Jane Leske, professor of nursing at the University of Wisconsin–Milwaukee, recently received a $414,481 grant from the National Institutes of Health (NIH)’s Institute for Nursing Research to study families who are present during resuscitation efforts for critically injured patients.
Leske’s research will focus on whether giving the families the option of being present during such a traumatic procedure is useful and appropriate. She’ll specifically be working with families of patients who’ve been involved in motor vehicle accidents or who have suffered gunshot wounds.
The American Association of Critical-Care Nurses (AACN), American Heart Association, Emergency Nurses Association and the Society of Critical Care Medicine have published clinical guidelines giving families the option of being present. However, the choice is a controversial one and not used in many emergency situations, says Leske.
Being present at the resuscitation effort means the family can either see the patient and/or have physical contact, says Leske. Earlier research, she adds, has shown that families benefited from knowing everything possible was being done for the patient and from feeling they were being supportive and helpful. Even if resuscitation efforts fail, families may gain closure and be able to begin the grieving process.
However, Leske adds, health care professionals have concerns that resuscitation efforts may be too traumatic for family members, and that family members may become emotionally out of control or get in the way of medical care. Health care organizations, she says, may also be worried about malpractice issues or not having enough staff available to help families.
The few studies of the benefits have only involved a small number of families, and the information on professional concerns is mainly anecdotal, says Leske. That’s why she says she hopes a more comprehensive study, which could eventually involve 140 families, will provide insights to help families and health professionals make better-informed decisions.
“This option isn’t for everyone,” says Leske, “but an increasing number of family members of trauma victims believe they have the right to be present during resuscitation efforts.”
Leske, a former critical-care nurse, has been researching ways to make critical care more family-centered for more than 25 years. Her work has helped drive changes in how families are treated in emergency rooms and critical-care units.
Leske and a colleague, Nancy C. Molter of the Institute of Surgical Research at Brooke Army Medical Center (San Antonio Military Medical Center North) in San Antonio, are co-developers of the Family Critical Care Needs Inventory – a survey tool that has been translated into more than 20 languages. The survey tool has been used to develop family-centered care guidelines for critical-care nursing in medical settings from Amman, Jordan, to Beijing, China.
In 2007, the AACN honored Leske and Molter for their work as patient advocates with the Pioneering Spirit Award, the association’s highest honor for significant contributions to critical-care nursing.
The AACN cited Leske and Molter’s “contributions in bringing the importance of family needs to the forefront of critical care and developing the body of evidence to support the need for change in critical care.”