This annotated bibliography examines four peer-reviewed studies on family presence during resuscitation (FPDR) in hospital and emergency settings. The reviewed studies explore family members' lived experiences of witnessing CPR, staff training curricula for supporting families during codes, the role of dedicated family support persons in critical care, and cultural factors influencing CPR termination decisions. Following the annotations, the paper reflects on current ICU practices, compares the evidence to typical clinical settings, and offers evidence-based recommendations for implementing FPDR protocols and trained support roles in alignment with NMBA Registered Nurse Standards.
The paper demonstrates evaluative annotation, a technique that goes beyond summarizing sources to critically assess their methodological strengths, limitations, and practical relevance. Each entry explicitly notes generalizability concerns or contextual constraints (e.g., single-hospital Taiwanese data), reflecting graduate-level source appraisal skills.
The paper is organized in two parts. The first part consists of four annotated bibliography entries, each covering a distinct aspect of FPDR: family experience, staff training, nurse roles, and cultural/contextual factors. The second part offers a reflective clinical application section with three subsections — reflecting on current literature, comparing evidence to practice, and making specific recommendations — that synthesize the annotations into actionable guidance.
This annotated bibliography examines the role of family presence during resuscitation (FPDR) in hospital and emergency settings. Four peer-reviewed studies are reviewed and evaluated for their contributions to understanding the benefits, challenges, and implementation of FPDR. Following the annotations, the paper reflects on current ICU practices, compares the evidence to typical clinical environments, and offers evidence-based recommendations aligned with NMBA Registered Nurse Standards.
De Stefano, C., Normand, D., Jabre, P., Azoulay, E., Kentish-Barnes, N., Lapostolle, F., Baubet, T., Reuter, P.-G., Javaud, N., Borron, S. W., Vicaut, E., & Adnet, F. (2016). Family Presence during Resuscitation: A Qualitative Analysis from a National Multicenter Randomized Clinical Trial. PLoS ONE, 11(6), 1–12.
The purpose of this qualitative study was to analyze a series of interviews to characterize the experiences of family members who were offered the choice to observe CPR on a loved one, within a multicenter randomized trial. Researchers interviewed 30 relatives at home three months after the cardiac arrest to understand their perspectives. Analysis identified four main themes: (1) opting for active involvement; (2) communication with providers; (3) perceiving the reality of death; and (4) reactions based on witnessing or not witnessing the event. Twelve sub-themes provided further detail. Findings highlighted communication's pivotal role in facilitating acceptance. Witnessing the resuscitation helped family members support the patient's passage and gain closure.
An evaluation of this study indicates that although the findings are not entirely generalizable, they were consistent in showing that family presence can ameliorate grief through togetherness, humanization, and comprehension during resuscitation events. Taken together, this study underscores the impacts of clinician communication and family presence on coping and meaning-making after tragic loss of life. These findings are highly congruent with NMBA Registered Nurse Standards that require nurses to engage in therapeutic and professional relationships and to provide safe, appropriate, and responsive quality nursing practice.
Mureau-Haines, R. M., Boes-Rossi, M., & Casperson, S. C. (2017). Family Support During Resuscitation: A Quality Improvement Initiative. Critical Care Nurse, 37(6), 14–23.
In the past, family members have been barred from observing hospital CPR on loved ones due to factors such as provider preference, perceived interference, concerns about psychological impact, hospital norms, and a lack of patient-centric models. Over the past 20 years, however, a body of literature has emerged supporting family presence during resuscitation (FPDR). Nevertheless, implementation varies considerably, highlighting the need for evidence-based policies and training to actualize FPDR's benefits for families and patients. This study developed and evaluated a curriculum to train dedicated staff in a new role supporting families during hospital resuscitations, in response to increasing advocacy for family presence yet a persistent lack of implementation protocols.
An interdisciplinary team created a four-hour session covering clinical aspects, integration and support steps, distress responses, and self-care strategies. Before and after the training, 59 social workers and 8 spiritual care providers completed surveys rating knowledge and attitudes. The results showed significant increases across all knowledge areas related to the family support role and self-care strategies. This study demonstrates that through tailored curricular offerings, healthcare institutions can effectively train resuscitation team members dedicated solely to providing family support. These findings facilitate safer implementation of family presence protocols during codes, which conforms to NMBA Registered Nurse Standards for providing safe, appropriate, and responsive quality nursing practice, as well as evaluating outcomes to inform nursing practice.
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