Impact of a Multifaceted Intervention on Nurses' and Physicians' Attitudes and Behaviors Toward Family Presence During Resuscitation

2.50
Hdl Handle:
http://hdl.handle.net/10755/163057
Type:
Presentation
Title:
Impact of a Multifaceted Intervention on Nurses' and Physicians' Attitudes and Behaviors Toward Family Presence During Resuscitation
Abstract:
Impact of a Multifaceted Intervention on Nurses' and Physicians' Attitudes and Behaviors Toward Family Presence During Resuscitation
Conference Sponsor:Emergency Nurses Association
Conference Year:2004
Author:Mian, Patricia, RN, MS, APN-BS
P.I. Institution Name:Massachusetts General Hospital
Title:Psychiatric Clinical Nurse Specialist
Contact Address:55 Fruit Street, Boston, MA, 02114, USA
Contact Telephone:(617) 724-4129
Co-Authors:Joan Fitzmaurice, RN, PhD, FAAN; Susan Warchal, RN; David Tancredi, MD; Susan Whitney, RN, BS
Purpose: Lack of shared beliefs about family presence (FP) during resuscitative procedures in the emergency
department (ED) may result in ethical dilemmas and conflict among nurses, physicians, and families.
The purpose of this study was to evaluate attitudes and behaviors of nurses (RN) and physicians (MD) during
piloting of family presence guidelines in the ED.
Design: A two group before and after ex post facto design was used.
Setting: The study was conducted in a northeast academic medical center with 77,000 annual visits.
Sample: Surveys were given to all nurses and physicians. A total of 86 RN (81%) and 36 MD (50%) completed
initial survey (T1) and follow up survey (T2) for a response rate of 80% (RN) and 14% (MD). The
nurses were between 30-49 years (65%), female (87%), BSN prepared (68%) with five or less years of ED
practice (52%).The physicians were less than 40 years old (80%), male (74%), with less than 6 years of ED
practice (74%).
Methodology: Following approval to implement the pilot guidelines by ED leadership, nurses and physicians
completed baseline surveys. The findings helped tailor an educational program to address staff concerns.
The programs reviewed family presence research and pilot guidelines, elicited values, and utilized
case studies. Education was completed in 2 months. Utilizing pilot guidelines, family presence was implemented.
The clinical nurse specialist guided the process acting as family facilitator. Monthly posters placed
in the staff lounge highlighted baseline survey findings. Surveys were re-administered at 12 months to
examine attitudes after education and clinical experience. Surveys consisted of 30-item Likert Scale (1-5)
agreement concerning values, attitudes, and behavior. The scale was validated using principal components
of Factor Analysis. Six components accounting for 70% of variance were demonstrated. Cronbach's alphas
of the resulting subscales ranged from .76 to .93. All subscales were judged reliable and valid. Section 2
consisted of 12 questions on professional and personal questions, 3 additional questions on
education/pilot program on survey 2. Demographic information collected.
Results: Both nurses and physicians reported more experience and positive attitudes with FP at T2. In
general, nurses held more favorable attitudes than physicians did on teaching impact (p < .05), staff distress
(p < .05), family benefits (p < .05) and rights (p < .05). Physicians had more concerns about malpractice
issues (p < .05).
Conclusions: Despite expressed differences in nurses and physicians attitudes, family presence was successfully
implemented. Guided by Roger's Innovative Diffusion Model, key strategies included developing a
critical mass, explicit leadership valuing, and facilitated role modeling. Future research could focus on
whether attitudes and preferences are influenced by culture.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleImpact of a Multifaceted Intervention on Nurses' and Physicians' Attitudes and Behaviors Toward Family Presence During Resuscitationen_GB
dc.identifier.urihttp://hdl.handle.net/10755/163057-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Impact of a Multifaceted Intervention on Nurses' and Physicians' Attitudes and Behaviors Toward Family Presence During Resuscitation</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2004</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Mian, Patricia, RN, MS, APN-BS</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Massachusetts General Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Psychiatric Clinical Nurse Specialist</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">55 Fruit Street, Boston, MA, 02114, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(617) 724-4129</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">pmian@partners.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Joan Fitzmaurice, RN, PhD, FAAN; Susan Warchal, RN; David Tancredi, MD; Susan Whitney, RN, BS<br/></td></tr><tr><td colspan="2" class="item-abstract">Purpose: Lack of shared beliefs about family presence (FP) during resuscitative procedures in the emergency<br/>department (ED) may result in ethical dilemmas and conflict among nurses, physicians, and families.<br/>The purpose of this study was to evaluate attitudes and behaviors of nurses (RN) and physicians (MD) during<br/>piloting of family presence guidelines in the ED.<br/>Design: A two group before and after ex post facto design was used.<br/>Setting: The study was conducted in a northeast academic medical center with 77,000 annual visits.<br/>Sample: Surveys were given to all nurses and physicians. A total of 86 RN (81%) and 36 MD (50%) completed<br/>initial survey (T1) and follow up survey (T2) for a response rate of 80% (RN) and 14% (MD). The<br/>nurses were between 30-49 years (65%), female (87%), BSN prepared (68%) with five or less years of ED<br/>practice (52%).The physicians were less than 40 years old (80%), male (74%), with less than 6 years of ED<br/>practice (74%).<br/>Methodology: Following approval to implement the pilot guidelines by ED leadership, nurses and physicians<br/>completed baseline surveys. The findings helped tailor an educational program to address staff concerns.<br/>The programs reviewed family presence research and pilot guidelines, elicited values, and utilized<br/>case studies. Education was completed in 2 months. Utilizing pilot guidelines, family presence was implemented.<br/>The clinical nurse specialist guided the process acting as family facilitator. Monthly posters placed<br/>in the staff lounge highlighted baseline survey findings. Surveys were re-administered at 12 months to<br/>examine attitudes after education and clinical experience. Surveys consisted of 30-item Likert Scale (1-5)<br/>agreement concerning values, attitudes, and behavior. The scale was validated using principal components<br/>of Factor Analysis. Six components accounting for 70% of variance were demonstrated. Cronbach's alphas<br/>of the resulting subscales ranged from .76 to .93. All subscales were judged reliable and valid. Section 2<br/>consisted of 12 questions on professional and personal questions, 3 additional questions on<br/>education/pilot program on survey 2. Demographic information collected.<br/>Results: Both nurses and physicians reported more experience and positive attitudes with FP at T2. In<br/>general, nurses held more favorable attitudes than physicians did on teaching impact (p &lt; .05), staff distress<br/>(p &lt; .05), family benefits (p &lt; .05) and rights (p &lt; .05). Physicians had more concerns about malpractice<br/>issues (p &lt; .05).<br/>Conclusions: Despite expressed differences in nurses and physicians attitudes, family presence was successfully<br/>implemented. Guided by Roger's Innovative Diffusion Model, key strategies included developing a<br/>critical mass, explicit leadership valuing, and facilitated role modeling. Future research could focus on<br/>whether attitudes and preferences are influenced by culture.</td></tr></table>en_GB
dc.date.available2011-10-27T10:38:50Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:38:50Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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