Family Presence During Resuscitation and Invasive Procedures Genna Gorte Ann Puruleski Shannon Grabe

Objectives Define AACN practice alerts Quality and Safety An AACN practice alert is a succinct, dynamic directives that are supported by authoritive evidence to ensure excellence in practice and a safe human work environment. AACN ensures reseach of high quality for developing their polices and procedures. This ensures that the alert supports quality and safety. The research that was used in this alert was a high level of evidence. The evidence used in this alert was level B and D Supporting Research

Introduction AACN Mission AACN Vision AACN Values Ethical Accountability and integrity Leadership to enable individuals to make their optimal contribution Excellence and innovation Collaboration Mission: Patients and their families rely on nurses at the most vulnerable times of their lives. Acute and critical care nurses rely on AACN for expert knowledge and the influence to fulfill their promise to patients and their families. AACN drives excellence because nothing less is acceptable. Vision: AACN is dedicated to creating a healthcare system driven by the needs of patients and families where acute and critical care nurses make their optimal contribution. Values: As AACN works to promote its mission and vision, it is guided by values that are rooted in, and arise from the association’s history, traditions and culture. AACN, it’s members, volunteers and staff will honor the following: -Ethical Accountability and integrity in relationships, organizational decisions and stewardship of resources. -Leadership to enable individuals to make their optimal contribution though lifelong learning, critical thinking and inquiry. -Excellence and innovation at every level of the organization to advance the profession. -Collaboration to ensure quality patient- and family- focused care

Level of Evidence Level B Level D Level B is a well designed, controlled studies with results that consistently support a specific action, intervention or treatment Level D is a peer reviewed professional organizational standards with clinical studies to support recommendations.

Practice Alert Practice Alert Family members of all patients undergoing resuscitation and invasive procedures should be given the option of presence at the bed side All patient care units should have an approved written practice document (i.e., policy, procedure, or standard of care) for presenting the option of family presence during resuscitation and bedside invasive procedures

Audit Tool Purpose: to determine compliance in offering the option for family members to be present during resuscitation and invasive procedures.

Support of Alert Support of Alert Public Poll: 50- 96% of family want the option to be present Currently only 5% of Critical Care Units have policies in place in regards to family presence. There is more and more evidence coming out about the presence of family at the bedside during resuscitation and invasive procedures. This evidence is showing that the presence is beneficial to the patient, the family, and the staff. When family is there psychosocial needs are being met for the patient. Pt Benefits: Children want their parents present during procedures and adult patients said that having family members comforted and helped them. Family Benefits: Presence at the bedside helped them remove doubt about the family members condition because they are able to see all the care being done. It also allows the family to be together and help reduce anxiety and fear the family may have. Also when they are present it allows the family to support the patient which helps with closure and the grief process. Family and loved ones want to be apart of all aspect of a loved ones care. In a public poll 50-96% of participants wanted the option to be apart of resuscitation and invasive procedures. Right now in the US, only 5% of critical care units have written policies allowing family presence. It was stated that nurses in Critical care units are often asked by family members if they can be at the bedside during these procedures and nurses allowed this despite the lack of formal hospital policy.

Quality and Safety Quality and Safety Ensure policy is in place Policy and procedures, and educational programs for professional staff Develop standards for staff to ensure patient, family, and staff safety Determine unit’s rate of compliance in offering family presence Ensure that the healthcare facility has a clearly stated policy that speaks to and supports having family presence during resuscitation and invasive procedures. These policies and procedures should include the following; benefits for the family and patient. Guidelines for assessing the family to ensure uninterrupted patient care. Description of the role of the family facilitator who will be interacting with the family. Support for the patient or family members who decide to not have family members present. And lastly the contraindications for having the family members present. There needs to be standards that are set for the staff involved in caring for a patient with family present. These standards need to ensure patient, family, and staff safety. The rate of compliance needs to be evaluated If the rate is less than 90% a new plan for compliance needs to be put in place.

Conclusion Conclusion Offer family presence Have formal policy in place If no policy Plan to improve compliance

References References American Association of Critical-Care Nurses. (2014). Key statements, beliefs and philosophies behind the American Association of Critical-Care Nurses (AACN). http://www.aacn.org/wd/publishing/content/pressroom/aacnfactsheet.pcms?menu=publications# American Association of Critical-Care Nurses. (2014). Mission and Values (AACN). Retrieved from http://www.aacn.org/wd/certifications/content/mission-vision.pcms?menu=certification Martin, B. (2010)Family Presence During Resuscitation and  Invasive Procedure retrieved from http://www.aacn.org/wd/practice/content/family-presence-practice-alert.pcms?menu=practice