n = 65) working in rural and metropolitan emergency departments, identified seven unique resuscitation team roles. Resuscitation teams were identified as comprising of three doctors, three nurses and one other which could be either. Respondents identified seven unique roles as consisting of a team leader, airway doctor, airway nurse, procedure doctor and procedure nurse, drugs nurse and a scribe. The respondents identified the following components as key to discussions with family members; emergency personnel, reassurance, diagnosis, regular updates, intervention, and prognosis (ER-DRIP). Conclusion: The acronym ER-DRIP can be used as a reminder to emergency staff when speaking with family members during resuscitation events ensuring they receive all the necessary information and support.
Description:
Aim To undertake a review of the quantitative research literature, to determine emergency staff and public attitudes, to support the implementation and practice of family presence during resuscitation in the emergency department. Background FPDR although endorsed by numerous resuscitation councils, cardiac, trauma and emergency associations, continues to be topical, the extent to which it is implemented and practiced remains unclear. Review methods A review of the quantitative studies published between 1992 and October 2011 was undertaken using the following databases: CINAHL, Ovid Medline, PSYCHINFO, Pro-Quest, Theses Database, Cochrane, and Google Scholar search engine. The primary search terms were ‘family presence’, and ‘resuscitation’. The final studies included in this paper were appraised using the Critical Appraisal Skills Programme criteria. Results Fourteen studies were included in this literature review. These included quantitative descriptive designs, pre and post-test designs and one randomized controlled trial (RCT). The studies were divided into three main research areas; investigation of emergency staff attitudes and opinions, family and general public attitudes, and four papers evaluating family presence programs in the emergency department. Studies published prior to 2000 were included in the background. Conclusion FPDR in the emergency department is well recognised and documented among policy makers, the extent in which it is implemented and practiced remains unclear. Further research is needed to assess how emergency staff are educated and trained in order to facilitate family presence during resuscitation attempts.
Description:
Introduction: Family presence during resuscitation (FPDR), remains inconsistently implemented by emergency personnel. The benefits for family members is well documented, providing opportunities for family to say goodbye, facilitates closure and enables family to provide emotional support to the patient. The aim of this study was to explore the experiences and attitudes of emergency personnel towards FPDR immediately post resuscitation events. Method: A descriptive qualitative design was used to explore the experiences of emergency personnel with FPDR. Data was collected from single rural and metropolitan emergency departments in the state of Victoria, Australia. The participants consisted of nurses and doctors who took active roles during resuscitation events. Following transcription of the audiotaped interviews Creswell's (2003) six step analysis process was employed. Result: A total of 29 interviews of key personnel, following 6 paediatric and 18 adult resuscitation events. Interviews were conducted over a period of two weeks in each venue. The data was organised into six themes following analysis including: care coordinators inconsistently called, gate keepers to implementation, effective communication strategies helping to deliver bad news, life experience generates confidence, allocation of family support person, and family members roles dependent on age of patient. Conclusion: FPDR is common practice in paediatric events however remains inconsistently implemented during adult resuscitations. A designated family support person is essential to successful implementation of FPDR and should be incorporated in to the allocation of the resuscitation team roles during both adult and paediatric resuscitation events. Education and training is important for clinicians to learn essential communication skills, building practice confidence, which is required to successfully implement FPDR.
Description:
Introduction There are a number of perceived benefits and barriers to family presence during resuscitation (FPDR) in the emergency department, and debate continues among health professionals regarding the practice of family presence. Aim This review of the literature aims to develop an understanding of the perceived benefits, barriers and enablers to implementing and practicing FPDR in the emergency department. Results The perceived benefits include; helping with the grieving process; everything possible was done, facilitates closure and healing and provides guidance and family understanding and allows relatives to recognise efforts. The perceived barriers included; increased stress and anxiety, distracted by relatives, fear of litigation, traumatic experience and family interference. There were four sub themes that emerged from the literature around the enablers of FPDR, these included; the need for a designated support person, the importance of training and education for staff and the development of a formal policy within the emergency department to inform practice. Conclusion In order to ensure that practice of FPDR becomes consistent, emergency personnel need to understand the need for advanced FPDR training and education, the importance of a designated support person role and the evidence of FPDR policy as enablers to implementation.
