Family presence during resuscitation and invasive procedures in pediatric critical care: a systematic review.

BACKGROUND: In pediatric critical care, family-centered care is a central theme that ensures holistic care of the patient and the patient's family. Parents expect and are encouraged to be involved in the care of their child throughout all phases of the child's illness. Family presence is generally accepted when the child's condition is stable; however, there is less consensus about family presence when the child becomes critically ill and requires resuscitation and/or invasive procedures.
METHODS: The PRISMA model guided this systematic literature search of CINAHL, MEDLINE, Ovid, and PubMed for articles published between 1995 and 2012. Specific search terms used included pediatric intensive care, parent presence, family presence, pediatrics, invasive procedures, and resuscitation.
RESULTS: This literature search yielded 117 articles. Ninety-five abstracts were evaluated for relevance. Six articles met criteria and were included in this review. The findings indicate that parents want to be present during invasive procedures and resuscitation, would choose to be present again, recommend being present to others, and would not have changed anything about the presence experience. Parents who were present had better coping and better adjustment to the child's death. Parents who were not present reported more distress.
CONCLUSIONS: These studies support the suggestion that family presence during resuscitation and invasive procedures increases parents' satisfaction and coping. However, the generalizability of these findings is limited by small sample sizes and inconsistent evaluation of confounding variables. Further research is needed to determine the benefits of family presence and prevent barriers to true implementation. ©2014 American Association of Critical-Care Nurses.