2.50
Hdl Handle:
http://hdl.handle.net/10755/166386
Category:
Abstract
Type:
Presentation
Title:
Family Presence During Resuscitation
Author(s):
Kramlich, Deb
Author Details:
Deb Kramlich, RN, BSN, CCRN, at the Maine Medical Center in Portland, ME, email: kramld@mmc.org
Abstract:
HEALTHCARE ORGANIZATION DESCRIPTION: Maine Medical Center (MMC) is a nonprofit, private corporation governed by volunteer trustees from the communities we serve. MMC serves as a community hospital for the people of greater Portland, Maine, and is the premier tertiary care center for northern New England. The hospital has 606 licensed beds, and provides comprehensive inpatient services in all medical specialties. Centers of excellence are being developed in cancer care, heart care, children's services, and other areas, building from existing excellence in multi-disciplinary services. MMC has a large and growing outpatient component, providing day surgery, cardiac catheterization, laboratory services, rehabilitation services, and three dozen outpatient clinics. There are also preventive and consultation services, including the MMC Diabetes Center, the AIDS Consultation Service, and the Center for Lipids and Cardiovascular Health. MMC is MaineÆs only acute care hospital with Magnet designation, heaving earned this designation in May 2006. BACKGROUND OF PRACTICE INNOVATION: The family is recognized as the major support system for the patient, and family-centered care is at the core of our culture at Maine Medical Center (MMC). Family presence during resuscitation (FPDR) is a topic that is gaining more public interest. The American Heart Association encourages FPDR. Several professional nursing organizations such as the Emergency Nursing Association (ENA) and the American Association of Critical Care Nursing (AACN) have position statements supporting family presence. The Society of Critical Care Medicine (SCCM), American College of Emergency Physicians (ACEP), and other professional medical associations are following suit. The topic of FPDR causes much concern and anxiety. Practice decisions are often based more on tradition than evidence. It has been recommended by many of the aforementioned organizations that healthcare facilities create policies and procedures to guide decisions concerning FPDR. MMC did not have a policy or guidelines in place regarding family presence. More families are asking to remain at their loved one's bed side. Such requests have been handled on an individual basis, causing confusion, anxiety and ambivalence. When occurrences are unplanned, appropriate staff may not be available to support the family or the caregivers, further contributing to negative experiences. PRACTICE INNOVATION PURPOSE: To determine if the development of guidelines for support for family presence during the resuscitation of a loved one would improve communication and support to families and enhance satisfaction. PRACTICE INNOVATION OBJECTIVES: Following the ENA recommendations for development of guidelines for the support of families during the resuscitation of a loved one, a multidisciplinary task force (including family members), was formed. The goal of the task force was to create a program that would provide consistent support for families in crisis and to decrease the anxiety and ambivalence felt by staff members when family presence was unplanned and families were left unattended. PRACTICE INNOVATION IMPLEMENTATION: Prior to development of the guidelines, staff surveys concerning family presence were distributed and analyzed. It was found that 45.5% strongly agreed and 24.1% somewhat agreed that family presence should be an option; 74% of staff would want the option of being present or having their families present. There were many concerns expressed about family interference with procedures, performance anxiety, fear of litigation, and traumatic memories. Staff also stated that lack of support for the family was a problem. Family members of patients who had experienced resuscitation were interviewed to gather information on the needs of these families. Common themes included: need for proximity to their loved one; accurate information about their loved oneÆs condition; importance of emotional support; depersonalization of their loved one during the resuscitation; not wanting to be in the way or interfere with the code team; and not focusing on or recalling the procedures or technology but feeling that everything possible was being done for their loved one. PRACTICE INNOVATION OUTCOMES: In the five months since implementation of the family support guidelines, 36% of the resuscitation events were attended by family members accompanied by either a family support staff member or staff nurse. Only one request for family presence was denied by the physician code team leader due to procedures; that family was supported in a "quiet room" by the family support staff. One request for family support (night shift) could not be fulfilled due to staffing. In all other cases, family members arrived after resuscitation efforts were discontinued, at which time grief counseling services were initiated. Anecdotal reports suggest that staff members are more comfortable with family presence, since families are not left unaccompanied, and family members feel more satisfied with the level of support and information they receive. Implementation of guidelines for family support during resuscitation of a loved one are resulting in increased family and staff satisfaction and decreased staff anxiety and fears of negative consequences of FPDR. Data collection, analysis, and evaluation of the program with revisions as necessary, are ongoing. CONCLUSIONS: The family support staff members have been called to seven resuscitation events in two months since the guidelines were introduced. Data are still being gathered and analyzed. Anecdotal reports suggest that staff and family members have been satisfied with the program. The program will continue to be monitored. If results suggest that the program is successful, a plan for implementation throughout the institution will be considered.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2008
Conference Name:
ANCC Magnet Practice Innovations
Conference Host:
American Nurses Credentialing Center
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host for further details regarding this item.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleFamily Presence During Resuscitationen_GB
