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Family presence during resuscitation: A survey of Canadian critical care nurses' practices and perceptions.

Background

The practice of allowing family members to be present at the bedside during cardiopulmonary resuscitation (CPR) is a controversial one (Mitchell & Lynch, 1997; Meyers, Eichhorn, Guzzetta, Clark, Klein, Taliaferro, et al., 2000; Redley & Hood, 1997; Sacchetti, Carraccio, Leva, Harris, & Lichenstein, 2000). Such a practice represents a significant paradigm shift among health care providers. Traditionally, family members have been excluded from viewing such events as CPR. Reasons cited for their exclusion include fear that families might lose emotional control and interrupt care, lack of space to accommodate family members in the resuscitation room, perceived increased risk of litigation, and worry that family members would suffer deleterious psychological consequences at having witnessed CPR (McClenathan, Torrington, & Uyehara, 2002; Zoltie, Sloan, & Wright, 1994).

Contrary to objections raised by some health care providers about allowing family presence during resuscitation, research in the United States (U.S.) and the United Kingdom suggests that health care providers' concerns may be unwarranted (Hanson & Strawser, 1992; York, 2004). On the basis of research-based evidence, public opinion polls, and expert opinion, a number of organizations have endorsed family presence during resuscitation (FPDR), recommending that family members be offered this option (American Association of Critical-Care Nurses, 2004; American Heart Association, 2000; Canadian Association of Critical Care Nurses, 2005; Emergency Nurses Association, 2005). In addition, the European federation of Critical Care Nursing Associations, the European Society of Pediatrics and Neonatal Intensive Care, and the European Society of Cardiology Council on Cardiovascular Nursing and Allied Professions jointly formulated a position statement on the presence of family members during CPR (Fulbrook et al., 2007).

Research shows that families want to be present during resuscitation efforts (Clark, Meyers, Eichhorn, & Guzzetta, 2001). The benefits for the family are numerous: decreased anxiety and hopelessness, an increased understanding of the seriousness of the patient's illness, the ability to provide a comforting presence to the patient, and facilitation of the grieving process (York, 2004). Family presence helps to remove family doubts about what is happening to the patient and provides them with the satisfaction and knowledge that everything possible is being done for their relative (Clark et al., 2001). Further, family members provide information at the bedside--especially for geriatric, pediatric, unconscious, or incompetent patients (Meyers et al., 2000).

Regardless of the positive responses from family members, there are a variety of concerns from healthcare staff. Fear is the primary reason for opposition against FPDR--fear that families may interrupt their performance, fear that their emotions may be evoked, fear of legal ramifications, and fear of giving up control (Belanger & Reed, 1997). The negative attitudes and opinions voiced by some doctors and nurses regularly involved in the resuscitation appear to be the primary obstacles to family being present in resuscitation rooms (Ardley, 2003).

Nurses have the most contact with family members of critically ill patients. Although research has been undertaken in the U.S. (MacLean et al., 2003) identifying the policies, practices, and preference of American critical care nurses, no published research was located examining these issues from the perspective of critical care nurses in Canada.

Objectives

In order to address this gap in the literature, research was undertaken to examine and describe family presence during resuscitation from a Canadian critical care nurse perspective concerning their practices and preferences about offering family the option of being present during the resuscitation of a loved one. The main objectives of the study were to:

1. explore the practices and preferences of critical care nurses regarding the need for written policies regarding FPDR

2. examine the extent to which formal guidelines/policies for family presence during cardiopulmonary resuscitation exist in hospitals in which critical care nurses work

3. explore the level of awareness of Canadian critical care nurses regarding the existence of the Canadian Association of Critical Care Nurses (CACCN) (2005) position statement related to FPDR.

A secondary objective was to compare the responses and perspectives of American (MacLean et al., 2003) and Canadian critical care nurses regarding FPDR.

Methods

Study design. An online survey design was used to collect data from critical care nurses who are members of CACCN and who had provided this organization with an e-mail address for the purposes of contact/communication.

