Family Presence at the Bedside

Abstract

“In Our Unit” highlights unique practices, innovations, research, or resourceful solutions to commonly encountered problems in critical care areas and settings where critically ill patients are cared for. If you have an idea for an upcoming “In Our Unit,” send it to Critical Care Nurse, 101 Columbia, Aliso Viejo, CA 92656; fax, (949) 362-2049; e-mail, ccn@aacn.org. The ICU team has embraced families and welcomed them at the bedside. We now have open visitation, so our families are integrated into the care of their loved ones. At Southern Ohio Medical Center in Portsmouth, Ohio, the intensive care unit (ICU) patient satisfaction team made a proactive choice to offer family presence during invasive procedures and cardiopulmonary resuscitation. In September 2007, a resuscitation team was formed consisting of 8 members, all registered nurses (RNs). In order to gain a better understanding of staff perceptions regarding family presence at the bedside, the project Family Presence During Resuscitation and Invasive Procedures was put together; the first phase of the project included a basic 5-item survey with answers measured on a 4 to 1 Likert scale. This survey was given to all ICU RNs, respiratory therapists, ICU physicians, pastoral care, unit clerks, nurse technicians, and security personnel. The survey questions were as follows: 1. Should family presence be permissible during simple procedures such as intravenous insertions? 2. Should family presence be permissible during phlebotomy? 3. Should family presence be permissible during all procedures, including central catheter insertions? 4. Should family presence not be permissible during any procedures? 5. Should family presence be permissible during resuscitation? The survey identified a common theme among staff members, namely, that education of the family is vital; however, almost half (47%) of staff members were opposed to family presence during resuscitation and procedures. During phase 2 of the project, a second survey was given to RNs, ICU physicians, and pastoral care representatives. Results from this survey indicated that a formal policy or protocol and a family facilitator would significantly improve the family presence process in our ICU. Phase 3 of the project consisted of compiling the data of both surveys, which were then presented to the ICU staff during the annual ICU education retreat. A PowerPoint presentation with the data results was shown as well as a video recorded by the resuscitation team. The video presented various scenarios the staff might encounter, including family members who were violent or angry, excessively emotional, drugor alcohol-altered, or arguing with one another. The staff members were then given helpful tips on how to use appropriate techniques to resolve the difficult situations shown in the video. It was reinforced many times that the safety of the patient and staff members is the priority in every situation. In Our Unit