Description:
Background: Family-witnessed resuscitation remains controversial among clinicians from implementation to practice and there are a number of countries, such as Iran, where that is considered a low priority. Objective: To explore the lived experience of resuscitation team members with the presence of the patient's family during resuscitation. Settings: The emergency departments and critical care units of 6 tertiary hospitals in Tabriz, Iran. Participants: There were potentially 380 nurses and physicians working in the emergency departments and acute care settings of 6 tertiary hospitals in Tabriz. A purposive sample of these nurses and physicians was used to recruit participants who had at least 2 years of experience, had experienced an actual family witnessed resuscitation event, and wanted to participate. The sample size was determined according to data saturation. Data collection ended when the data were considered rich and varied enough to illuminate the phenomenon, and no new themes emerged following the interview of 12 nurses and 8 physicians. Methods: Semi-structured, face-to-face interviews were held with the participants over a period of 6 months (April 2015 to September 2015), and Van Manen's method of data analysis was adopted. Results: Three main themes emerged from the data analysis, including 'Futile resuscitation', 'Family support liaison', and 'Influence on team's performance'. A further 9 sub-themes emerged under the 3 main themes, which included 'futile resuscitation in end-stage cancer patients', 'when a patient dies', 'young patients', 'care of the elderly', 'accountable person', 'family supporter', 'no influence', 'positive influence', and 'negative influence'. Conclusions: Participants noted both positive and negative experiences of having family members present during cardiopulmonary resuscitation. Welltrained and expert resuscitation team members are less likely to be stressed in the presence of family. A family support liaison would act to decrease family anxiety levels and to de-escalate any potentially aggressive person during the resuscitation. It is recommended that an experienced health care professional be designated to be responsible for explaining the process of resuscitation to the patient's family.
Description:
Bacicgrottral: Family-witnessed resuscitation remains controversial among clinicians from implementation to practice and there are a number of countries, such as Iran, where that is considered a low priority. Objective: To explore the lived experience of resuscitation team members with the presence of the patient's family during resuscitation. Settings: The emergency departments and critical care units of 6 tertiary hospitals in Tabriz, Iran. Participants: There were potentially 380 nurses and physicians working in the emergency departments and acute care settings of 6 tertiary hospitals in Tabriz. A purposive sample of these nurses and physicians was used to recruit participants who had at least 2 years of experience, had experienced an actual family witnessed resuscitation event, and wanted to participate. The sample size was determined according to data saturation. Data collection ended when the data were considered rich and varied enough to illuminate the phenomenon, and no new themes emerged following the interview of 12 nurses and 8 physicians. Methods: Semi-structured, face-to-face interviews were held with the participants over a period of 6 months (April 2015 to September 2015), and Van Manen's method of data analysis was adopted. Results: Three main themes emerged from the data analysis, including 'Futile resuscitation', 'Family support liaison', and 'Influence on team's performance'. A further 9 sub-themes emerged under the 3 main themes, which included 'futile resuscitation in end-stage cancer patients', 'when a patient dies', 'young patients', 'care of the elderly', 'accountable person', 'family supporter', 'no influence', 'positive influence', and 'negative influence'. Conclusions: Participants noted both positive and negative experiences of having family members present during cardiopulmonary resuscitation. Welltrained and expert resuscitation team members are less likely to be stressed in the presence of family. A family support liaison would act to decrease family anxiety levels and to de-escalate any potentially aggressive person during the resuscitation. It is recommended that an experienced health care professional be designated to be responsible for explaining the process of resuscitation to the patient's family.