Accident and emergency staff opinion on the effects of family presence during adult resuscitation: critical literature review

AIM: This paper is a report of a critical literature review to identify the positive and negative effects of family presence during adult resuscitation, as perceived by accident and emergency healthcare staff based in primary (out-of-hospital) and secondary (in-hospital) environments of care. BACKGROUND: The controversial practice of family presence during resuscitation of adults has stimulated debate over the past two decades, giving rise to a growing body of literature and the development of clinical guidelines for practice. METHODS: A search was carried out for the period 1987-2007 using the Science Direct, CINAHL, Medline, EMBASE, psychINFO and BNI databases and the search terms resuscitation, witnessed resuscitation, family presence, relatives' presence, attitudes and opinions and accident and emergency. RESULTS: Eighteen studies were included in the critical review, primarily comprising retrospective survey research. The majority of studies were descriptive in design. A standardized approach to the appraisal process was achieved through the utilization of guidelines for critiquing self-reports. The findings revealed that accident and emergency healthcare staff perceive both positive and negative effects as a consequence of family presence during adult resuscitation and their opinions suggest that there are more risks than benefit. CONCLUSION: Further research is essential if family presence during resuscitation of adults is to be better defined and understood. Qualitative methods of enquiry are recommended as a way of gaining a deeper insight into and understanding of this practice.