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ED Staff More Open to Family Presence During Cardiopulmonary Resuscitation

BRONX, NY – Among all hospital personnel, emergency department staff members are the most amenable to family presence during resuscitation (FPDR), according to a new study.

A presentation at the recent CHEST 2016 conference in Los Angeles analyzed the perceptions and attitudes of the healthcare team about FPDR. These attitudes varied based on staff roles and locations in the hospital.

For the study, researchers from St. Barnabas Hospital in the Bronx, a 460-bed academic hospital, focused on 195 randomly selected physicians, respiratory therapists, nurses, and resident trainee physicians, finding that only 36.9% were in favor of FPDR.

Overall, according to the report, attending physicians were the most comfortable with FPDR, 47%, while respiratory therapists were the least comfortable, 21%. Results indicate that those most comfortable with the practice were personnel in the ED, 51%, and intensive care unit, 48%.

At the same time, only 24% of staff on the general medical floors was in favor of families being present during what sometimes is called Code Blue.

The study reports that 85% of respondents said FPDR likely would increase their own stress and anxiety during cardiopulmonary resuscitation (CPR). In addition, many also expressed concerns that family members potentially could interfere with the resuscitation efforts, suffer serious emotional trauma, or be more likely to pursue litigation.

Yet, 55% of the staff agreed that family members should be given the option to witness CPR.

“Overall, the attitudes towards FPDR are negative, but perceptions significantly vary among the different members of the CPR team, depending on their roles. Previous negative experiences with FPDR are associated with less positive attitudes,” study authors conclude, adding that most studies have found a higher level of acceptance among nurses.

The researchers also point out that those surveyed suggested they would benefit from FPDR training.

"We found that staff working in the ICU and emergency department, where the need for CPR is most common, felt more comfortable with the practice of FPDR," explained lead researcher Alvaro Martin, MD. "We also found overall lack of knowledge about the place of FPDR in daily clinical practice and institutional policies in this regard. We believe that structured education could have a positive influence on perceptions and attitudes towards FPDR."