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Nursing and Allied Health Topics:

Family Presence During Resuscitation


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Research has become a valued part of many nursing school programs with nursing students needing to present a variety of presentations and research papers on a variety of topics. Another somewhat recent development is more demand on students to find a special type of credible information called evidence-based practice information/articles. There are different levels of evidence-based practice information. A variety of sources are listed on the "Nursing and Allied Health Topics" web page to help Nursing and Allied Health students find credible peer-reviewed journal articles, including articles based on evidence-based practice. It seems that a majority of Nursing and Allied Health classes ask the students to cite according the APA Manual SIXTH EDITION, so the articles listed on the various Nursing and Allied Health Topics web pages will be presented according to the the American Psychological Association Manual.

Family Presence During Resuscitation


Family presence during a loved one's resuscitaton means that the family is actually present to view ALL that takes place during the health care worker's attempt to revive the patient. For anyone that has actually witnessed such a situation, all that takes place during this time can be VERY EMOTIONAL to all involved, to put it mildly. There are many questions that have to be answered when developing a policy to allow or not to allow the presence of the family during resuscitation. Most of the following articles are from peer-reviewed journals AND many of them are considered by many teachers as evidence-based practice information. Remember, that your teacher has the final word on which articles are acceptable. The following articles are cited according to APA Manual 6th edition.


  Assarroudi, A., Heshmati, N. F., Ebadi, A., & Esmaily, H. (2017). Do-not-resuscitate order: The experiences of Iranian cardiopulmonary resuscitation team members.

  Indian Journal of Palliative Care, 23(1), 88-92.

One dilemma in the end-of-life care is making decisions for conducting cardiopulmonary resuscitation (CPR). This dilemma is perceived in different ways due to the influence of culture and religion. This study aimed to understand the experiences of CPR team members about the do-not-resuscitate order.

This article can be found online for free at:



  Bradley, C., Keithline, M., Petrocelli, M., Scanlon, M., & Parkosewich, J. (2017). Perceptions of adult hospitalized patients on family presence during cardiopulmonary resuscitation.

  American Journal of Critical Care, 26(2), 103-110. doi:10.4037/ajcc2017550.

The entire article is found in CINAHL.  This seems to give a good overall view of the topic.  

  De Stefano, C., Normand, D., Jabre, P., Azoulay, E., Kentish-Barnes, N., Lapostolle, F., ...Adnet, F. (2016). Family presence during resuscitation: A qualitative analysis from

  a national multicenter randomized clinical trial. PLoS ONE, 11(6).

This is a research study. There is evidence here that is analyzed. The fourth page is interesting giving the “Results.” Seems like some good information on how the presence of the family during resuscitation impacts different groups of the process.  PubMed provides a link to the entire article at:



  Fallis, W., McClement, S., & Periera, A. (2008). Family presence during resuscitation: a survey of Canadian critical care nurses' practices and

  perceptions. Dynamics, 19(3), 22-28.

This is a journal article. The article provides a statement that sugests that the authors reviewed literature. Definitely, they provide a summary of what they found. I would consider this an evidence-based article. There is A LOT here that might help. The entire article was found in PubMed.

Impact on institution?:
Page 202: “A major concern of some practitioners is that FPDR could lead to increased litigation because families may misinterpret resuscitation efforts as being substandard. This has not been demonstrated in the largest RCT to date, which included >500 patients (75). The legal risks to health care providers of FPDR, although a regular source of worry, are small, and should lessen as FPDR becomes routine practice (1-3,7,87,88).”

Interesting on Page 202 under heading of “Respect for persons (autonomy).”  Debates similar to those raised by FPDR were made in the past about paternal presence during childbirth, now a common accepted practice (85).” Does this have something to do with diversity?

Is this about Diversity?: “Justice (fair distribution of resources)
The principle of justice encourages us to ensure that all people have equal, reasonable access to health care and social resources. Justice
suggests that we should strive for equal access to interventions such as FPDR.”



  Jermark, K., & Rosen, L. (2017). Family presence during resuscitation. Kansas Nurse, 92(1), 7-9.

This is an article in a peer-reviewed journal. The article seems more informative than a research study. Still, there is some helpful information.
A lot of PRO information for allowing the family to be present during the resuscitation process.

IMPACT on Institution?:

"Clark et al. (2013) shared that healthcare staff also feared FPDR would increase the number of lawsuits. Jabre et al. (2013), found that during two years of FPDR, out of 570 participants, there were no legal claims against the medical team. The observers get to view “the exhaustive process that transpired to save the patient’s life and thus diminishes potential lawsuits” (Parial, Torres, & Macindo, 2016, p. 220)."

"Lack of policies about FPDR in healthcare settings is an issue. Doolinet al. (2011) suggested that upon admission, if able, the patient would receive information about the facility’s policy on FPDR, and if interested, receive a handbook on FPDR. A trained family support facilitator (designated nursing staff member, social worker, or a chaplin) should be available to stay with the family if a code should occur (Doolin et al., 2011). This person’s job is to prepare patients and family for what to expect in the code setting upon entering (Jabre et al., 2013). The family support person should continually assess for escalating behaviors and escort the relative to a designated debriefing area if needed (Jabre et al., 2013). Doolin et al. (2011) suggested that participation be limited to immediate family members and possibly to limit how many can observe, as space can be an issue during codes. To accommodate FPDR and space issues it was suggested to increase the room size in critical care settings, where codes most likely occur."

  Lin, K.H., Chen, Y.S., Chou, N.K., Huang, S.J., Wu, C.C., & Chen, Y.Y. (2016). The associations between the religious background, social supports, and do-not-resuscitate orders in Taiwan:

  An observational study. Medicine (Balitmore), 95(3), e2571. doi: 10.1097/MD.0000000000002571.

This study may be helpful for diversity and cultural considerations. The article covers Taiwan and religions such as Buddhism/Daoism. However, there really may some useful information that can be used relating to resuscitation and diversity.

Page four states:
“In Taiwan, either patients or surrogates can consent to a DNR order after sufficient communication with health care professionals. Nevertheless, the majority of end-of-life decisions in Taiwan, for example, DNR, withholding artificial nutrition,  withdrawing mechanical ventilation, and so on, is made by surrogate  decision-makers.  The patients’ family members who are surrogate decision-makers may consent to LSTs for the patients without carefully deliberating the patients’ preferences. Instead, the surrogate decision-makers may consent to DNR based on their personal preferences influenced by their religious backgrounds, religiosity, race/ethnicity, information
given by significant others, and so on.” 

This entire article can be found at:



ur Rahman, M., Abuhasna, S., & Abu-Zidan, F.M. (2013). Care of terminally-ill patients: an opinion survey among critical care healthcare providers in the Middle East.

  African Health Sciences, 13(4), 893-8.


This is a research study in a scholarly journal. Religion and culture does play a role in resuscitation. Diversity can be an issue. I suppose legalities can result from the resuscitation team not listening to the right person, whether it is the patient or the family? That means policy decisions for the institution? The entire article can be found at:

“Modern medicine has allowed physicians to support the dying terminally-ill patient with artificial means. However, a common dilemma faced by physicians in general, and intensivist in particular is when to limit or withdraw aggressive intervention.”
“In the Middle East, doctors have to consider religious and cultural issues more than economic considerations when taking the DNR decision.”

“Like Christianity and Judaism, Islam acknowledges that the death is the inevitable phase of life of human beings. Medical management should not be given if it prolongs the final stage of a terminal illness as opposed to treating a superimposed, life-threatening condition 9. However, Islam believes that all healing comes from God, so Man has an obligation to search medical care and right to receive appropriate medical treatment.”

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