Dear Editor,
Education in the field of family presence during cardiopulmonary resuscitation (FPDR) improves support for nurses in the care of patients with FPDR. According to the author's conclusions, it is necessary to examine cultural educational needs in this regard.1 The results of the research indicate that the most frequently reported needs of nurses responsible for patient care within the FPDR are currently not satisfied.1 We agree with the statement that it is important that teacher nurses and scientists develop and test educational interventions to meet nurses' needs for guidance on the implementation of FPDR in clinical practice.1 The following studies, including Polish studies, indicate that lack of nurses' knowledge, despite their positive experiences, limits family support during the FDPR.
The article by Powers and Reeve from 2018 is a cross-sectional study that aimed to assess the factors related to nurses' perception and self-confidence and the invitation of the family to be present during intensive care unit (ICU) resuscitation. The authors found that despite the high frequency of cardiopulmonary resuscitation (CPR), more than half of the participants (61%) reported a request from a family member to be present during resuscitation at their professional work. As far as hospital standards are concerned, 46% of nurses claim that there is no policy of family presence at CPR in their center, 37% were uncertain, and only 17% could confirm that their institution has this policy, and 131 of 395 participants (33%) never offered family members to be present at CPR. In addition, 33% invited the family to be present at the bed during resuscitation between 1 and 5 times during their career. The rest of the participants indicated that they invited them 6 to 10 times (10%), 11 to 20 times (10%), or more than 20 times (14%) during their career. Having clinical experience with FPDR was the strongest predictor of positive perceptions, greater self-confidence, and increasing number of invitations. In addition, it has been demonstrated that having education in the field of family presence during resuscitation and having a written policy of the facility are key professional predictors.2
In Poland, the situation is even worse because, according to unpublished data, in a group of 465 ICU nurses, only 179 (38.66%) had experience in the presence of family members during CPR and 101 (21.81%) ICU nurses were asked about the possibility of being present at CPR. It is definitely not enough; that is, 14 (3.2%) have ever invited a family member to be present during CPR. The functioning of established procedures regarding the presence of family members during the patient's CPR in the workplace (ward) was declared by 160 (34.56%) nurses. A total of 51 (11.02%) nurses indicated at least 1 positive experience related to the presence of families during CPR, whereas 152 (32.83%) nurses had at least 1 negative experience related to the presence of families during CPR. The obtained results indicate that to a very small extent, medical staff was interested in the possibility of family presence during resuscitation.
According to the guidelines for family-centered care in neonatal, pediatric, and adult ICUs, support for a family of critically ill ICU patients, including the possibility of family participation in CPR, is crucial.3 Further research is recommended on nursing factors that may influence perception, self-confidence, and inviting of family during CPR.4 It is recommended to develop detailed recommendations on clinical practice, including principles based on clinical experience, and nurse education5 at the pregraduate and postgraduate level. Competences in the field of knowledge, skills, and social competences, as well as conducting multinational research,6 will further expand knowledge about the family and its presence during CPR from a global perspective. This is important for the development of more effective interventions to increase the invitation of family members in clinical practice. In addition, research shows that online education is a viable and effective method of education for a large number of nurses responsible for the care in FPDR. Online learning can improve the perception and self-confidence associated with FPDR, which can promote wider implementation of FPDR in practice.7
It is worth taking up a global discussion, considering the arguments and cultural conditions in search of a common consensus.
Edyta Niemczyk, RN, MSc, PhD
Department of Emergency Medicine,
Faculty of Medicine, University of
Rzeszow, Poland.
Dorota Ozga, RN, MSc, MBA, PhD, CCRN
Department of Emergency Medicine,
Faculty of Medicine, University of
Rzeszow, Poland.
References