Family presence during trauma activations and medical resuscitations in a pediatric emergency department: an evidence-based practice project.
BACKGROUND
The existing family presence literature indicates that implementation of a family presence policy can result in positive outcomes. The purpose of our evidence-based practice project was to evaluate a family presence intervention using the 6 A's of the evidence cycle (ask, acquire, appraise, apply, analyze, and adopt/adapt). For step 1 (ask), we propose the following question: Is it feasible to implement a family presence intervention during trauma team activations and medical resuscitations in a pediatric emergency department using national guidelines to ensure appropriate family member behavior and uninterrupted patient care?


METHODS
Regarding steps 2 through 4 (acquire, appraise, and apply), our demonstration project was conducted in a pediatric emergency department during the implementation of a new family presence policy. Our family presence intervention incorporated current appraisal of literature and national guidelines including family screening, family preparation, and use of family presence facilitators. We evaluated whether it was feasible to implement the steps of our intervention and whether the intervention was safe in ensuring uninterrupted patient care.


RESULTS
With regard to step 5 (analyze), family presence was evaluated in 106 events, in which 96 families were deemed appropriate and chose to be present. Nearly all families (96%) were screened before entering the room, and all were deemed appropriate candidates. Facilitators guided the family during all events. One family presence event was terminated. In all cases patient care was not interrupted.


CONCLUSIONS
Regarding step 6 (adopt/adapt), our findings document the feasibility of implementing a family presence intervention in a pediatric emergency department while ensuring uninterrupted patient care. We have adopted family presence as a standard practice. This project can serve as the prototype for others.
Kingsnorth
Jennifer
J
Emergency Medicine and Trauma Center Nurse Manager, Children's National Medical Center, Washington, DC, USA. jhinrich@cnmc.org
O'Connell
Karen
K
Guzzetta
Cathie E
CE
Edens
Jacki Curreri
JC
Atabaki
Shireen
S
Mecherikunnel
Anne
A
Brown
Kathleen
K
D016887:Cardiopulmonary Resuscitation; D002648:Child; D004636:Emergency Service, Hospital; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D019982:Organizational Case Studies; D010865:Pilot Projects; D014789:Visitors to Patients