Clinicians and parents: Working together during invasive procedures

December 4, 2012, University of Pennsylvania School of Nursing

(Medical Xpress)—New research from the University of Pennsylvania School of Nursing reports that parents present during a child's more invasive procedures reported higher levels of comfort, more procedural understanding and less emotional distress – while clinicians reported parent presence did not affect their technical performance, therapeutic decision-making, or ability to teach.

The study, conducted at Boston's Children's Hospital over a four-year period in the cardiovascular and critical care programs (for procedures such as cardiopulmonary resuscitation, chest tube placement, and endotracheal tube extubation), utilized multiphase pre-post surveys of clinician perceptions and practice from the perspective of clinicians and experiencing the same procedure. More than 750 clinicians participated in the surveys and more than 500 clinicians and 250 parents participated in practice surveys.

"Clinicians reported parents to be calmer and less distraught. Across both phases, clinicians reported that the parents' need for information and support were met," said Martha A.Q. Curley, PhD, RN, FAAN, the Ellen and Robert Kapito Professor in Nursing Science at Penn Nursing. "Regardless of whether parents were present or not, most clinicians would, under future similar circumstances, provide parents with the option to remain."

Parent presence during invasive procedures and/or resuscitation is relatively underdeveloped and controversial, with most concern coming from the . The nature of procedures, including resuscitation, had clinicians concerned that parents could interrupt their or . Data indicated that on the part of parents occurs very infrequently, only two percent of the time.

The researchers found that parents generally believed their presence during procedures helped their children and helped them, and the preparation regarding the procedure and what was going to happen helped. Parents reported higher levels of procedural understanding and emotional support and given the opportunity in the future would prefer the option to stay during procedures.

Prior to data collection, interprofessional staff members were invited to participate in a half-day Program to Enhance Relational and Communication Skills (PERCS) Parent Facilitator training workshop. The workshop utilized high realism simulations with pediatric mannequins and professional actors as parents. Clinicians who attended the workshop reported higher levels of comfort and preparation to equip parents to be present, support parents during procedures, and help parents who were unable to endure evolving events. Clinician surveys indicated that 72% (pre) and 84% (post) would provide parents with the option to stay in the future.

During more invasive procedures facilitators accompanied parents and were able to reassure them and explain procedural steps at the bedside while clinicians could attend to the patients. Facilitators were called to the bedside two-thirds of the time, and while initially thought to be helpful for the parents, more exploration is needed for potential impact on parental experience.

"Implementation of practice guidelines and an interprofessional educational initiative had a positive impact on helping to be better prepared, capable, and more deliberative when providing parents with more options during invasive procedures," said Dr. Curley. "The intervention facilitated a cultural shift in the clinical practice of providing parental support during their children's and resuscitation."

Explore further: Parent-clinician communication about children's drug reactions needs improvement

Related Stories

Parent-clinician communication about children's drug reactions needs improvement

October 10, 2012
Many parents are dissatisfied with communication regarding adverse drug reactions experienced by their child, and the implications of such reactions for the child's future use of medicines, according to a new study published ...

Study supports allowing family members in ED during critical care

April 29, 2012
Contrary to what many trauma teams believe, the presence of family members does not impede the care of injured children in the emergency department, according to a study presented at the Pediatric Academic Societies (PAS) ...

Recommended for you

Who uses phone apps to track sleep habits? Mostly the healthy and wealthy in US

January 16, 2018
The profile of most Americans who use popular mobile phone apps that track sleep habits is that they are relatively affluent, claim to eat well, and say they are in good health, even if some of them tend to smoke.

Improvements in mortality rates are slowed by rise in obesity in the United States

January 15, 2018
With countless medical advances and efforts to curb smoking, one might expect that life expectancy in the United States would improve. Yet according to recent studies, there's been a reduction in the rate of improvement in ...

Teens likely to crave junk food after watching TV ads

January 15, 2018
Teenagers who watch more than three hours of commercial TV a day are more likely to eat hundreds of extra junk food snacks, according to a report by Cancer Research UK.

Can muesli help against arthritis?

January 15, 2018
It is well known that healthy eating increases a general sense of wellbeing. Researchers at Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) have now discovered that a fibre-rich diet can have a positive influence ...

Your dishwasher is not as sterile as you think

January 13, 2018
(HealthDay)—Your dishwasher may get those plates spotless, but it is also probably teeming with bacteria and fungus, a new study suggests.

Study reveals what sleep talkers have to say

January 12, 2018
A team of researchers with members from several institutions in France has conducted a study regarding sleep talking and has found that most sleep talking is not only negative in nature, but involves a large amount of swearing. ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.