Sample. Convenience sampling was used. Following ethical approval from the University of Manitoba Research Ethics Board and permission from the board of directors of the CACCN, the survey was sent out by the CACCN national office to all members with e-mail addresses. At the time of the survey launch, 1,134 nurses were members of CACCN and 944 (83.2%) had a contact e-mail address. Completion of the anonymous survey indicated the respondents' willingness to participate in the project. At no time did the researchers or CACCN have access to names or e-mail addresses of the respondents.

Instrument. The survey used to determine the practices and preferences of Canadian critical care nurses in relation to FPDR was patterned after work conducted by MacLean and colleagues (2003) in the U.S. The original 30-item survey, which focused on family presence during CPR as well as during invasive procedures, had established content validity and clarity. Our research team made minor adjustments to the original survey to reflect both the Canadian context and the focus--family presence during CPR. With questions from the original survey relating to invasive procedures deleted and a question aimed at capturing respondents' level of awareness about CACCN's position statement added, the final survey contained 18 multiple-choice or dichotomous (yes/no) questions plus one open-ended question that invited participants to share any experiences and reflections they had about FPDR. Permission was obtained from the publisher both to use the survey and modify it in this fashion.

Similar to MacLean et al. (2003), the 18-item Canadian survey included questions about the demographic characteristics of the respondents and questions about the respondents' practices, preferences, and hospital/professional organization policies related to FPDR (Table One). In order to ensure the clarity of the online survey, it was pilot-tested among members of the research team, all previous critical care nurses. Only minor revisions were required and pilot work suggested the survey was clear, user-friendly, and would take less than 10 minutes to complete. Pilot-test data were not used in the final analyses of the survey data.

Procedure. The services of SurveyMonkey[c], a company that specializes in online surveys, were used for collection of all completed surveys. The final survey was formatted using the technology provided by SurveyMonkey[c]. Data from completed surveys were sent online by participants directly to SurveyMonkey.com.

Information that accompanied the online survey explained the purpose of the survey, the estimated amount of time it would take to complete, and the voluntary nature of involvement in the project. The process for maintaining anonymity also was explained.

To enhance survey response rates, e-mail reminders were sent out though the CACCN office at one and three weeks respectively from the date of the initial survey launch. Because the researchers did not know who had or had not taken part in the study, all individuals received the reminder notices.

Data analysis. Data were analyzed by SurveyMonkey[c] that generated descriptive statistics (percentages) to characterize the sample and analyze each of the survey items. Additional analysis was undertaken by the researchers using Fisher's exact tests for comparison of categorical data.

Results

Demographic data. Almost half of the 944 nurses contacted electronically completed the survey (n = 450; 47.7%). The majority was female (93.3%), between the ages of 40 and 49 years (40.6%), and worked with adult patients (85%) in a teaching hospital (68.3%). With the exceptions of Prince Edward Island, Yukon, and Nunavut, nurses from all provinces/territories responded (Table Two). Almost equal numbers of respondents were prepared at the diploma (43.2%) or baccalaureate (44.6%) level. Most worked full time (76.6%) as staff nurses (62.5%), and had been practising as critical care nurses for more than 15 years (47.7%) (Table Three). Sixty-six per cent of respondents (252/450) responded to the open-ended question. This qualitative data will be reported in a separate publication.

Practices and preferences for written policies regarding FPDR. The majority of CACCN respondents (92%) supported the option of FPDR, either with (60.6%) or without (31.4%) a written policy (Figure One). Many respondents indicated they had, of their own volition, either taken a patient's family member to the bedside during CPR in the past year (32.5%) or would do so if the opportunity arose (32.5%). A smaller percentage (18.5%) reported they had been asked by family members to be present at the bedside during CPR. Interestingly, further analysis of the data indicated that of the 143 nurses who had taken a family member to the bedside, 95.8% were in agreement with allowing FPDR. Of the 154 nurses who had not taken a family member to the bedside, slightly less (81.8%) were in agreement with allowing FPDR.

