Understanding Healthcare Professionals Views of Family Presence During Pediatric Resuscitation: Implications for Family-Centered Care

Background and Purpose: Family presence during pediatric resuscitation is a social conflict within pediatric emergency departments. Family presence (FP) is defined as the attendance of family members in a location that allows visual or physical contact with the patient during invasive procedures or CPR. In the past, families have been excluded from the emergency room during resuscitation attempts due to concerns that clinical procedures may be too traumatic for families, and possibly become a liability risk for the medical institution. Recently, the Pediatric Advanced Life Support manual was revised to support the option of FP during resuscitation. While this practice has been recommended, some health professionals still do not allow FP during pediatric resuscitation. FP remains controversial even though multiple studies have demonstrated that the majority of family members favor the practice. The purpose of the present study was to examine the conflicting perceptions that healthcare professionals hold regarding FP during pediatric resuscitation.

Methods: This multi-disciplinary, mixed method study was conducted with 137 healthcare providers (physicians, nurses, other) at 3 sites in Central Texas. The first phase utilized quantitative MANOVAs to identify healthcare professionals' views and perceptions regarding FP. The second phase of this study used a constant comparative qualitative approach to highlight healthcare professionals' beliefs about the impact that FP may have on families and trauma teams.

Results: Results revealed that both the pro and anti FP health professionals experience empathy for families and trauma team members, and perceived the family's well-being as justification or motivation for their stance on the FP debate. Additionally all respondents indicated that legal concerns and risks were important factors during FP, however pro FP participants believed that legal concerns and risks were minimized when families were present while anti FP respondents believed the opposite.

Conclusion and Implications: In this study, healthcare professionals all believed that those who held opposing views on FP were less sympathetic and concerned about families, trauma teams, healthcare providers, and overly preoccupied with legal concerns and potential risks involved with family presence during pediatric resuscitations. These findings add to the national dialogue regarding the FP debate by providing a deeper understanding of the views of healthcare professionals and how these views might impact the delivery of family-centered care. There is a need for dialogue amongst healthcare professionals to reduce misperceptions about family presences during resuscitation. A better understanding of how health professionals view their opponents on the issue of family presence, may not lead to a consensus about FP, but could lead to improvements in care that increase the ability to serve families. Understanding the perceptions of both families and healthcare professionals can help pediatric clinicians develop policies and practices that are truly family-centered.