Medical staff attitudes toward family presence during pediatric procedures.
OBJECTIVE
Investigate health care providers' perceived advantages and disadvantages of family member presence (FMP) for a wide spectrum of procedures in the pediatric emergency department.


METHODS
Urban tertiary care children's hospital.


METHODS
Pediatric emergency department faculty and nurses, pediatric residents.


METHODS
In a written survey, participants rated approval of FMP for 9 procedures: intravenous (IV) placement, urinary catheterization, suturing, lumbar puncture, fracture reduction, chest tube placement, endotracheal intubation, medical resuscitation, and trauma resuscitation. Respondents listed advantages and disadvantages of FMP for patients, families, and staff.


RESULTS
71% (104/146) of the surveys were completed. Attending physicians and nurses provided similarly high approval rating for less invasive procedures, with a decrement in approval for more invasive or life-threatening situations. Attending physicians and nurses were more likely than residents to approve FMP for all procedures except IV placement, suturing, and urinary catheterization, which had similar approval rates for all respondents. Commonly expressed potential advantages were ability to calm the patient, decreased parental "helplessness," and increased parental knowledge that everything was done. Disadvantages included higher anxiety in room, disturbing parental memories, and detriment to success of the procedure. Medical-legal concerns, mistrust of providers, and more difficult teaching environment were uncommonly listed as disadvantages.


CONCLUSIONS
Emergency department staff support FMP for minor procedures, yet express concern regarding the effects of this practice on the family and the success of the procedure. Most attending physicians and nurses support FMP during highly invasive procedures and resuscitations, whereas residents do not. This information provides insight into the educational and systematic requirements of implementation of FMP.
Fein
Joel A
JA
Division of Emergency Medicine, The Children's Hospital of Philadelphia, and the Department of Pediatrics, The University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. fein@email.chop.edu
Ganesh
Jaya
J
Alpern
Elizabeth R
ER
D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D003625:Data Collection; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005180:Faculty, Medical; D005190:Family; D050723:Fractures, Bone / Q000523:psychology / Q000628:therapy; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D007262:Infusions, Intravenous / Q000523:psychology; D007396:Internship and Residency; D007440:Intubation / Q000523:psychology; D009726:Nurses / Q000523:psychology; D010372:Pediatrics; D015143:Philadelphia; D010820:Physicians / Q000523:psychology; D011368:Professional-Family Relations; D012151:Resuscitation / Q000523:psychology; D013129:Spinal Puncture / Q000523:psychology; D013536:Suture Techniques / Q000523:psychology; D014546:Urinary Catheterization / Q000523:psychology; D014789:Visitors to Patients