Because of the complex nature of family needs, high anxiety, and frequency of reported stress-related symptoms following critical injury, multidisciplinary interventions are essential for promoting positive family outcomes. One such intervention may be providing the option of family presence during resuscitation (FPDR). Families expect a larger role in healthcare and are asking providers to be present during resuscitation without adequate research to demonstrate potential benefits. The American Association of Critical-Care Nurses, American Heart Association, Emergency Nurses Association, and the Society of Critical Care Medicine have published clinical guidelines on providing the option of FPDR. However, the FPDR option remains controversial, underutilized, and not the usual practice with critical care patients. The primary aim of this study is to examine the effects of the FPDR option on family outcomes of anxiety, stress, well-being, and satisfaction and compare those outcomes in families who participate in FPDR to those families who do not participate in FPDR in patients experiencing critical injury after motor vehicle crashes (MVC) and gun shot wounds (GSW). A multivariate, comparison design will be used in this study. A conceptual model of family stress and adaptation that depicts a relationship between family strengths and outcomes guides the design and selection of variables. Data will be collected from 70 family members of critically ill patients with trauma from MVC and GSW in each group. Measures include family strengths (resources, coping, and problem-solving communication) and outcomes (state-anxiety, state stress, well-being, and satisfaction). A two-way analysis of co-variance will be used to examine the effects of FPDR on the family outcomes between families who participate in FPDR to those who do not participate in FPDR. The FPDR is a novel, multidisciplinary option that is intended to introduce family-centered care early in the critical care experience. This study is a significant area of inquiry because further empirical evidence is needed as to the utility and appropriateness of this option in healthcare. This project is aligned with the mission of National Institute of Nursing Research by seeking to establish a scientific base for improving the healthcare of families using a multidisciplinary team of researchers and addresses the important public health concern of traumatic injury. The proposed study has the potential to bring understanding to an often neglected and vulnerable adult population who participate in the FPDR option by describing if the experience fosters any initial positive family outcomes. The results of this study have the potential to have an impact on family- centered clinical practice in critical care.

Public Health Relevance

Families expect a larger role in healthcare and are asking providers to be present during resuscitation without adequate research to demonstrate potential benefits. The family presence during resuscitation (FPDR) option remains controversial, underutilized, and not the usual practice with critical care patients. FPDR is a multidisciplinary intervention that has the potential to have an impact on family-centered clinical practice in critical care.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Exploratory/Developmental Grants (R21)
Project #
1R21NR011063-01A2
Application #
7982482
Study Section
Nursing Science: Adults and Older Adults Study Section (NSAA)
Program Officer
Huss, Karen
Project Start
2010-06-01
Project End
2012-05-31
Budget Start
2010-06-01
Budget End
2011-05-31
Support Year
1
Fiscal Year
2010
Total Cost
$197,654
Indirect Cost
Name
University of Wisconsin Milwaukee
Department
Type
Schools of Nursing
DUNS #
627906399
City
Milwaukee
State
WI
Country
United States
Zip Code
53201
Leske, Jane S; McAndrew, Natalie S; Brasel, Karen J et al. (2017) Family Presence During Resuscitation After Trauma. J Trauma Nurs 24:85-96