Learning Objective 1: describe benefits of family presence during medical resuscitations.
Learning Objective 2: describe methods for implementation of family presence based on the Barnes Jewish Hospital model in their own institution.
Background/Significance: FP began in the 1980's. Current research shows multiple benefits: increased rapport with the treatment time, decreased sense of exclusion from the loved one, and improved professionalism by the treatment team.
Methods: The Evidence Based Practice work team at Barnes-Jewish Hospital reviewed current position statements and literature about FP. Information was provided supporting FP to nursing and physician leadership, developed consensus, created a FP protocol specific to our department and obtained IRB approval to conduct a pre-post survey of staff regarding FP. Following collection of the pre-implementation survey from all staff, two months were dedicated to in-servicing on the FP protocol. A post implementation survey was distributed to all staff in the E.D. to determine if changes in attitudes had occurred due to the education and practice implementation.
Results: The team had 150 surveys returned for the pre-implementation survey and 113 from the post implementation survey. Staff reported having worked with FP at the bedside during resuscitation 44% in the pre-survey and 51% post survey. Staff reported they would want their family present during their resuscitation (82% pre, 87% post) and would want to be present for family members during their resuscitation (62% pre, 76% post). No changes in reported frequency of family interference with the treatment team (34% pre, 33% post). Narrative responses indicated these situations occurred prior to formal department implementation when no coach was present.
Conclusion: The majority of respondents support the option of facilitated FP. Concerns that family could interfere with the treatment team were identified but staff reported these instances occurred if the family was not provided a supportive staff member as a coach.