Comparisons between nurses (n = 35; 8%) who, irrespective of a written policy or not, preferred to prohibit FPDR, with nurses supporting FPDR (n = 415, 92%) were undertaken to determine if there were significant differences between the two groups in relation to demographic characteristics; nursing experience; knowledge of existence of CACCN position statement; and previous exposure to requests by family members to be taken, or having taken family members to the bedside during a resuscitation. There were no significant differences between the groups on the variables of age, education level, and experience as an RN or critical care nurse. However, the groups differed significantly regarding knowledge of the CACCN position statement (p = .002) and whether nurses had previous experience having taken a family member to the bedside during a resuscitation (p = .015) with those nurses being aware of the position statement and having previously taken a family member to the bedside being more supportive of FPDR.

The existence of formal guidelines/policies for FPDR. Only 8% of the nurses reported that a written guideline/policy for FPDR was available in their hospital. However, almost a quarter of the nurses (23.6%) did not know whether or not a policy existed in their facility (Table Three).

Level of awareness of Canadian critical care nurses regarding CACCN's FPDR position statement. Half of the respondents (49.8%) were aware that CACCN had a position statement related to FPDR (Figure Two). A similar percentage (44.5%), however, did not know whether CACCN had or did not have a position statement about FPDR.

Comparison of American and Canadian critical care nurses surveys regarding FPDR. MacLean and colleagues (2003) undertook a mail-out survey of 1,500 members of the American Association of Critical Care Nurses (AACN) and 1,500 members of the Emergency Nurses Association (ENA) to identify their policies, practices, and preferences for allowing family members to be present during CPR or invasive procedures. Of the 984 respondents (response rate 33%), almost half (48.1%) identified themselves as critical care nurses. Similar to our survey, the majority of all respondents were between the ages of 40 and 49 (43%), female (90%), with greater than 15 years of experience as an RN (55%) and worked full-time (74%) in a direct care/staff nurse position (80%). Less than 10% of the respondents of both surveys reported they worked on a unit/hospital with written guidelines for FPDR (Figure Three). Similarly, MacLean and colleagues (2003) concluded that although the majority of respondents had no written policy for FPDR, most have done it or would do it (57%), and preferred FPDR to be offered (76%). As noted in Figure Three, similar but slightly higher results were noted for the Canadian survey.

Discussion

Compared to the American nurses who worked in ER or critical care in MacLean et al.'s study (2003), Canadian critical care nurses reported a slightly lower percentage of having taken a family member to the bedside during CPR; 32.5% compared to 36%. The slight difference may be accounted for by the inclusion of ER nurses in the survey by MacLean et al., but not in the CACCN survey. Family members are more likely to be present or accompanying a patient in the ER than in the ICU when resuscitation events are occurring. This difference also may be accounted for by the plethora of both lay and professional literature coming out of the U.S. on the topic of family-witnessed resuscitation. In Canada, although there have been a few articles in the lay press on FPDR (Branswell, 2002; Enman, 1998; Kirkey, 1997; Tuller, 2001), there has been a paucity of published research on this topic. Interestingly, both Canadian and American percentages regarding taking a family member to the bedside are lower than the 47.8% reported by European critical care nurses (Fulbrook, Albarran, & Latour, 2005), but similar to nurses in Turkey (36.3%) (Badir & Sepit, 2007). Regarding Canadian nurses, the introduction of the CACCN position statement in 2005 endorsing FPDR may have increased the awareness of this concept to practising clinicians. This hypothesis is supported by a qualitative comment made by one CACCN member who stated: "I knew of the CACCN support of this issue [FPDR], so I took a leadership role in supporting the family ..."

CACCN respondents also were asked less frequently (18.5%) than their American counterparts (31%) by family members to be present during resuscitation. This may be the result of less awareness about and advertisement of this option to the Canadian consumer compared with the American population where articles related to FPDR have appeared in the popular press (Davis, 2000; Graham, 2006) and major magazines such as The New Yorker (Groopman, 2006).

