Paper
Saturday, November 12, 2005
A Tertiary Teaching Hospital's Experience with Family-Witnessed Resuscitation
Cheryl Riwitis, BSN, RN, CEN1, Susan Beatty, RN1, Denise Bousman, BSN, CCRN1, Sherry Harrigan, RN, BS, CCRN, BC, CVNI1, Doreen Johnson, RN, BS, MA, CHE1, Alexis Neal, RN, MA1, Debra Siela, DNSc, RN, CCNS, APRN, BC, CCRN, RRT2, Renee Samples Twibell, DNS, RN2, and Joe Wheatley, BSN, CRRN1. (1) Nursing, Ball Memorial Hospital, Muncie, IN, USA, (2) Nursing, Ball State University/Ball Memorial Hospital, Muncie, IN, USA
| Learning Objective #1: Discuss research findings related to family-witnessed resuscitation and the extent to which the evidence guides practice |
| Learning Objective #2: Describe an approach to leading nurses in examining evidence, applying theory, and conducting research on a clinically relevant issue |
Family witnessed resuscitation (FWR) is a controversial issue worldwide. This topic was featured at a recent journal club in a large, tertiary hospital in the Midwestern USA. Diverse opinions and practices abounded. The inquiry was posed, “What does scientific evidence confirm about FWR?” A work group formed to explore the state of the science related to FWR. An extensive literature review revealed that families overwhelmingly desired the option to be present during resuscitation of loved ones, citing better grieving, closure, and a positive relationship with health care team members during FWR (MacLean, 2003). However, health care providers reported marked ambiguity regarding FWR, citing numerous risks and benefits. Published research to date has consisted primarily of descriptive studies and has included few rigorous intervention studies. Furthermore, few instruments had been validated to measure concepts related to FWR.
Since the state of the science was insufficient to guide practice across multiple clinical settings, the work group designed a research study to examine the perceptions of nurses and physicians regarding risks and benefits of FWR. Instrumentation was developed, and tests are in process with five samples of nurses and physicians. Peplau's (1970) theory of interpersonal relationships framed the group's view of the nurses' role in FWR. Specifically, the nurse-family relationship was conceptualized in phases as the resuscitation event unfolded, and the nurse functioned in various roles, described by Peplau.
This endeavor is generating new knowledge about perceptions of FWR and has provided nurses with experience in the research process, evaluation of evidence, and theory application. Research findings will elucidate factors that contribute to nurses' decisions about FWR and will guide education for health care providers. Future research will lead to a practice standard. This professional experience can be duplicated in other settings, following basic principles of team-building, inquiry, research, and theoretical critique.