family presence during resuscitation and invasive procedures

1. Family Presence During Resuscitation and Invasive Procedures Issued April 2010

2. Family Presence During Resuscitation and Invasive Procedures 2

3. Family Presence During Resuscitation and Invasive Procedures 3 Expected Practice Approved written practice document (i.e., policy, procedure, or standard of care) for family presence (Evidence Level D)

4. Family Presence During Resuscitation and Invasive Procedures 4 Scope and Impact of the Problem Family presence is beneficial to patients, families and staff. Meeting needs in time of crisis exemplifies care driven by the patients and families.

5. Family Presence During Resuscitation and Invasive Procedures 5 Supporting Evidence 50% to 96% of consumers believe that family members should be offered the opportunity to be present

6. Family Presence During Resuscitation and Invasive Procedures 6 Supporting Evidence Only 5% of critical care unit in the U.S. have written policies allowing family presence. Most critical care nurses have brought families to the bedside, despite the lack of formal hospital policies.

7. Family Presence During Resuscitation and Invasive Procedures 7 Supporting Evidence �Benefits For patients: Almost all children want to have their parents present during medical procedures Adult patients report that having family members at the bedside comforted and helped them.

8. Family Presence During Resuscitation and Invasive Procedures 8 Supporting Evidence �Benefits For family members: Removed doubt about the patient�s condition Witnessing that everything possible was done Decreased their anxiety and fear Facilitated their need to be together Facilitated a sense of closure

9. Family Presence During Resuscitation and Invasive Procedures 9 Supporting Evidence 94% to 100% of families would do so again No patient care disruptions No negative outcomes during family presence events No adverse psychological effects among family members

10. Family Presence During Resuscitation and Invasive Procedures 10 Actions for Nursing Practice Ensure that your healthcare facility has written policies and procedures that support family presence during resuscitation and invasive procedures.

11. Family Presence During Resuscitation and Invasive Procedures 11 Actions for Nursing Practice Policies, procedures, and educational programs should include: Benefits of family presence. Criteria for assessing the family. Role of the family facilitator in preparing families. Handling the development of untoward reactions by family members. Support for patient�s or family members� decision not to have family present. Contraindications to family presence.

12. Family Presence During Resuscitation and Invasive Procedures 12 Actions for Nursing Practice Develop proficiency standards for all staff. Determine your unit�s rate of compliance.

13. Family Presence During Resuscitation and Invasive Procedures 13 Actions for Nursing Practice If compliance is <90%, develop a plan to improve compliance: A multidisciplinary task force or a unit core group of staff. Re-educate staff about family presence. Incorporate into orientation programs and annual competencies. Develop a variety of communications strategies. Develop documentation standards for family presence.

14. Family Presence During Resuscitation and Invasive Procedures 14 For More Information Practice Alerts are online at www.aacn.org. For additional information / assistance go to the Practice Resource Network at www.aacn.org.

15. Family Presence During Resuscitation and Invasive Procedures 15 Resources Presenting the Option of Family Presence. Product #120632 is available online at www.aacn.org American College of Chest Physician�s Critical Care Family Assistance Program. Product #120631 is available online at www.aacn.org