Family Presence During Trauma Resuscitation: Family Members' Attitudes, Behaviors, and Experiences.

BACKGROUND: The paradigm is shifting from separating family members from their children during resuscitation to one of patient- and family-centered care. However, widespread acceptance is still lacking. OBJECTIVE: To measure attitudes, behaviors, and experiences of family members of pediatric patients during the resuscitation phase of trauma care, including family members who were present and those who were not. METHODS: An observational mixed-methods study using structured interviews and focus groups was conducted at 3 level 1 pediatric trauma centers. Family members of children who met trauma team activation criteria (N = 126; 99 present, 27 not present) were interviewed; 25 also participated in focus groups. RESULTS: Mean attitude scores indicated a positive attitude about being present during the resuscitation phase of trauma care (3.65; SD, 0.37) or wanting to be present (3.2; SD, 0.60). Families present reported providing emotional support (94%) for their child and health care information (92%) to the medical team. Being present allowed them to advocate for their child, understand their child's condition, and provide comfort. Families in both groups felt strongly that the choice was their right but was contingent upon their bedside behavior. CONCLUSIONS: Study findings demonstrated compelling family benefits for presence during pediatric trauma care. This study is one of the first to report on family members who were not present. The practice of family presence should be made a priority at pediatric trauma centers.

Effects of family presence during resuscitation and invasive procedures in a pediatric emergency department.

INTRODUCTION: No research exists evaluating family presence (FP) during resuscitation interventions (RIs) and invasive procedures (IPs) using ENA guidelines in a pediatric emergency department. The purpose of this study was to determine the effectiveness of an FP protocol in facilitating uninterrupted care and describe parents' and providers' experiences. METHODS: FP was offered by a family facilitator to parents of children undergoing RIs or IPs. Data were collected during 64 FP events (28 RIs and 36 IPs). Following the event, 92 providers and 22 parents completed a survey about their experiences. RESULTS: In 100% of FP cases, patient care was uninterrupted. Parents were positive about FP, believed it helped their child, and reported that it eased their fears. All parents described an active role during the event, and most believed they had a right to be present. Three months later, no parents reported traumatic memories. Providers also were positive about FP and reported that the presence of parents did not negatively affect care. Although most (70%) supported FP during RIs, more nurses (92%) and physicians (78%) supported it than did residents (35%, P < .05). DISCUSSION: The findings suggest the effectiveness of a pediatric emergency department FP protocol in facilitating uninterrupted patient care. The benefits identified for parents support implementation of FP programs.