Paediatric critical care nurses’ attitudes and experiences of parental presence during cardiopulmonary resuscitation: A European survey

https://doi.org/10.1016/j.ijnurstu.2006.05.006Get rights and content

Abstract

Background

Although recent resuscitation guidelines are supportive of family presence during cardiopulmonary resuscitation literature from the last decade suggests that it is often discouraged, and the subject remains a controversial issue.

Objectives

To determine the experiences and attitudes of European paediatric critical care nurses about parental presence during the resuscitation of a child.

Design

A survey design was employed.

Participants

A convenience sample of European paediatric critical care nurses was used.

Methods

A structured questionnaire was used, which incorporated a series of attitude statements that were rated using a 5-point Likert scale. Differences in attitudes were explored in three areas: decision-making, processes and outcomes of resuscitation.

Results

The results from this survey suggest that European paediatric nurses are very supportive of parental presence during cardiopulmonary resuscitation. Only a few nurses reported that their unit had a policy that covered parental presence during cardiopulmonary resuscitation and most nurses did not support the use of a dedicated nurse to look after the parents during resuscitation.

Conclusions

Compared with previous studies relating to adult cardiopulmonary resuscitation, paediatric nurses experience family member presence more frequently than adult critical care nurses and appear to be more supportive of relatives’ presence. It is recommended that paediatric intensive care units establish local policies that cover parental presence during cardiopulmonary resuscitation.

Section snippets

What is already known about the topic?

  • Parents would like to be given the choice to remain with their child during cardiopulmonary resuscitation (CPR).

  • 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.

  • Current guidelines support family presence during CPR.

What this paper adds

  • Most paediatric critical care nurses are supportive of parental presence during CPR.

  • 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.

  • 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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