Family presence during resuscitation: a needs assessment of education, policy, and opinion in Canada.

PURPOSE: Family presence during resuscitation (FPDR) has been widely endorsed. Nevertheless, there is limited information available on current education and training used to support FPDR implementation, including that of relevant policy. Understanding the current state of FPDR educational opportunities, policies, and practices across Canadian hospitals is crucial to advancing and standardizing these within our medical community. Our objective was to identify the current and desired state of education and policy on FPDR, as well as current practices and opinions of Canadian healthcare professionals. METHODS: We selected questionnaire topics and employed a modified Delphi consensus technique using a group of subject matter experts in resuscitation. We contacted a stratified sample of Canadian healthcare professionals via select listservs and surveyed the cohort using RedCAP™. We used descriptive statistics and conducted quantitative analyses to describe and test for significant differences among groups. RESULTS: In total, 635 surveys were completed. Only 46.3% of participants reported ever attending an educational opportunity involving learning how to manage FPDR; however, 92% wanted training. Only 11% knew if they had an official FPDR policy in their current hospital but 62.9% indicated they wanted one. In support of FPDR, 88% agreed that family members should be allowed to be present during a resuscitation. CONCLUSION: While opinions are mostly positive towards FPDR, there exists a gap between the current and desired state of education and policy supporting it within Canada.

RéSUMé: OBJECTIF: La présence de la famille pendant la réanimation est largement appuyée. Néanmoins, il existe peu d'informations disponibles sur l'éducation et la formation actuelles utilisées pour soutenir la mise en œuvre de la présence de la famille pendant la réanimation, y compris l'information touchant les politiques pertinentes. Il est essentiel de comprendre l'état actuel des opportunités de formation, des politiques et des pratiques en matière de présence familiale pendant la réanimation dans l'ensemble des hôpitaux canadiens afin de les faire progresser et de les standardiser au sein de la communauté médicale. Notre objectif était de déterminer l'état actuel et souhaité de la formation et des politiques en matière de présence familiale pendant la réanimation, ainsi que les pratiques et les opinions actuelles des professionnels de la santé canadiens. MéTHODE: Nous avons sélectionné un questionnaire et utilisé une technique de consensus Delphi modifiée afin d'obtenir les réponses d'un groupe d'experts en matière de réanimation. Nous avons communiqué avec un échantillon stratifié de professionnels de la santé canadiens par l'entremise de gestionnaires de liste sélectionnés et avons sondé notre cohorte à l'aide de l'application RedCAP™. Nous avons utilisé des statistiques descriptives et effectué des analyses quantitatives pour décrire et tester les différences significatives entre les groupes. RéSULTATS: Au total, 635 sondages ont été complétés. Seuls 46,3 % des participants ont déclaré avoir déjà assisté à une opportunité de formation portant sur l'apprentissage de la gestion de la présence familiale pendant la réanimation; toutefois, 92 % des répondants ont déclaré désirer une formation. Seulement 11 % des répondants savaient s'il existait une politique officielle de présence de la famille pendant la réanimation dans leur hôpital, mais 62,9 % ont indiqué qu'ils souhaitaient en avoir une. En faveur de la présence familiale, 88 % étaient d'avis que les membres de la famille devraient être autorisés à être présents lors d'une réanimation. CONCLUSION: Bien que les opinions soient pour la plupart positives à l'égard de la présence familiale pendant la réanimation, il existe un écart entre l'état actuel et souhaité de la formation et des politiques qui l'appuient au Canada.

A Qualitative Exploration of the Impact of a Distressed Family Member on Pediatric Resuscitation Teams.

BACKGROUND AND OBJECTIVES: Family presence during resuscitation (FPDR) is commonplace in many hospitals today. Research has supported the positive effects it can have on family members; however, there is little research about how it may affect the resuscitation team's performance, especially in a pediatric population. Our objective was to identify how resuscitation team members perceive and respond to the presence of a distressed family member during a resuscitation. METHODS: This is a qualitative study in which we examine FPDR-related themes raised by pediatric resuscitation team members after a resuscitation simulation. As part of a team training educational intervention, pediatric resuscitation teams, composed of nurses, respiratory therapists, and resident physicians, participated in a video-recorded simulated event in which they attempted to resuscitate an infant. During the scenario, a confederate actor played the role of a distressed "parent." Video-recorded debriefs occurred immediately after each simulation. Video recordings were transcribed verbatim, and then transcripts were coded and analyzed via thematic analysis to saturation. RESULTS: Thirteen postevent video debriefs were analyzed. A total of 74 participants took part in these simulations and debriefs. Analysis revealed 15 major and 29 minor themes, which were mapped to 5 factors, namely resuscitation environment, affective responses, cognitive responses, behavioral responses, and team dynamics. CONCLUSIONS: FPDR has an impact on resuscitation team members' responses and influences their adaptive behavior. If not managed well, this may pose potential patient safety concerns. Policy and training of specific teamwork skills are ways in which we can better equip health care providers to effectively manage FPDR.

A Scoping Review of the Impact of Family Presence on Pediatric Resuscitation Team Members.

OBJECTIVES: The purpose of this scoping review was to identify the extent, range, and nature of information currently available on family presence during pediatric resuscitation on resuscitation team members and their performance. DATA SOURCES: A comprehensive search strategy was created and executed by identifying primary keywords in central articles, pretesting key words and combinations of them in databases to confirm articles returned fell within the search parameters, and checking that key articles were returned which confirmed the search strategy was not too narrow. STUDY SELECTION: Two members of the research team independently conducted relevance screening using predetermined inclusion and exclusion parameters. Titles and abstracts of retrieved articles were reviewed using the set criteria involving. From the refined list of selected articles, full texts of each article were considered for final determination of inclusion. DATA EXTRACTION: Key items of information were gathered from each article selected using a predefined extraction list. The extracted information was then sorted into themes and relevant issues. DATA SYNTHESIS: Of the 3,012 studies initially identified, 48 met the inclusion criteria. Themes identified included as follows: 1) attitudes and opinions on family presence during pediatric resuscitation; 2) reasons in support of or against family presence during pediatric resuscitation; 3) education, training, and support; and 4) resuscitation performance and outcomes. Our review of the available information highlighted that the majority of work done to this point has focused heavily on healthcare provider opinions and relied mainly on survey method. CONCLUSIONS: We propose that future research employ more rigorous research techniques, such as randomized control trials, place greater emphasis on healthcare provider behaviors and clinical outcomes during family presence during pediatric resuscitation, and increase exploration into the education and training needs of healthcare providers who already currently manage family presence during pediatric resuscitation.