Study: Your ED needs policy for family presence

Does your ED allow family members to be present during emergency procedures? Chances are you have no written policy for this practice, even if it’s a common occurrence. A just-published study found that only 5% of ED and critical care nurses surveyed had written policies permitting family members to be present during cardiopulmonary resuscitation or invasive procedures.1

Here are key findings:

  • About half of the hospital units covered by the survey allowed family members to be present, but did so without a written policy.
  • Nurses said family members asked to be present about one-third of the time for resuscitation and about two-thirds of the time for invasive procedures.
  • About 25% of nurses reported that family presence was prohibited for cardiopulmonary resuscitation and invasive procedures, even though their units had no written policies prohibiting such access.

However, there is a trend toward more EDs allowing family members access during procedures, says Theresa Meyers, RN, BSN, MS, director of the emergency and trauma service at Memorial Hospital in Colorado Springs, CO, and one of the study’s investigators. "To have families present at the bedside during resuscitation is a paradigm shift from what most nurses were educated on and have practiced," she says.

Having the family at the bedside during the resuscitation is an important way to advocate for the patient, by including the family and keeping them informed of what is happening with their loved one, says Meyers. "Often, the family initiates the discussion of making the decision to stop resuscitation efforts once they have seen all that has been done to save their loved one," she says.

Meyers points to the study’s findings that "critical care and emergency departments should consider developing written policies or guidelines on family presence to meet the needs of patients and their families and provide consistent, safe, and caring practices for patients, patients’ families and staff."

If written protocols are developed, they should include a statement that supports the option of having the practice and a procedure for the staff to refer to when needed, says Meyers. "It should provide guidelines for the family facilitator or support person and also include information on evaluating the need for a debriefing for the staff following the case," she adds.

Reference

1. MacLean SL, Guzzetta CE, White C, et al. Family presence during cardiopulmonary resuscitation and invasive procedures: Practices of critical care and emergency nurses. Am J Crit Care 2003; 12:246-247.

Resources

For more information on the study, contact:

Theresa Meyers, RN, BSN, MS, Director Emergency and Trauma Service, Memorial Hospital, 1400 E. Boulder St., Colorado Springs, CO 80909. Telephone: (719) 365-2700. Fax: (719) 365-6595. E-mail: Theresa.Meyers@memhospcs.org.

The Emergency Nurses Association (ENA) has developed a resource for developing and implementing a family presence program. To order, go to the Emergency Nurses Association web site (www.ena.org). Click on "Marketplace," and under "Books/Journals," click on "Clinical Books," and "Presenting the Option for Family Presence (Second Edition)." The cost is $48 for nonmembers plus a $10 shipping charge, and $38 for members plus a $6.50 shipping charge. A position statement on family presence in the ED can be accessed free of charge on the ENA web site. Under "Publications," click on "Position Statements" and scroll down to "Family Presence at the Bedside during Invasive Procedures and/or Resuscitation."