Family Presence During Brain Death Evaluation

Tawil, Isaac; Brown, Lawrence H.; Comfort, David; Crandall, Cameron; West, Sonlee D.; Rollstin, Amber; Dettmer, Todd; Malkoff, Marc; Marinaro, Jonathan

doi:10.1097/ccm.0000000000000102

Cited by 54 publications

(63 citation statements)

References 33 publications

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“…This is in opposition with studies reporting family satisfaction, with an improvement of post-traumatic stress disorders, when they participated in comfort care [28], when they were present during brain death evaluation [29] or even during cardiopulmonary resuscitation [30]. Satisfaction and well-being of families in participation of care could be induced by giving a bedside role, by favoring the link with the loved one, and thus having the family feeling useful for the ICU staff.…”

Section: Discussionmentioning

confidence: 70%

Reappraisal of visiting policies and procedures of patient’s family information in 188 French ICUs: a report of the Outcomerea Research Group

Garrouste-Orgeas

Vinatier

Tabah

et al. 2016

Ann. Intensive Care

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BackgroundThe relatives of intensive care unit (ICU) patients must cope with both the severity of illness of their loved one and the unfamiliar and stressful ICU environment. This hardship may lead to post-intensive care syndrome. French guidelines provide recommendations on welcoming and informing families of ICU patients. We questioned whether and how they are applied 5 years after their publication.MethodsWe conducted a large survey among French ICUs to evaluate their visiting policies and how information was provided to patient’s family. A questionnaire was built up by intensivists and nurses. French ICUs were solicited, and the questionnaire was sent to all participating ICUs, for being filled in by the unit medical and/or nursing head. Data regarding the hospital and ICU characteristics, the visiting policy and procedures, and the management of family information were collected.ResultsAmong the 289 French ICUs, 188 (65 %) participated. Most ICUs have a waiting room 118/188 (62.8 %) and a dedicated room for meeting the family 152/188 (80.8 %). Of the 188 ICUs, 45 (23.9 %) were opened on a 24-h-a-day basis. In the remaining ICUs, the time period allowed for visits was 4.75 ± 1.83 h (median 5 h). In ICUs where visiting restrictions were reported, open visiting was allowed for end-of-life situations in 107/143 (74.8 %). Children are allowed to visit a patient in 164/188 (87.2 %) regardless of their age in 97/164 (59.1 %) of ICUs. Families received an information leaflet in 168/188 (89.3 %). Information was provided to families through structured meetings in 149/188 (79.2 %) of ICUs at patient admission with participation of nurses and nursing assistants in 133/188 (70.4 %) and 55/188 (29.2 %), respectively. Information delivered to the family was reported in the patient chart by only 111/188 ICUs (59 %). Participation in care was infrequent.ConclusionsAlthough French ICUs do not follow the consensus recommendations, slow progress exists compared to previous reports. Implementation of these recommendations is largely needed to offer better welcome and information improvement. Further studies on that topic would enable evaluating remaining obstacles and increasing caregivers’ awareness, both critical for further progresses on that topic.Electronic supplementary materialThe online version of this article (doi:10.1186/s13613-016-0185-x) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 70%

Reappraisal of visiting policies and procedures of patient’s family information in 188 French ICUs: a report of the Outcomerea Research Group

Garrouste-Orgeas

Vinatier

Tabah

et al. 2016

Ann. Intensive Care

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“…For example, Tawil et al recently conducted a small randomized trial demonstrating that family presence during brain death evaluation has the potential to improve understanding of brain death without causing psychological harm at 30 and 90 days. 85 …”

Section: Resultsmentioning

confidence: 99%

Patient Preferences and Surrogate Decision Making in Neuroscience Intensive Care Units

et al. 2015

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In the neuroscience intensive care unit (NICU), most patients lack the capacity to make their own preferences known. This fact leads to situations where surrogate decision makers must fill the role of the patient in terms of making preference-based treatment decisions, oftentimes in challenging situations where prognosis is uncertain. The neurointensivist has a large responsibility and role to play in this shared decision making process. This review covers how NICU patient preferences are determined through existing advance care documentation or surrogate decision makers and how the optimum roles of the physician and surrogate decision maker are addressed. We outline the process of reaching a shared decision between family and care team and describe a practice for conducting optimum family meetings based on studies of ICU families in crisis. We review challenges in the decision making process between surrogate decision makers and medical teams in neurocritical care settings, as well as methods to ameliorate conflicts. Ultimately, the goal of shared decision making is to increase knowledge amongst surrogates and care providers, decrease decisional conflict, promote realistic expectations and preference-centered treatment strategies, and lift the emotional burden on families of neurocritical care patients.

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“…, Twail et al . ). Participant responses demonstrated that the right of families to be present conflicted with the routines of care and illustrated the influence of the professional and environmental context and culture.…”

Section: Discussionmentioning

confidence: 97%

Seeing for themselves – healthcare professionals’ views about the presence of family members during brainstem death testing

Doran

Black

2017

Journal of Clinical Nursing

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Family Presence During Brain Death Evaluation

Abstract: Family presence during brain death evaluation improves understanding of brain death with no apparent adverse impact on psychological well-being. Family presence during brain death evaluation is feasible and safe.

Cited by 54 publications

References 33 publications

Reappraisal of visiting policies and procedures of patient’s family information in 188 French ICUs: a report of the Outcomerea Research Group

Reappraisal of visiting policies and procedures of patient’s family information in 188 French ICUs: a report of the Outcomerea Research Group

Patient Preferences and Surrogate Decision Making in Neuroscience Intensive Care Units

Seeing for themselves – healthcare professionals’ views about the presence of family members during brainstem death testing

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