Of importance is the finding that nurses who were aware of the CACCN position statement on FPDR were more likely to endorse or allow FPDR in their facility, compared to those nurses who were not aware of the position statement. If FPDR is to become an accepted practice, it underscores the need for CACCN to continue to communicate with its members to ensure all are aware of this position statement. More than half of the CACCN members (50.2%) either did not know about this position statement, or reported CACCN did not have one.

Of concern is the finding that very few nurses reported that policies related to FPDR existed in their place of work. Nurses appear to be engaging in the practice of FPDR without adequate policy or clinical guidelines to support their practice. This lack of policy is evident not only in the U.S. survey (MacLean et al., 2003), but also in surveys of critical care nurses recently undertaken in other countries (Badir & Sepit, 2007; Fulbrook et al., 2005). With family-witnessed resuscitation being a fairly new phenomenon, the establishment of structured guidelines and adoption of policies regarding family presence have been encouraged by nurse leaders in critical care (Guzzetta, 2004; MacLean et al., 2003). CACCN's (2005) position statement also aligns itself with this perspective.

The findings of this Canadian study must be viewed in light of its limitations. Slightly less than half of the CACCN members to whom the survey was e-mailed, responded to the survey. The practices and preferences of the remaining CACCN members, as well as those without e-mail addresses are, therefore, not known. Thus, the extent to which their responses would be similar to those completing the online survey are unknown. Although not expected, it is possible some nurses may have responded more than once to the survey. Because SurveyMonkey[c] was the recipient of all survey data, there was no way to track this information or determine if, indeed, this did occur. Lastly, the responses of the Canadian critical care nurses were compared to American nurses working in both critical care and emergency. Separation of the latter data was not undertaken by MacLean et al. (2003). Therefore, comparison of the views of only the nurses who were members of the AACN with their Canadian counterparts could not be undertaken. Differences of opinion between nurses working in ICU compared with nurses working in other areas including ER have been noted by other researchers (Fulbrook et al., 2005).

Conclusion

To our knowledge, this survey is the first of its kind in Canada that has attempted to determine the practices and preferences of a wide variety of critical care nurses who deal with the issues of resuscitation and family member presence in the critical care setting on a daily basis. Although approximately one-third of the CACCN nurses who responded to the survey had been put in the position of being asked by family members to be present at the bedside during a resuscitation in the previous year, we anticipate that this number will increase as FPDR becomes more widely accepted by staff, physicians, and the public, and as policies come into place in acute care institutions.

Although the majority of hospitals in which CACCN nurses worked did not have a written policy related to FPDR, most nurses prefer that policies be in place. If FPDR is to become an accepted practice in Canada, then systematic ongoing education of all members of the health care team regarding the purpose and practice of FPDR is required, which includes the dissemination of extant empirical work in this area. One strategy for knowledge dissemination at the unit level might be the introduction of FPDR literature at critical care journal club meetings (Kearley, 2007). At the national level, similar to that published collaboratively by the American Journal of Critical Care and AACN (AACN & Cox, 2007), CACCN may wish to publish a "Patient Care Page" to elaborate on CACCN's practice guidelines in relation to FPDR. This service informs readers about what steps need to be undertaken to ensure their health care facility has written policies and procedures to support family-witnessed resuscitation. This initiative by CACCN would be congruent with its position statement comment "CACCN supports Critical Care nurses in the development of policies and procedures supporting the option of family presence during resuscitation" (CACCN, 2005).

Finally, research into the perceptions and practices of Canadian physicians in critical care and emergency, as well as emergency room nurses in Canada, also is recommended.

Acknowledgements

The Canadian Association of Critical Care Nurses (CACCN) is acknowledged for its assistance in enabling the distribution of the research survey to its membership.

References

American Association of Critical-Care Nurses. (2004). Practice alert: Family presence during CPR and invasive procedures. AACN News, 21(11), 4.

AACN Practice Department Editors, & Cox, B. (2007). AJCC patient care page: Family presence during CPR and invasive procedures. American Journal of Critical Care, 16, 283.

American Heart Association. (2000). Guidelines 2000 for cardiopulmonary resuscitation and emergency cardiovascular care: Part 2, Ethical aspects of CPR and ECC. Circulation, 102, 12-21.

Ardley, C. (2003). Should relatives be denied access to the resuscitation room? Intensive and Critical Care Nursing, 19, 1-10.

Badir, A., & Sepit, D. (2007). Family presence during CPR: A study of the experiences and opinions of Turkish critical care nurses. International Journal of Nursing Studies, 44, 83-92.

Belanger, M., & Reed, S. (1997). A rural community hospital's experience with family-witnessed resuscitation. Journal of Emergency Nursing, 23, 238-239.

Branswell, H. (2002, March 27). Doctors should let family members watch attempts to resuscitate patients. Canadian Press NewsWire.

Canadian Association of Critical Care Nurses. (2005). Position statement: Family presence during resuscitation. London, Ontario: Author.

Clark, A., Meyers, T., Eichhorn, D., & Guzzetta, C. (2001). Family presence during cardiopulmonary resuscitation and invasive procedures. Critical Care Nursing Clinics of North America, 13, 569-575.

Davis, R. (2000, March 7). Bedside in the ED: Hospitals allowing family member access. USA Today, 1-2.

Emergency Nurses Association. (2005). Emergency Nurses Association position statement: Family presence at the bedside during invasive procedures and cardiopulmonary resuscitation. Retrieved January 3, 2007, from http://www.ena.org/about/position/PDFs/ 5F118F5052C2479C848012F5BCF87F7C.PDF

Enman, C. (1998, October 19). Family should stay close by in ER: Study. The Ottawa Citizen, A3.

Fulbrook, P., Albarran, J.W., & Latour, J.M. (2005). A European survey of critical care nurses' attitudes and experiences of having family members present during cardiopulmonary resuscitation. International Journal of Nursing Studies, 42, 557-568.

Fulbrook, P., Latour, J., Albarran, J., Graaf de, W., Lynch, F., Devictor, D., et al. (2007). The presence of family members during cardiopulmonary resuscitation: European federation of Critical Care Nursing associations, European Society of Paediatric and Neonatal Intensive Care and European Society of Cardiology Council on Cardiovascular Nursing and Allied Professions joint position statement. Connect: The World of Critical Care Nursing, 5(4), 86-88.

Graham, J. (2006, July 24). Emergency room finds place for family: Hospitals see value in having loved ones present during life-and-death moments of trauma care. Chicago Tribune, 1.

Groopman, J. (2006 April, 3). Being there: Should patients' families see what happens in the emergency room? The New Yorker, LXXXII(7), 34-39.

Guzzetta, C. (2004). Weaving a body-mind spirit tapestry. American Journal of Critical Care, 13, 320-327.

Hanson, C., & Strawser, D. (1992). Family presence during cardiopulmonary resuscitation: Foote Hospital emergency department's nine-year perspective. Journal of Emergency Nursing, 18,104-106.

Kearley, K. (2007). The 6 steps of evidence-based medicine: Action plans and changing clinical practice through journal clubs. Evidence Based Medicine, 12, 98-100.

Kirkey, S. (1997, September 23). Families share in fight for life: ER nurses open door to relatives of dying patients. Calgary Herald, A2.

MacLean, S.L., Guzetta, C.E., White, C., Fontaine, D., Eichorn, D.J., Meyers, T.A., et al. (2003). Family presence during cardiopulmonary resuscitation and invasive procedures: Practices of critical care and emergency nurses. Journal of Emergency Nursing, 29, 208-221.

