Date Available

11-21-2016

Year of Publication

2016

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Carol Thompson

Clinical Mentor

Dr. Patti K. Howard

Committee Member

Dr. Paul Netzel

Abstract

Background: Family presence during cardiopulmonary resuscitation has been provided for more than 20 years (Hanson & Strawser, 1992). The American Association of Critical Care Nurses, The Emergency Nurses Association, The American College of Emergency Physicians, The American Heart Association, and The American Academy of Pediatrics have all endorsed family presence during resuscitation (AACN, 2004; AHA, 2000; Dingeman, Mitchell, Meyer, & Curley, 2007; ENA, 1994; Lowry, 2012). Despite validation by distinguished professional organizations, the option of family presence remains inconsistent. Objectives: 1.) To explore the attitudes and barriers to family presence during resuscitation. 2.) To examine the relationship between pre, midpoint and final data points to assess for a sustained practice change in family presence during resuscitation following policy implementation; 3.) To explore the relationship of attitudes and beliefs to evaluate domains for future education. Methods: Faculty and staff, including nurses, pharmacists, physicians, residents and fellows, chaplains, respiratory therapists and paramedics at a large academic medical center were surveyed via convenience sampling. Results: Does UK healthcare have a written policy, 57 percent of respondents were unsure if a policy existed in the 2016 survey. Statistical significance existed between 2012 and 2014 surveys (p = 0.013), as well as the 2014 and 2016 surveys (p = 0.003). Does family presence interfere with resuscitation, 59 percent of respondents answered no. Statistical significance existed between the 2014 and 2016 surveys (p = 0.004). Does family presence increase stress on staff, 49 percent of respondents answered yes. Statistical significance existed between 2014 and 2016 surveys (p = < 0.001). Does family presence increase fear of medico-legal litigation, 41 percent of respondents answered no. Statistical significance existed between 2012 and 2014 surveys (p = 0.005). Consistently across all 3 surveys, greater than 70 percent of staff identified that an increased understanding of family presence was needed. No statistical significance was found between surveys. Data points 2014 and 2016 highlighted statistical significance among consensus needed to have successful family presence (p = < 0.001). Support for family presence revealed statistical significance between the 2014 and 2016 data points (p = < 0.001). Does family presence assist with end of life decision making revealed statistical significance between 2014 and 2016 surveys (p = < 0.001). Roles revealed nurses responded more in 2012 and 2014 surveys. More pharmacists and paramedics (EMT-P) responded to the 2016 survey than to the 2012 and 2014 surveys combined. Conclusions: Attitudes and beliefs about family presence during cardiopulmonary resuscitation have improved post policy implementation. However, policy implementation is unlikely the exact reason for change as only a small number of respondents expressed knowledge of a policy.

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