title: Emergency care staff experiences of lay presence during adult cardiopulmonary resuscitation: a phenomenological study.
abstract: BACKGROUND
  Public support in favour of family presence during an adult cardiopulmonary resuscitation (CPR) attempt is a contentious issue among providers of emergency care. Researchers have mostly relied on attitudinal surveys to elicit staff views, leaving the life-world of those who have experienced this phenomenon, largely unexplored.
  
  
  OBJECTIVE
  To explore the lived experience of lay presence during an adult CPR attempt in primary (out-of-hospital) and secondary (inhospital) environments of care.
  
  
  METHODS
  Hermeneutical phenomenological study.
  
  
  METHODS
  Semistructured, face-to-face interviews with 8 ambulance staff and 12 registered nurses. The interviews were audio-recorded and subjected to thematic analysis.
  
  
  RESULTS
  Participants provided insight into situations where lay presence during adult CPR came about either spontaneously or as a planned event. Their accounts portrayed a mixture of benefits and concerns. Familiarity of working in the presence of lay people, practical experience in emergency care and personal confidence were important antecedents. Divergent practices within and across the contexts of care were revealed. The concept of exposure emerged as the essence of this phenomenon. Overall, the study findings serve to challenge some of the previously reported attitudes and opinions of emergency care staff.
  
  
  CONCLUSIONS
  Improved intraprofessional and interprofessional collaboration is essential to overcoming the barriers associated with lay presence during adult CPR. The future of this practice is dependent on initiatives that seek to bring about attitudinal change. Priority should be given to further exploring this phenomenon in the context of patient and family centred end-of-life care.
authors.forename: Wendy Marina
authors.initials: WM
authors.lastname: Walker
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D016887:Cardiopulmonary Resuscitation / Q000523:psychology*; D002985:Clinical Protocols; D003422:Critical Care / Q000458:organization & administration / Q000523:psychology*; D004632:Emergency Medical Services; D004739:England; D005190:Family; D006801:Humans; D026684:Personal Autonomy; D011368:Professional-Family Relations
keywords: cardiac arrest; death/mortality; emergency department; prehospital care; resuscitation