dc.contributor.authorKramlich, Deben_US
dc.author.detailsDeb Kramlich, RN, BSN, CCRN, at the Maine Medical Center in Portland, ME, email: kramld@mmc.orgen_US
dc.identifier.urihttp://hdl.handle.net/10755/166386-
dc.description.abstractHEALTHCARE ORGANIZATION DESCRIPTION: Maine Medical Center (MMC) is a nonprofit, private corporation governed by volunteer trustees from the communities we serve. MMC serves as a community hospital for the people of greater Portland, Maine, and is the premier tertiary care center for northern New England. The hospital has 606 licensed beds, and provides comprehensive inpatient services in all medical specialties. Centers of excellence are being developed in cancer care, heart care, children's services, and other areas, building from existing excellence in multi-disciplinary services. MMC has a large and growing outpatient component, providing day surgery, cardiac catheterization, laboratory services, rehabilitation services, and three dozen outpatient clinics. There are also preventive and consultation services, including the MMC Diabetes Center, the AIDS Consultation Service, and the Center for Lipids and Cardiovascular Health. MMC is MaineÆs only acute care hospital with Magnet designation, heaving earned this designation in May 2006. BACKGROUND OF PRACTICE INNOVATION: The family is recognized as the major support system for the patient, and family-centered care is at the core of our culture at Maine Medical Center (MMC). Family presence during resuscitation (FPDR) is a topic that is gaining more public interest. The American Heart Association encourages FPDR. Several professional nursing organizations such as the Emergency Nursing Association (ENA) and the American Association of Critical Care Nursing (AACN) have position statements supporting family presence. The Society of Critical Care Medicine (SCCM), American College of Emergency Physicians (ACEP), and other professional medical associations are following suit. The topic of FPDR causes much concern and anxiety. Practice decisions are often based more on tradition than evidence. It has been recommended by many of the aforementioned organizations that healthcare facilities create policies and procedures to guide decisions concerning FPDR. MMC did not have a policy or guidelines in place regarding family presence. More families are asking to remain at their loved one's bed side. Such requests have been handled on an individual basis, causing confusion, anxiety and ambivalence. When occurrences are unplanned, appropriate staff may not be available to support the family or the caregivers, further contributing to negative experiences. PRACTICE INNOVATION PURPOSE: To determine if the development of guidelines for support for family presence during the resuscitation of a loved one would improve communication and support to families and enhance satisfaction. PRACTICE INNOVATION OBJECTIVES: Following the ENA recommendations for development of guidelines for the support of families during the resuscitation of a loved one, a multidisciplinary task force (including family members), was formed. The goal of the task force was to create a program that would provide consistent support for families in crisis and to decrease the anxiety and ambivalence felt by staff members when family presence was unplanned and families were left unattended. PRACTICE INNOVATION IMPLEMENTATION: Prior to development of the guidelines, staff surveys concerning family presence were distributed and analyzed. It was found that 45.5% strongly agreed and 24.1% somewhat agreed that family presence should be an option; 74% of staff would want the option of being present or having their families present. There were many concerns expressed about family interference with procedures, performance anxiety, fear of litigation, and traumatic memories. Staff also stated that lack of support for the family was a problem. Family members of patients who had experienced resuscitation were interviewed to gather information on the needs of these families. Common themes included: need for proximity to their loved one; accurate information about their loved oneÆs condition; importance of emotional support; depersonalization of their loved one during the resuscitation; not wanting to be in the way or interfere with the code team; and not focusing on or recalling the procedures or technology but feeling that everything possible was being done for their loved one. PRACTICE INNOVATION OUTCOMES: In the five months since implementation of the family support guidelines, 36% of the resuscitation events were attended by family members accompanied by either a family support staff member or staff nurse. Only one request for family presence was denied by the physician code team leader due to procedures; that family was supported in a "quiet room" by the family support staff. One request for family support (night shift) could not be fulfilled due to staffing. In all other cases, family members arrived after resuscitation efforts were discontinued, at which time grief counseling services were initiated. Anecdotal reports suggest that staff members are more comfortable with family presence, since families are not left unaccompanied, and family members feel more satisfied with the level of support and information they receive. Implementation of guidelines for family support during resuscitation of a loved one are resulting in increased family and staff satisfaction and decreased staff anxiety and fears of negative consequences of FPDR. Data collection, analysis, and evaluation of the program with revisions as necessary, are ongoing. CONCLUSIONS: The family support staff members have been called to seven resuscitation events in two months since the guidelines were introduced. Data are still being gathered and analyzed. Anecdotal reports suggest that staff and family members have been satisfied with the program. The program will continue to be monitored. If results suggest that the program is successful, a plan for implementation throughout the institution will be considered.en_US
dc.date.available2011-10-27T15:32:33Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T15:32:33Z-
dc.conference.date2008en_US
dc.conference.nameANCC Magnet Practice Innovationsen_US
dc.conference.hostAmerican Nurses Credentialing Centeren_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host for further details regarding this item.-
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