Family presence during invasive procedures at the emergency department: what is the opinion of Spanish medical staff?
OBJECTIVE
Family presence (FP) during invasive procedures (IPs) in children remains controversial among pediatric emergency department (PED) staff. The authors aimed to determine health care providers' attitudes toward FP during IPs in Spain, to learn whether parents are given the option of being present during different IPs, and to study which factors influence the providers' opinions.


METHODS
Observational study. Physicians and nurses were asked to answer a questionnaire, which was sent to 43 PEDs and was available at the Spanish Pediatric Emergency Society Web site.


RESULTS
We obtained 222 questionnaires from 36 Spanish hospitals. A total of 65.8% of the surveys were answered by physicians (66.4% pediatricians) and 34.2% by nurses. The median age of the respondents was 32 years, and 69.2% were women. Parents were given the option of being present during blood sampling (36.4%), intravenous line placement (32.7%), urethral catheterization (32.1%), lumbar puncture (13.5%), and resuscitation (1%). More than 60% of providers approved of FP during blood sampling, sutures, intravenous line placement, and urethral catheterization; however, only 10.8% of providers encourages FP during resuscitation. Against FP, health care staff argue procedural invasiveness (75.6%), parents' anxiety (87.6%), and worsened performance of the procedure (66%). Commonly expressed advantages were reducing patient distress (72.9%) and parent anxiety (62.3%). Physicians, especially the older ones, are more likely to encourage FP than nurses for some IPs.


CONCLUSIONS
The PED staff tend to prefer parents not to be present during IPs as the level of invasiveness increases. Family presence is not common in Spanish PEDs. Older physicians are more likely to support FP than nurses.
Pediatric Emergency Department, Hospital Universitari de Sant Joan de Déu, Passeig Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain. cparra@hsjdbcn.org
Patricia
P
Corniero
Anna
A
Gamell
Cristina
C
Parra Cotanda
Victoria
V
Trenchs
Carlos Luaces
CL
Cubells
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel / Q000208:ethnology*; D003422:Critical Care / Q000379:methods*; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital; D008875:Middle Aged; D010287:Parent-Child Relations; D010290:Parents; D010372:Pediatrics / Q000379:methods; D011368:Professional-Family Relations; D011786:Quality Control; D013030:Spain; D011795:Surveys and Questionnaires; D014789:Visitors to Patients / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult