Family Presence During Trauma Resuscitation: Family Members’ Attitudes, Behaviors, and Experiences

O’Connell, Karen; Fritzeen, Jennifer; Guzzetta, Cathie E.; Clark, Angela P.; Lloyd, Christina; Scott, Shari H.; Aldridge, Michael D.; Kreling, Barbara

doi:10.4037/ajcc2017503

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Families in Critical Care| May 01 2017

Family Presence During Trauma Resuscitation: Family Members’ Attitudes, Behaviors, and Experiences

Karen O’Connell, MD, MEd;

Karen O’Connell, MD, MEd

Karen O’Connell is associate professor of pediatrics and emergency medicine at the George Washington University School of Medicine and Health Sciences, and Children’s National Health System, Washington, DC. Jennifer Fritzeen is program manager, Trauma and Burn Surgery, Children’s National Health System. Cathie E. Guzzetta is a nursing research consultant and a clinical professor, The George Washington University School of Nursing. Angela P. Clark is associate professor emeritus, The University of Texas at Austin School of Nursing, Austin, Texas. Christina Lloyd is a nursing consultant in Washington, DC. She was a neonatal intensive care unit family specialist, Children’s National Health System. Shari H. Scott is a psychiatric nurse practitioner, psychiatric emergency room, Parkland Health and Hospital System, Dallas, Texas. Michael D. Aldridge is an assistant professor of nursing, Concordia University, Austin, Texas. Barbara Kreling is a qualitative research consultant, Children’s National Health System.

Corresponding author: Karen J. O’Connell, md, med, faap, Emergency Medicine and Trauma Center, Children’s National Health System, 111 Michigan Ave, Washington, DC 20010 (e-mail: koconnel@childrensnational.org).

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Jennifer Fritzeen, RN, MSN, PCNS;

Jennifer Fritzeen, RN, MSN, PCNS

Karen O’Connell is associate professor of pediatrics and emergency medicine at the George Washington University School of Medicine and Health Sciences, and Children’s National Health System, Washington, DC. Jennifer Fritzeen is program manager, Trauma and Burn Surgery, Children’s National Health System. Cathie E. Guzzetta is a nursing research consultant and a clinical professor, The George Washington University School of Nursing. Angela P. Clark is associate professor emeritus, The University of Texas at Austin School of Nursing, Austin, Texas. Christina Lloyd is a nursing consultant in Washington, DC. She was a neonatal intensive care unit family specialist, Children’s National Health System. Shari H. Scott is a psychiatric nurse practitioner, psychiatric emergency room, Parkland Health and Hospital System, Dallas, Texas. Michael D. Aldridge is an assistant professor of nursing, Concordia University, Austin, Texas. Barbara Kreling is a qualitative research consultant, Children’s National Health System.

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Cathie E. Guzzetta, RN, PhD;

Cathie E. Guzzetta, RN, PhD

Karen O’Connell is associate professor of pediatrics and emergency medicine at the George Washington University School of Medicine and Health Sciences, and Children’s National Health System, Washington, DC. Jennifer Fritzeen is program manager, Trauma and Burn Surgery, Children’s National Health System. Cathie E. Guzzetta is a nursing research consultant and a clinical professor, The George Washington University School of Nursing. Angela P. Clark is associate professor emeritus, The University of Texas at Austin School of Nursing, Austin, Texas. Christina Lloyd is a nursing consultant in Washington, DC. She was a neonatal intensive care unit family specialist, Children’s National Health System. Shari H. Scott is a psychiatric nurse practitioner, psychiatric emergency room, Parkland Health and Hospital System, Dallas, Texas. Michael D. Aldridge is an assistant professor of nursing, Concordia University, Austin, Texas. Barbara Kreling is a qualitative research consultant, Children’s National Health System.

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Angela P. Clark, RN, PhD, ACNS-BC;

Angela P. Clark, RN, PhD, ACNS-BC

Karen O’Connell is associate professor of pediatrics and emergency medicine at the George Washington University School of Medicine and Health Sciences, and Children’s National Health System, Washington, DC. Jennifer Fritzeen is program manager, Trauma and Burn Surgery, Children’s National Health System. Cathie E. Guzzetta is a nursing research consultant and a clinical professor, The George Washington University School of Nursing. Angela P. Clark is associate professor emeritus, The University of Texas at Austin School of Nursing, Austin, Texas. Christina Lloyd is a nursing consultant in Washington, DC. She was a neonatal intensive care unit family specialist, Children’s National Health System. Shari H. Scott is a psychiatric nurse practitioner, psychiatric emergency room, Parkland Health and Hospital System, Dallas, Texas. Michael D. Aldridge is an assistant professor of nursing, Concordia University, Austin, Texas. Barbara Kreling is a qualitative research consultant, Children’s National Health System.

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Christina Lloyd, RN, MS;

Christina Lloyd, RN, MS

Karen O’Connell is associate professor of pediatrics and emergency medicine at the George Washington University School of Medicine and Health Sciences, and Children’s National Health System, Washington, DC. Jennifer Fritzeen is program manager, Trauma and Burn Surgery, Children’s National Health System. Cathie E. Guzzetta is a nursing research consultant and a clinical professor, The George Washington University School of Nursing. Angela P. Clark is associate professor emeritus, The University of Texas at Austin School of Nursing, Austin, Texas. Christina Lloyd is a nursing consultant in Washington, DC. She was a neonatal intensive care unit family specialist, Children’s National Health System. Shari H. Scott is a psychiatric nurse practitioner, psychiatric emergency room, Parkland Health and Hospital System, Dallas, Texas. Michael D. Aldridge is an assistant professor of nursing, Concordia University, Austin, Texas. Barbara Kreling is a qualitative research consultant, Children’s National Health System.

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Shari H. Scott, APRN, PhD, PMHNP-BC, LMFT-S, LPC-S;

Shari H. Scott, APRN, PhD, PMHNP-BC, LMFT-S, LPC-S

Karen O’Connell is associate professor of pediatrics and emergency medicine at the George Washington University School of Medicine and Health Sciences, and Children’s National Health System, Washington, DC. Jennifer Fritzeen is program manager, Trauma and Burn Surgery, Children’s National Health System. Cathie E. Guzzetta is a nursing research consultant and a clinical professor, The George Washington University School of Nursing. Angela P. Clark is associate professor emeritus, The University of Texas at Austin School of Nursing, Austin, Texas. Christina Lloyd is a nursing consultant in Washington, DC. She was a neonatal intensive care unit family specialist, Children’s National Health System. Shari H. Scott is a psychiatric nurse practitioner, psychiatric emergency room, Parkland Health and Hospital System, Dallas, Texas. Michael D. Aldridge is an assistant professor of nursing, Concordia University, Austin, Texas. Barbara Kreling is a qualitative research consultant, Children’s National Health System.

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Michael D. Aldridge, RN, PhD, CNE;

Michael D. Aldridge, RN, PhD, CNE

Karen O’Connell is associate professor of pediatrics and emergency medicine at the George Washington University School of Medicine and Health Sciences, and Children’s National Health System, Washington, DC. Jennifer Fritzeen is program manager, Trauma and Burn Surgery, Children’s National Health System. Cathie E. Guzzetta is a nursing research consultant and a clinical professor, The George Washington University School of Nursing. Angela P. Clark is associate professor emeritus, The University of Texas at Austin School of Nursing, Austin, Texas. Christina Lloyd is a nursing consultant in Washington, DC. She was a neonatal intensive care unit family specialist, Children’s National Health System. Shari H. Scott is a psychiatric nurse practitioner, psychiatric emergency room, Parkland Health and Hospital System, Dallas, Texas. Michael D. Aldridge is an assistant professor of nursing, Concordia University, Austin, Texas. Barbara Kreling is a qualitative research consultant, Children’s National Health System.

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Barbara Kreling, PhD, MPH

Karen O’Connell is associate professor of pediatrics and emergency medicine at the George Washington University School of Medicine and Health Sciences, and Children’s National Health System, Washington, DC. Jennifer Fritzeen is program manager, Trauma and Burn Surgery, Children’s National Health System. Cathie E. Guzzetta is a nursing research consultant and a clinical professor, The George Washington University School of Nursing. Angela P. Clark is associate professor emeritus, The University of Texas at Austin School of Nursing, Austin, Texas. Christina Lloyd is a nursing consultant in Washington, DC. She was a neonatal intensive care unit family specialist, Children’s National Health System. Shari H. Scott is a psychiatric nurse practitioner, psychiatric emergency room, Parkland Health and Hospital System, Dallas, Texas. Michael D. Aldridge is an assistant professor of nursing, Concordia University, Austin, Texas. Barbara Kreling is a qualitative research consultant, Children’s National Health System.

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Am J Crit Care (2017) 26 (3): 229–239.

https://doi.org/10.4037/ajcc2017503

Background

The paradigm is shifting from separating family members from their children during resuscitation to one of patient- and family-centered care. However, widespread acceptance is still lacking.

Objective

To measure attitudes, behaviors, and experiences of family members of pediatric patients during the resuscitation phase of trauma care, including family members who were present and those who were not.

Methods

An observational mixed-methods study using structured interviews and focus groups was conducted at 3 level 1 pediatric trauma centers. Family members of children who met trauma team activation criteria (N = 126; 99 present, 27 not present) were interviewed; 25 also participated in focus groups.

Results

Mean attitude scores indicated a positive attitude about being present during the resuscitation phase of trauma care (3.65; SD, 0.37) or wanting to be present (3.2; SD, 0.60). Families present reported providing emotional support (94%) for their child and health care information (92%) to the medical team. Being present allowed them to advocate for their child, understand their child’s condition, and provide comfort. Families in both groups felt strongly that the choice was their right but was contingent upon their bedside behavior.

Conclusions

Study findings demonstrated compelling family benefits for presence during pediatric trauma care. This study is one of the first to report on family members who were not present. The practice of family presence should be made a priority at pediatric trauma centers.

2017

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