A computerized system for care planning and documentation of patient care was initiated at a western teaching hospital, using the framework of Nursing Interventions Classification and Nursing Outcomes Classification standardized languages. The software integrates care planning and documentation, and includes both order entry as well as a charting application. Prior to initiating the project, a study was conducted to evaluate staff attitude toward computerization, time needed for documentation, and comprehensiveness of charting entries. Data from staff surveys, observations, and chart audits conducted pre- and post-computer project implementation demonstrated that the staff attitudes toward computers were less positive, the time required for charting was unchanged, and there were improvements in how completely the nurses documented charting elements.

Background Although some healthcare providers remain hesitant, family presence, defined as the presence of patients’ family members during resuscitation and/or invasive procedures, is becoming an accepted practice. Evidence indicates that family presence is beneficial to patients and their families. Objectives To describe and compare the beliefs about and attitudes toward family presence of clinicians, patients’ families, and patients. Methods Clinicians, patients’ families, and patients in the emergency department and adult and neonatal intensive care units of a 300-bed urban academic hospital were surveyed. Results Surveys were completed by 202 clinicians, 72 family members, and 62 patients. Clinicians had positive attitudes toward family presence but had concerns about safety, the emotional responses of the family members, and performance anxiety. Nurses had more favorable attitudes toward family presence than physicians did. Patients and their families had positive attitudes toward family presence. Conclusions Family presence is beneficial to patients, patients’ families, and healthcare providers. As family presence becomes a more accepted practice, healthcare providers will need to accommodate patients’ families at the bedside and address the barriers that impede the practice.

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Further inquiry of the patient's experience with mechanical ventilation, the use of a ventilation sedation management protocol, and the evaluation of effective communication tools such as the use of bedside reporting or patient communication boards is warranted.