Cultural Considerations with
Family Presence during
Resuscitation
Nashrene Ahmed Raafat Elbar, BSN, RN, MAN
13 January 2018
DISCLOSURE
I do not have any relevant financial relationship
with commercial interest to disclose.
Learning Objectives:
 Explain the evidence and rationale for family
presence during a resuscitation.
FPDR:
 attendance of family
members in a location
that affords visual/physical
contact with the patient
during resuscitation
Clark AP et al. Family presence during cardiopulmonary resuscitation. Crit Care Nurse Clin N Am. 2005
Changing times, changing opinions..
Concept first
Impact on PFCC
AHA
pioneered in Guidelines
& Visitation
Foote Hospital in
Policies
1989
Endorsed
by
AACN and ENA
Jabre P et al. Family presence during cardiopulmonary resuscitation. New England Journal of Medicine. 2013
FPDR, ready for prime time?
Pros
- decreased anxiety, enhanced
coping
- emotional & spiritual needs
- helps understand patient
condition
- increased trust, collaboration
and communication
Cons
-
interruption of care
emotional trauma
stress & performance anxiety
violation of confidentiality
risk of litigation environmental
concerns
McGahey, P. FPDR: A Focus on Staff. Critical Care Nurse Journal AACCN. Sept 2017
Cultural Perspective:
 Western VS Eastern
 What about in Qatar?
- way of life is highly influenced by Islam
- God’s will
- religious duty to care for sick
Al Mutair et al. FPDR: A descriptive study of nurses attitudes in Saudi Hospitals. Nursing in Critical
Care Journ. Vol 17 2012
Debunking Myths:
 Decreased PTSD related
symptoms
 No evidence for increased
risk for litigation
 FPDR had no effect on
resuscitation or survival
rate
Jabre P et al. Family presence during cardiopulmonary resuscitation. New England Journal of Medicine. 2013
McLean et al. FPDR and invasive procedures : Practices of critical care and emergency nurses.
Journ of Emerg Nursing. 2003
Where do we go from here?
1
Explicit protocol and written policy
2
Family facilitator
3
Staff education
4
FPDR consistent with PFCC
Oczkowski et al. FPDR: A Canadian Critical Care Society Position Paper. Can Respi Journ. Aug 2015
“WE
are challenged to advocate
FAMILY PRESENCE
in this changing healthcare landscape..”