Having family members present during cardiopulmonary resuscitation (CPR) and invasive bedside procedures remains a controversial topic in clinical nursing practice for the hospitalized high-acuity patient. Family presence during cardiopulmonary resuscitation (FPDR) is a complex ethical dilemma in modern medicine. Historically, before the development of Intensive Care Units (ICU’s), death occurred at home in a family-centered environment (Doolin, Quinn, Bryant, Lyons, & Kleinpell, 2011). As medical technology and advanced CPR guidelines progressed, patients moved from dying at home in the presence of family to high-acuity hospital settings such as ICU’s or emergency departments (Doolin et al., 2011). Healthcare providers are often reluctant
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Staff fear that hysterical family members will serve as a distraction to the team attempting a resuscitation (Doolin et al., 2011). Medical personnel also worry that their clinical skills will decline under the pressure of having family members watching their every move in an already stressful situation (Egging et al., 2011). However, the evidence indicates the opposite is true. According to Jabre et al. (2011), FPDR causes no significant increase in stress to staff and does not impact decisions made by physicians or nurses. CPR survival rates are unchanged when a family is present (Jabre et al., 2011). In summary, the notion that family members serve as a major distraction to the code team is inaccurate. Families do not interfere with the team’s ability to make lifesaving decisions or their clinical …show more content…
Recommendations established by Twibell et al. (2015) could be used to implement a written policy on FPDR in Regina Qu’Appelle Health Region. Twibell et al.’s first recommendation are; health regions must establish written policies to support the provision of FPDR (2015). The written policies must include contraindications for family presence, benefits to FPDR, family assessment criteria, the role of facilitators, and must indicate it is the family or patient’s choice to be present (Twibell et al., 2015). Contraindications to FPDR include violent or abusive behavior, individuals under the influence of drugs or alcohol, and families that display uncontrollable outbursts (Twibell et al., 2015). After written policies are implemented on a unit, compliance of the staff members should be assessed. If compliance is less than ninety percent of a unit, steps must be taken to increase compliance (Twibell et al., 2015). Actions to improve compliance may include re-educating staff on the benefits to FPDR, ensure staff is aware a policy exists, add the standards into annual competency reviews, and ask staff what is working well with the new policy and what may need to change (Twibell et al., 2015). Other key nursing actions include, creating documentation protocols for FPDR, and developing competency standards to keep staff, family, and patients safe (Twibell
Staff fear that hysterical family members will serve as a distraction to the team attempting a resuscitation (Doolin et al., 2011). Medical personnel also worry that their clinical skills will decline under the pressure of having family members watching their every move in an already stressful situation (Egging et al., 2011). However, the evidence indicates the opposite is true. According to Jabre et al. (2011), FPDR causes no significant increase in stress to staff and does not impact decisions made by physicians or nurses. CPR survival rates are unchanged when a family is present (Jabre et al., 2011). In summary, the notion that family members serve as a major distraction to the code team is inaccurate. Families do not interfere with the team’s ability to make lifesaving decisions or their clinical …show more content…
Recommendations established by Twibell et al. (2015) could be used to implement a written policy on FPDR in Regina Qu’Appelle Health Region. Twibell et al.’s first recommendation are; health regions must establish written policies to support the provision of FPDR (2015). The written policies must include contraindications for family presence, benefits to FPDR, family assessment criteria, the role of facilitators, and must indicate it is the family or patient’s choice to be present (Twibell et al., 2015). Contraindications to FPDR include violent or abusive behavior, individuals under the influence of drugs or alcohol, and families that display uncontrollable outbursts (Twibell et al., 2015). After written policies are implemented on a unit, compliance of the staff members should be assessed. If compliance is less than ninety percent of a unit, steps must be taken to increase compliance (Twibell et al., 2015). Actions to improve compliance may include re-educating staff on the benefits to FPDR, ensure staff is aware a policy exists, add the standards into annual competency reviews, and ask staff what is working well with the new policy and what may need to change (Twibell et al., 2015). Other key nursing actions include, creating documentation protocols for FPDR, and developing competency standards to keep staff, family, and patients safe (Twibell