Parent Presence During Complex Invasive Procedures and Cardiopulmonary Resuscitation: A Systematic Review of the Literature

Author:

Dingeman R. Scott12,Mitchell Elizabeth A.3,Meyer Elaine C.45,Curley Martha A.Q.36

Affiliation:

1. Department of Anesthesiology, Perioperative and Pain Medicine

2. Departments of Anesthesiology

3. Cardiovascular and Critical Care Nursing Program

4. Institute for Professionalism and Ethical Practice, Division of Critical Care Medicine, Children's Hospital Boston, Boston, Massachusetts

5. Psychiatry, Harvard Medical School, Boston, Massachusetts

6. University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania

Abstract

We conducted a systematic review of the literature on parent presence during complex invasive pediatric procedures and/or resuscitation. We identified 15 studies that met our inclusion criteria. All studies were summarized chronologically according to level of evidence. The studies all demonstrated that parents prefer to have the choice about whether they remain at their child's side during complex invasive procedures and resuscitation, but they also revealed that apprehensions and controversy abound among clinicians regarding this practice. Despite the endorsements of the American Academy of Pediatrics and the Society of Critical Care Medicine and the recommendations of the American Heart Association, few pediatric institutions have drafted guidelines, conducted clinical education, or committed sufficient staff resources to fully support this practice. We present this review not only to illustrate the various perspectives of parents/guardians, clinicians, and pediatric patients themselves that have been reported to date but also to encourage more research so that the practice can be performed safely and benefit parents, their children, and clinicians alike.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology, and Child Health

Reference27 articles.

1. Emergency Nurses Association. Presenting the Option for Family Presence . 2nd ed. Park Ridge, IL: The Association; 2001

2. American Association of Critical-Care Nurses. Practice alert: family presence during CPR and invasive procedures. AACN News. 2004;21:4

3. American Heart Association; American Academy of Pediatrics. 2005 American Heart Association (AHA) guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC) of pediatric and neonatal patients: neonatal resuscitation guidelines. Pediatrics. 2006;117(5). Available at: www.pediatrics.org/cgi/content/full/117/5/e1029

4. Hazinsky MF, Zaritsky AL, Nadkarani VM, Hirkey RW, Schexnayder SM, Berg RA, eds. Coping with death and dying. In: PALS Provider Manual . Dallas, TX: American Heart Association, American Academy of Pediatrics; 2002:401–402

5. Maclean SL, Guzzetta CE, White C, et al. Family presence during cardiopulmonary resuscitation and invasive procedures: practices of critical care and emergency nurses. J Emerg Nurs. 2003;29:208–221

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