1. Eschiti, Valerie S. PhD, RN, CHTP, AHN-BC

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A descriptive, retrospective study was conducted to examine family presence during children's resuscitation at Texas Children's Hospital emergency department in Houston, Texas. Hendricks-Munoz KD, Prendergast CC. Am J Perinatol. 2007;24:71-78.


Healthcare providers have concerns regarding having family members present during resuscitation efforts. These include interference with resuscitation, lack of preparedness of family to view resuscitation, adverse psychological effects on families, and increase in staff stress. However, there have been few studies regarding family members of pediatric patients exclusively. Researchers sought to describe family member experiences, identify how to improve circumstances for future families, and assess mental and health functioning of family members.


One-hour audiotaped interviews were obtained with 10 family members whose children had resuscitation initiated before arrival at the emergency department. There were 7 family members present during resuscitation and 3 who were not. Data were collected using qualitative and quantitative methods.


Themes identified from the interviews included (a)It's My Right to be There, (b) Connection and Comfort Make a Difference, (c) Seeing Is Believing, (d) Getting in, and (e) Information Giving. Family members felt that it was their right to be given the option of being present during resuscitation, voicing that primary caregivers of the children should be given priority. They felt that their connection with the children during resuscitation provided comfort to the children as well as healing for themselves. Families felt that seeing the resuscitation efforts made them realize that everything possible was done for their children, and it helped to provide closure for them. Families commented on the ways in which they were able or not able to get in the room to be with their children. They felt that having a family facilitator with them would have been helpful to have things explained when they requested. Family members remarked that they should not be pressured when being queried about organ donation.


Family members' scores relating to mental and physical health were similar to those of the general population. Their measures of stress ranked at the 66th percentile, whereas normed population scored ranked at the 50th percentile, indicating higher stress levels of the sample. Scores indicated an absence of posttraumatic stress disorder.


The researchers note that because this was a small sample, results cannot be generalized. However, these findings indicate the need for further research to provide evidence-based guidelines for instituting family presence policies in pediatric clinical settings.



A descriptive, cross-sectional self-survey analysis was conducted to examine developmental care and barriers to implementing it in neonatal intensive care units (NICUs). McGahey-Oakland PR, Lieder HS, Young A, Jefferson LS. J Pediatr Health Care. 2007;21:217-225.


Considerations regarding enhancement of neurodevelopmental outcomes is vital in the neonatal intensive care unit (NICU) to provide an environment conducive to healing and proper development of infants. Researchers created a 12-item developmental survey based on existing literature of developmental care practices in the NICU. It was provided to nurses during 2 neonatal nursing conferences in New York City. There were 146 nurses (86% return rate) representing 24 regional hospitals who returned the surveys.


Most (n = 136; 93%) of the nurses perceived developmental care as essential, but most (n = 125; 86%) believed that their NICU was not providing optimal developmental care. Light and sound standards were seen to be important to providing developmental care, yet only 4 (3%) NICUs had light and sound meters. Perceived barriers to optimal developmental care were staff nurses and staff physicians (53%), NICU funds (42%), physician leadership (37%), facility limitations (31%), and registered nurse leadership (25%). Those nurses whose NICUs did not use developmental multidisciplinary team meetings were more likely to identify nurses or physicians as barriers to developmental care as compared with those whose NICUs did.


The researchers note that the findings of the study indicate that nurses perceive provision of developmental care to be important to their NICU patients. They conclude that improving nurse-nurse and physician-nurse relationships through implementation of multidisciplinary developmental team meetings may be critical to improving developmental care of the premature infant.