Paediatric critical care nurses’ attitudes and experiences of parental presence during cardiopulmonary resuscitation: A European survey
Section snippets
What is already known about the topic?
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Parents would like to be given the choice to remain with their child during cardiopulmonary resuscitation (CPR).
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Healthcare professionals are concerned that family presence during CPR may affect the performance of the resuscitation team and may have damaging psychological effects on the relatives.
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Current guidelines support family presence during CPR.
What this paper adds
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Most paediatric critical care nurses are supportive of parental presence during CPR.
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Paediatric critical care nurses in this study are more supportive of parental presence than adult critical care nurses and physicians, as reported in previous studies.
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In this study, the majority of paediatric intensive care units do not have a resuscitation policy on parental presence.
Background: parental presence during resuscitation of a child
Whilst most of the evidence regarding family-witnessed resuscitation has been gathered in relation to adult patients; predominantly within emergency department settings, there is a growing body of literature in other critical care areas such as intensive care (Albarran and Stafford, 1999) and with respect to parental presence (Latour, 2001).
Although only three children were critically ill in Sacchetti's et al. (1996) survey of emergency department procedures, parental presence was favoured by
Design
A survey design was used, incorporating a structured attitudinal questionnaire using a Likert scale.
Method
A convenience sample of 158 paediatric critical care nurses who attended the 8th European Society of Paediatric and Neonatal Intensive Care (ESPNIC) Nursing Symposium, held in Göthenburg, Sweden in September 2002 was invited to participate in this study. The nurses were assured that data would be anonymous and kept confidential, and consent was implied by their voluntary decision to return the
Results
Data were analysed using the Statistical Package for Social Scientists (SPSS). Descriptive statistics and appropriate parametric and non-parametric tests of difference were applied. Because the results of this survey were not intended to change practice, significance was set at <0.05.
Discussion
Parental presence during resuscitation creates challenges for both parents and healthcare professionals. To our knowledge this is the only study to date that has examined European paediatric critical care nurses’ experiences and attitudes of parental presence during CPR. Whilst the results are encouraging, in that most nurses are supportive of parental presence, it is also clear that there are some areas of disagreement and uncertainty.
Limitations
Only conference delegates were eligible to participate and as such the sample is not representative of the paediatric critical care nursing population. It might also be argued that only those with an interest in the subject and those competent in one of the four languages completed the questionnaire. Finally, as the majority of the informants was based in paediatric intensive care units, the findings are unrepresentative of all critical care nurses’ experiences or attitudes.
Conclusions
The majority of paediatric critical care nurses in this survey support parental presence during CPR. Whilst some have legitimate concerns about the potential negative effects on both parents and resuscitation team members, our findings suggest that these concerns are mostly over-ridden by the intention to do what is best for the parents and their child.
Compared with previous studies relating to adult CPR, paediatric nurses appear to be more supportive of parental presence. This may be a
Acknowledgements
The authors would like to thank Marjo Frings, registered translator, for assisting with the preparation of the questionnaire into different European languages and the European Society of Paediatric and Neonatal Intensive Care (Nursing) for their permission to undertake this study.
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Family presence during resuscitation: A narrative review of the practices and views of critical care nurses
2019, Intensive and Critical Care NursingCitation Excerpt :It was also reportedly uncommon for nurses to be approached by family members requesting to be present (Badir and Sepit, 2007; Fulbrook et al., 2005, Fallis et al., 2008; Ganz and Yoffe, 2012; Gutysz-Wojnicka et al., 2018; Köberich et al., 2010). CCNs career experience of family requests for FPDR (61%) was notable in the study by Powers and Candela (2017), as was an approach by parents, with 50% paediatric nurses reporting this experience (Fulbrook et al., 2007b). Among the reported findings was a majority view that nurses do not want family members to be present (Badir and Sepit, 2007; Güneş and Zaybak, 2009; Ganz and Yoffe, 2012; Köberich et al., 2010), and that doctors do not want FPDR either (Badir and Sepit, 2007; Fulbrook et al., 2005, 2007b; Ganz and Yoffe, 2012; Güneş and Zaybak, 2009; Köberich et al., 2010).
Factors associated with nurses’ perceptions, self-confidence, and invitations of family presence during resuscitation in the intensive care unit: A cross-sectional survey
2018, International Journal of Nursing StudiesA survey of key opinion leaders on ethical resuscitation practices in 31 European Countries
2016, ResuscitationCitation Excerpt :Family presence may occasionally not be permitted because of healthcare professionals’ fear of litigation, or because the resuscitation attempt is considered as too traumatic for the family.16 Written policies on family presence during resuscitation have been adopted by 5% of hospitals in North America17 and 12% of hospitals in Europe.18 The questions of domain B are associated with justice and beneficence.
Inviting family to be present during cardiopulmonary resuscitation: Impact of education
2016, Nurse Education in PracticeCitation Excerpt :The challenge clearly is to identify ways to ensure these positive attitudes influence the teams' intent to invite family to be present. Reasons for the positive attitudes reported in this group may be three fold; nurses (American Heart Association, 2005; Davidson et al., 2007; Emergency Nurses Association, 2001; Fulbrook et al., 2007, 2008; Moreland and Manor, 2005; Redley et al., 2004; Walker, 2006), members of the MET and prior FPDR exposure (Chapman et al., 2012; Feagan and Fisher, 2011; Holzhauser and Finucane, 2008; Lowry, 2012; Samples Twibell et al., 2008) are all positively correlated with FPDR support. Variable support for FPDR in the literature was evident in the current study (Pankop et al., 2013).