Family Presence During Resuscitation (FPDR): Observational case studies of emergency personnel in Victoria, Australia

• Published in: International emergency nursing 2017-07, Vol.33, p.37-42
• Main Authors: Porter, Joanne E., Miller, Nareeda, Giannis, Anita, Coombs, Nicole
• Format: Article
• Language: English
• Subjects: Cardiopulmonary resuscitation; Care coordinators; Clinical nursing; CPR; Emergency department; Emergency services; Families & family life; Family presence; Hospitals; Liaison; Nurses; Observation; Parent participation; Physicians; Relatives; Resuscitation; Teams
• ISSN: 1755-599X; 1532-9267; 1878-013X
• DOI: 10.1016/j.ienj.2016.12.002

•Emergency staff continues to inconsistently implement family presence during resuscitation.•Family members remain at times isolated from the patient.•Miscommunication remains an issue with resuscitation staff ill prepared to speak with family members.•A designated support person streamlines communication with family and removes role ambiguity for resuscitation team members. Family Presence During Resuscitation (FPDR), although not a new concept, remains inconsistently implemented by emergency personnel. Many larger metropolitan emergency departments (ED) have instigated a care coordinator role, however these personnel are often from a non-nursing background and have therefore limited knowledge about the clinical aspects of the resuscitation. In rural emergency departments there are simply not enough staff to allocate an independent role. A separate care coordinator role, who is assigned to care for the family and not take part in the resuscitation has been well documented as essential to the successful implementation of FPDR. One rural and one metropolitan emergency department in the state of Victoria, Australia were observed and data was collected on FPDR events. The participants consisted of resuscitation team members, including; emergency trained nurses, senior medical officers, general nurses and doctors. The participants were not told that the data would be recorded around interactions with family members or team discussions regarding family involvement in the resuscitation, following ethical approval involving limited disclosure of the aims of the study. Seventeen adult presentations (Metro n=9, Rural n=8) were included in this study and will be presented as resuscitation case studies. The key themes identified included ambiguity around resuscitation status, keeping the family informed, family isolation and inter-professional communication. During 17 adult resuscitation cases, staff were witnessed communicating with family, which was often limited and isolation resulted. Family were often uninformed or separated from their family member, however when a family liaison person was available it was found to be beneficial. This research indicated that staff could benefit from a designated family liaison role, formal policy and further education.