In-hospital family-witnessed resuscitation with a focus on the prevalence, processes, and outcomes of resuscitation: A retrospective observational cohort study

Waldemar, Annette; Bremer, Anders; Holm, Anna; Strömberg, Anna; Thylén, Ingela

doi:10.1016/j.resuscitation.2021.05.031

Cited by 15 publications

(33 citation statements)

References 31 publications

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“…However, research indicates that there is no evidence of harm in family presence during acute deterioration of a patient. In fact, in a study by Waldemar et al (2021), it is reported that family presence had neither a positive nor negative effect on the outcome of the clinical intervention( 29 ). Conversely, there is a proven negative effect from the restriction of family presence on the physiological well-being of patients, including an increased incidence of delirium ( 30 ), decreased nutritional intake, increased incidence of pain, and psychological manifestations of loneliness, agitation, aggression and depressive symptoms ( 5 ).…”

Section: Discussionmentioning

confidence: 99%

Family presence during patient acute deterioration: A survey of nurses' attitudes and reflection on COVID-19 in an African setting

Botes

Mabetshe

2022

African Journal of Emergency Medicine

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Section: Discussionmentioning

confidence: 99%

Family presence during patient acute deterioration: A survey of nurses' attitudes and reflection on COVID-19 in an African setting

Botes

Mabetshe

2022

African Journal of Emergency Medicine

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“…So far, there are only limited data on the effects of family presence on the quality of CPR 31. Observational studies from institutions allowing family presence during CPR reported no apparent differences in patients’ outcome after their change in policy 8 18 32. In a small simulator-based study the presence of a family witness resulted in delayed defibrillation and fewer defibrillation attempts 16.…”

Section: Discussionmentioning

confidence: 99%

“…Data available are conflicting and cover the range from no perceived additional stress to perceived significant hampering one’s own activity due to family presence 1 4 8 16. So far, there are no apparent negative effects on patients’ outcomes in hospitals that allow families to be present during CPR 17 18. However, the most desirable outcome of CPR, survival with good neurological function, unfortunately occurs comparatively rarely.…”

Section: Introductionmentioning

confidence: 99%

Impact of family presence during cardiopulmonary resuscitation on team performance and perceived task load: a prospective randomised simulator-based trial

et al. 2022

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ObjectivesGuidelines recommend family presence to be offered during cardiopulmonary resuscitation (CPR). Data on the effects of family presence on the quality of CPR and rescuers’ workload and stress levels are sparse and conflicting. This randomised trial investigated the effects of family presence on quality of CPR, and rescuers’ perceived stress.DesignProspective randomised single-blind trial.SettingVoluntary workshops of educational courses.Participants1085 physicians (565 men) randomised to 325 teams entered the trial. 318 teams completed the trial without protocol violation.InterventionsTeams were randomised to a family presence group (n=160) or a control group (n=158) and to three versions of leadership: (a) designated at random, (b) designated by the team or (c) left open. Thereafter, teams were confronted with a simulated cardiac arrest which was video-recorded. Trained actors played a family member according a scripted role.Main outcome measuresThe primary endpoint was hands-on time. Secondary outcomes included interaction time, rescuers’ perceived task load and adherence to CPR algorithms.ResultsTeams interacted with the family member during 24 (17–36) % of the time spent for resuscitation. Family presence had no effect on hands-on time (88% (84%–91%) vs 89% (85%–91%); p=0.18). Family presence increased frustration (60 (30–75) vs 45 (30–70); p<0.001) and perceived temporal (75 (55–85) vs 70 (50–80); p=0.001) and mental demands (75 (60–85) vs 70 (55–80); p=0.009), but had no relevant effect on CPR performance markers. Leadership condition had no effects.ConclusionsInteracting with a family member occupied about a quarter of the time spent for CPR. While this additional task was associated with an increase in frustration and perceived temporal and mental demands, family presence had no relevant negative effect on the quality of CPR.Trial registration numberDRKS00024759.

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“…Interestingly, none of the papers on relatives’ presence during CPR quoted here commented on CPR quality itself [ 1 , 2 , 3 , 4 , 10 ]. Observational studies of facilities that allow relatives to be present during CPR found no obvious differences in patient outcomes after changing their protocols [ 20 , 26 , 27 ]. So far, there is only limited moderate to low-quality evidence suggesting that the presence of family members does not affect paediatric or adult CPR outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Studies addressing the additional stress inflicted by family presence showed conflicting results covering an extent of no perceived additional strain to a sensed significant impairment of own activity due to family presence [ 1 , 4 , 10 , 11 , 12 , 13 ]. Regarding the quality of CPR, real-life studies and simulations have repeatedly shown high variability in CPR provision and sub-optimal compliance with guideline algorithms [ 14 , 15 , 16 , 17 , 18 ], but until now, however, no data reporting negative effects on patient outcomes have been published from institutions allowing relatives to be present during resuscitation [ 19 , 20 ]. Moreover, the presence of a “normally” behaving “unobtrusive” relative during simulated CA increased task load and frustration but did not impair the quality of CPR [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

The Impact of Withdrawn vs. Agitated Relatives during Resuscitation on Team Workload: A Single-Center Randomised Simulation-Based Study

Sellmann

Oendorf

Wetzchewald

et al. 2022

JCM

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Background: Guidelines recommend that relatives be present during cardiopulmonary resuscitation (CPR). This randomised trial investigated the effects of two different behaviour patterns of relatives on rescuers’ perceived stress and quality of CPR. Material and methods: Teams of three to four physicians were randomised to perform CPR in the presence of no relatives (control group), a withdrawn relative, or an agitated relative, played by actors according to a scripted role, and to three different models of leadership (randomly determined or left open by the team or tutor). The scenarios were video-recorded. Hands-on time was primary, and the secondary outcomes comprised compliance to CPR algorithms, perceived workload, and the influence of leadership. Results: 1229 physicians randomised to 366 teams took part. The presence of a relative did not effect hands-on time (91% [87–93] vs. 92% [88–94] for “withdrawn” and 92 [88–93] for “agitated” relatives; p = 0.15). The teams interacted significantly less with a “withdrawn” than with an “agitated” relative (11 [7–16]% vs. 23 [15–30]% of the time spent for resuscitation, p < 0.01). The teams confronted with an “agitated” relative showed more unsafe defibrillations, higher ventilation rates, and a delay in starting CPR (all p < 0.05 vs. control). The presence of a relative increased frustration, effort, and perceived temporal demands (all <0.05 compared to control); in addition, an “agitated” relative increased mental demands and total task load (both p < 0.05 compared to “withdrawn” and control group). The type of leadership condition did not show any effects. Conclusions: Interaction with a relative accounted for up to 25% of resuscitation time. Whereas the presence of a relative per se increased the task load in different domains, only the presence of an “agitated” relative had a marginal detrimental effect on CPR quality (GERMAN study registers number DRKS00024761).

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In-hospital family-witnessed resuscitation with a focus on the prevalence, processes, and outcomes of resuscitation: A retrospective observational cohort study

Cited by 15 publications

References 31 publications

Family presence during patient acute deterioration: A survey of nurses' attitudes and reflection on COVID-19 in an African setting

Family presence during patient acute deterioration: A survey of nurses' attitudes and reflection on COVID-19 in an African setting

Impact of family presence during cardiopulmonary resuscitation on team performance and perceived task load: a prospective randomised simulator-based trial

The Impact of Withdrawn vs. Agitated Relatives during Resuscitation on Team Workload: A Single-Center Randomised Simulation-Based Study

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