Family Presence Study

Jun 01, 2016

Added to Collection

Children’s Hospital of Pittsburgh of UPMC team supports parents’ presence at the bedside during CPR

Article in Critical Care Nurse discusses the creation of an interdisciplinary team to support parents during a child’s medical crisis

 — June 1, 2016 — Inviting parents to the bedside while their child receives CPR is supported by professional associations, joint position and policy statements, and clinical practice guidelines, but hospitals often find that putting those recommendations into practice requires more than a new policy.

An article in the June issue of Critical Care Nurse (CCN) describes how Children’s Hospital of Pittsburgh of UPMC developed an interdisciplinary team in its pediatric intensive care unit (PICU) to support parents when their child requires CPR.

“Parents prefer to be given a choice to be with their children during resuscitation, even though having them present remains somewhat controversial among providers,” said Tracy Ann Pasek, RN, MSN, DNP, CCNS, CCRN, CIMI, clinical nurse specialist in the PICU at Children’s Hospital and lead author of the article in CCN. “Patient- and family-centered care is part of our culture at Children’s Hospital, but we wanted to take an extra step to support families during their child’s medical crisis.”

The article, “Parent Advocacy Group for Events of Resuscitation,” discusses the steps taken before the launch of the new initiative, including assessing the status quo and educating staff.

Children’s Hospital Parent Advocacy Group for Events of Resuscitation (PAGER) aims to assure patients’ families have the option of being with their child during CPR and are supported throughout the experience with skilled and sensitive care.

The group extends the capabilities of existing clinical social work staff by helping fulfill a need for critically ill children and their families during off-shifts and weekends and in situations when those resources may be limited or exhausted.

Before launching the initiative, the research team collected CPR data from all shifts in the hospital’s 36-bed PICU during a 12-month period. Out of a total of eight incidents, families were given the option to be present for six CPR events and were supported by at least one provider during the medical crisis.

The investigators also surveyed PICU staff nurses about their attitudes toward providing family-sensitive care to families in crisis. The survey results were used to develop a two-hour class focused on how to assist families during a medical crisis. The class included role play and discussion to help participants prepare for their PAGER role. Participants also completed the hospital’s self-defense course.

PAGER is composed of seven PICU staff nurses, a clinical social worker, a clinical nurse leader, a clinical nurse specialist and a physician who serves as a liaison to the critical care medicine division. More PICU nurses may join the group, and the initiative may also be expanded to the neonatal and cardiac ICUs.

PAGER members wear a special pin on their uniform to indicate their role as parent advocates during CPR.

Within a month after the program was officially launched, PAGER members facilitated parental presence during two CPR events. The nurses wrote summaries of their experiences to share with PICU staff, reflecting on challenges and emphasizing supportive reactions from their peers and the affected families.

Early implementation of the PAGER role has met with positive feedback from families and staff, finding that family presence did not impede the workflow of the providers, and the families appreciated the option of being present with their child.

The American Association of Critical-Care Nurses (AACN), which publishes CCN, developed a practice alert in support of family members of all patients undergoing resuscitation being given the option to be present at the bedside. The AACN Practice Alert Family Presence During Resuscitation and Invasive Procedures outlines administrative and practical considerations for nurses related to creating a formal hospital policy and a culture shift in support of the practice. All AACN Practice Alerts can be downloaded free of charge at

Access the article abstract and full-text PDF by visiting the CCN website at

About Critical Care Nurse:Critical Care Nurse (CCN), a bimonthly clinical practice journal published by the American Association of Critical-Care Nurses, provides current, relevant and useful information about the bedside care of critically and acutely ill patients. The journal also offers columns on traditional and emerging issues across the spectrum of critical care, keeping critical care nurses informed on topics that affect their practice in high acuity, progressive and critical care settings. CCN enjoys a circulation of more than 107,000 and can be accessed at

About the American Association of Critical-Care Nurses: Founded in 1969 and based in Aliso Viejo, California, the American Association of Critical-Care Nurses (AACN) is the largest specialty nursing organization in the world. AACN represents the interests of more than 500,000 acute and critical care nurses and includes more than 225 chapters worldwide. The organization's vision is to create a healthcare system driven by the needs of patients and their families in which acute and critical care nurses make their optimal contribution.

About Children’s Hospital of Pittsburgh of UPMC: Regionally, nationally, and globally, Children's Hospital of Pittsburgh of UPMC is a leader in the treatment of childhood conditions and diseases, a pioneer in the development of new and improved therapies, and a top educator of the next generation of pediatricians and pediatric subspecialists. Children’s Hospital has fulfilled this mission since its founding in 1890. Children’s is named consistently to several elite lists of pediatric hospitals, including ranking 7th among children’s hospitals and schools of medicine (FY 2014) in funding for pediatric research provided by the National Institutes of Health, and is one of 10 pediatric hospitals in the United States named to U.S. News & World Report’s Honor Roll of America’s “Best Children’s Hospitals” for 2015-2016.