McClenathan, B., Torrington, K., & Uyehara, C. (2002). Family member presence during cardiopulmonary resuscitation: A survey of US and International critical care professionals. Chest, 122, 2204-2210.

Meyers, T.A., Eichhorn, D.J., Guzzetta, C.E., Clark, A., Klein, J., Taliaferro, E., et al. (2000). Family presence during invasive procedures and resuscitation. American Journal of Nursing, 100, 32-43.

Mitchell, M., & Lynch, M. (1997). Should relatives be allowed in the resuscitation room? Journal of Accident and Emergency Medicine, 14, 366-369.

Redley, B., & Hood, K. (1997). Staff attitudes towards family presence during resuscitation. Accident and Emergency Nursing, 4, 145-151.

Sacchetti, A., Carraccio C., Leva, E., Harris, R., & Lichenstein, R. (2000). Acceptance of family members' presence during pediatric resuscitation in the emergency department. Pediatric Emergency Care, 16, 85-87.

Tuller, D. (2001, May 16). Do families have a place in emergency room? Some benefits, but big concerns with this trend in U.S. Edmonton Journal, A13.

York, N.L. (2004). Implementing a family presence protocol option. Dimensions of Critical Care Nursing, 23, 2408.

Zoltie, N., Sloan, J.P., & Wright, B. (1994). Should relatives watch resuscitation? British Medical Journal, 309, 406-407.

By Wendy M. Fallis, RN, PhD, Susan McClement, RN, PhD, and Asha Pereira, RN, BA, BN, CNCC(C)

About the authors

Wendy M. Fallis, RN, PhD, Director, Clinical Institute of Applied Research and Education, Victoria General Hospital, Winnipeg; Adjunct Professor, Faculty of Nursing, University of Manitoba, Winnipeg.

Susan McClement, RN, PhD, Associate Professor, Faculty of Nursing, University of Manitoba, Winnipeg; Research Associate, Manitoba Palliative Care Research Unit, CancerCare Manitoba.

Asha Pereira, RN, BA, BN, CNCC(C), Clinical Nurse Specialist, Acute Pain Service, Health Sciences Centre, Winnipeg.

Address for correspondence: Dr. Wendy M. Fallis, RN, PhD, Director, Clinical Institute of Applied Research and Education, Victoria General Hospital, 2340 Pembina Hwy, Winnipeg, MB R3T 2E8. Phone 204 477-3372; Fax 204 261-3280; E-mail wfallis@vgh.mb.ca
Table One. Survey questions relating to family
presence during resuscitation

Does the Canadian Association of Critical Care Nurses
(CACCN) have a position statement related to family
presence during resuscitation?

0. No
1. Yes
2. Don't know

Does your unit/hospital currently have written
guidelines/policy for family presence during CPR?

0. No
1. Yes
2. Don't know

In the past year, have you ever taken a family member to
the patient's bedside during CPR?

0. No
1. No, but would do so if the opportunity arose
2. Yes

In the past year, have you been asked by family members
if they could be present during CPR?

0. No
1. Yes

PREFERENCES:

In your unit, how would you prefer that the option of
family presence be managed?

(CHOOSE FROM a, b, c, OR d)

a. Prefer a written policy allowing the option of family
presence for CPR

b. Prefer a written policy prohibiting the option of
family presence for CPR

c. Prefer no written policy, but want the unit to allow the
option of family presence for CPR

d. Prefer no written policy, but want the unit to prohibit
the option of family presence for CPR

Reprinted and adapted from Journal of Emergency
Nursing, 29(3), MacLean, S.L., et al., "Family presence
during cardiopulmonary resuscitation and invasive
procedures: Practices of critical care and emergency
nurses", 208-221, [c] 2003, with permission from The
Emergency Nurses Association.

