Impact of Family Members on Health Care Providers During Resuscitation Eric Izaguirre, Dani Meek, Duan Nguyen, Cindy Tanory, Erika Villalpando • Dr. Jacqueline Sherman • Nursing 350 Introduction Future Research Questions FPDR is when one or more family members is present in a place allows them to see or touch the family member that is receiving cardiopulmonary resuscitation (CPR) (Dwyer & Friel, 2016). FPDR involves family members, health care providers (HCP) as well as hospitals. Current controversial topic. About 5% of hospitals in the Unites States has a policy allowing family members to be present (Oman & Duran, 2011). Low percentage of the implemented policies attributed to: Fear of the health care members not being able to maintain a professional stance Lack of emotional distance Fear of the emotional strain on the family member (Jensen & Kosowan, 2011). HCP in support of having family members present believe it can help with the grieving process (Jensen & Kosowan, 2011). The purpose if this research was to investigate how the presence of family members impacts HCP. 1. What steps can hospitals take to minimize disruptions and distractions (if they arise) from the patient’s family? 2. How may hospitals accommodate for health care providers who report that they feel an increased amount of stress during family presence? 3. What do hospitals need to consider when developing and implementing a FPDR policy? 4. Should hospitals offer all family members to be involved and present during resuscitation? Disruptions and Distractions Dwyer and Friel (2016) performed a quasi experimental study that included 200 HCP to determine if educating them would shift their attitudes regarding FPDR. Only 29 of the participants were used for analysis. The pre-test/post-test questionnaire determined that distractions was a concern. Distractions include family members taking up space, family members observing CPR, and unprofessional behavior of the staff member (Dwyer & Friel, 2016). Distractions result in an increase in anxiety because of pressure of feeling the need to perform CPR perfectly. (Dwyer & Friel, 2016). Stress A study by Jensen and Kosowan (2011), consisted of a 19 question survey distributed to five hospitals involving 169 HCP. The purpose of the study was to find out how HCP felt when they performed CPR when the family member was present (Jensen and Kosowan, 2011). 42.6% of the participants expressed an increase in their stress level when the family member was present which in turn hindered their performance. 82.9% of the participants were in favor of having a policy in place because they felt that providing psychosocial support to the patient was a key component. Correlated to a study performed by Jabre et al., (2013), their results showed no significant difference is the level of stress in HCP who performed CPR with or without the family member present. References Basol, R., Ohman, K., Simones, J., & Skillings, K. (2009). Using research to determine support for a policy on family presence during resuscitation. Dimensions of Critical Care Nursing : DCCN, 28(5), 237. Dwyer, T., & Friel, D. (2016). Inviting family to be present during cardiopulmonary resuscitation: Impact of education. Nurse Education in Practice, 16(1), 274. Hocevar, R. (2013, September 9). Family Presence in Adult CPR. Retrieved April 27, 2016, from http://nursing.advanceweb.com/Features/Articles/Family-Presence-in-Adult-CPR.aspx Itzhaki, M., Bar‐Tal, Y., & Barnoy, S. (2012). Reactions of staff members and lay people to family presence during resuscitation: The effect of visible bleeding, resuscitation outcome and gender. Journal of Advanced Nursing, 68(9), 1967-1977 Jabre, P., Belpomme, V., Azoulay, E., Jacob, L., Bertrand, L., et al. (2013). Family presence during cardiopulmonary resuscitation. The New England Journal of Medicine, 368(11), 1008. Jensen, L., & Kosowan, S. (2011). Family Presence During Cardiopulmonary Resuscitation: Cardiac Health Care Professionals' Perspectives. Canadian Journal Of Cardiovascular Nursing, 21(3), 23-29 7p. McClenathan, B., Torrington, K., & Uyehara, C. (2002). Family member presence during cardiopulmonary resuscitation: a survey of US and international critical care professionals. Chest, 122(6), 2204-2211 8p. New England Journal of Medicine 2013. (n.d.). Retrieved April 27, 2016, from https:// www.pinterest.com/pin/211387776232010044/ Oman, K., & Duran, C. (2010). Health care providers' evaluations of family presence during resuscitation. Journal of Emergency Nursing, 36(6), 524-533. Stock Photography: Search Royalty Free Images & Photos - iStock. (n.d.). Retrieved April 28, 2016,from http://www.istockphoto.com/vector/glowing-ekg-strip-gm455423785-16797875 TrueCPR Coaching Device | EMSWorld.com. (n.d.). Retrieved April 27, 2016, from http:// www.emsworld.com/product/10946223/physio-control-truecpr-coaching-device Emotional Strain In a study conducted in Israel by Itzhaki, Bar-Tal & Barnoy (2012), 421 participants were given eight scenarios that depicted resuscitation with manipulated variables being blood involvement and patient outcome. A questionnaire identified whether participants had negative views on FPDR. Results displayed that FPDR differed based on gender and blood involvement. Male nurses (n=72) had positive attitudes, while female nurses (n=74) displayed negative feelings (Itzhaki et al, 2012). Research also determined that both male and female nurses had positive views towards FPDR without blood involvement. Researchers concluded that blood involvement demonstrate increased emotional strain on family members that can cause disruption to healthcare providers (Itzhaki et al, 2012). Threats of Legal Consequences Fear of legal litigation is a major concern regarding FPDR. 23% of HCP were opposed of allowing FPDR due to fear of lawsuits or claims by the family members if they witnessed and injury or death (McClenathan, Torrington, & Uyehara, 2012). Jabre et al., (2013) conducted a cluster randomized study on prehospital emergency medical service units which were randomly assigned to either the intervention group of allowing FPDR or the control group, which did not allow FPDR. Their goal was to determine how the presence of family members affected the legal aspect of the situation. The results indicated that no family members in the intervention nor control group filed any claims or lawsuits (Jabre et al., 2013)