Table Two. Demographics of survey respondents

Variable                                         n (%)

Sex (n = 450)
Female                                         420 (93.3)
Male                                            30 (6.7)

Age distribution in years (n = 448)
<30                                             50 (11.2)
30-39                                          102 (22.8)
40-49                                          182 (40.6)
50-59                                          107 (23.9)
[greater than or equal to] 60                    7 (1.6)

Province/territory of work (n = 441)
Ontario                                        214 (48.5)
Alberta                                         66 (15.0)
Manitoba                                        47 (10.7)
British Columbia                                32 (7.3)
Saskatchewan                                    24 (5.4)
Nova Scotia                                     19 (4.3)
Quebec                                          18 (4.1)
Newfoundland/Labrador                           11 (2.5)
New Brunswick                                    8 (1.8)
North West Territories                           2 (0.5)
Prince Edward Island                             0 (0.0)
Nunavut                                          0 (0.0)
Yukon                                            0 (0.0)

Hospital location (n = 442)
Urban                                          400 (90.5)
Rural                                           42 (9.5)

Type of hospital/facility (n = 442)
Teaching hospital                              302 (68.3)
Community hospital                             127 (28.7)
Regional facility                                8 (1.8)
Other                                            5 (1.1)

Patient type typically on the unit (n = 441)
Adult                                          375 (85.0)
Newborns/Children                               30 (6.8)
Combined adult child                            32 (7.3)
Not applicable                                   4 (0.9)

Table Three. Education and
work conditions of survey respondents

Highest degree obtained in nursing (n = 447) n (%)

Diploma                                 193 (43.2)
Baccalaureate                           195 (43.6)
Graduate (Master's or PhD)               59 (13.2)

Years of experience as a RN (n = 446)

[less than or equal to] 3                27 (6.1)
4-5                                      23 (5.2)
6-10                                     51 (11.4)
11-15                                    44 (9.9)
16-20                                    91 (20.4)
> 20                                    210 (47.1)

Years of experience as a critical care nurse (n = 445)

[less than or equal to] 3                57 (12.8)
4-5                                      41 (9.2)
6-10                                     73 (16.4)
11-15                                    62 (13.9)
16-20                                    88 (19.8)
> 20                                    124 (27.9)

Current work hours (n = 444)

Full-time                               340 (76.6)
Part-time                                84 (18.9)
Casual/as needed                         20 (4.5)

Primary position currently held (n = 443)

Staff nurse                             277 (62.5)
Manager/administrator                    41 (9.3)

Advanced practice nurse/clinical nurse specialist

31 (7.0)
Educator                                 44 (9.9)
Other                                    50 (11.3)

Percentage of time spent in direct patient care (n = 442)

>75%                                    272 (61.5)
25-75%                                   55 (12.4)
<25%                                     77 (17.4)
0%                                       38 (8.6)

Hospital policy in place for family presence during
resuscitation (n = 440)

Yes                                      35 (8.0)
No                                      301 (68.4)
Don't Know                              104 (23.6)

Figure One. Respondents' preference for a written or unwritten
policy allowing or prohibiting family presence during
resuscitation (n = 437).

Written policy allowing FPDR 265            61%
Written policy prohibiting FPDR 21           5%
No written policy but allowing FPDR 137     31%
No written policy and prohibiting FPDR 14    3%

Note: Table made from pie chart.

Figure Two. Level of awareness that the Canadian
Association of Critical Care Nurses has a position
statement on family presence during resuscitation
(n=440).

             Number of respondents

No            (25)    5.7%
Yes          (219)   49.8%
Don't know   (196)   44.5%

Note: Table made from bar graph.

Figure Three. Comparison of Canadian (2007) and
American (2003) responses to family presence during
resuscitation surveys.

                                              CAN   US

Written policy in FPDR available               8%    5%
Support option of FPDR                        92%   76%
Either had practiced or would practise FPDR   65%   57%

Note: Table made from bar graph.
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Author:Fallis, Wendy M.; McClement, Susan; Pereira, Asha
Publication:Dynamics
Article Type:Survey
Geographic Code:1CANA
Date:Sep 22, 2008
Words:4651
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