The relationship between the hospital setting and perceptions of family-witnessed resuscitation in the emergency department

SummaryObjectiveTo compare the support for, and perceptions of, family-witnessed resuscitation (FWR) in urban and suburban emergency departments (ED).MethodsA convenience sample of ED personnel from two urban and two suburban midwestern hospitals in the United States were surveyed. Survey questions assessed respondents’ opinions and experiences regarding the presence of family members during a resuscitation attempt. Data analysis was conducted using descriptive statistics, 95% confidence intervals (CI), and χ2 tests.ResultsThere were 218 respondents to the survey (108 urban, 110 suburban) of which the majority (63.3%) were female, and a mean (S.D.) age of 36.9 (10.2). The majority [131 (60.1%)] were health care providers (i.e. physicians, nurses, and physician assistants) while the remainder included support staff (i.e. security, pastoral care, and social workers). Half (50.9%; 95% CI: 44.3–57.6) of all ED personnel felt it was appropriate for an escorted family member to be allowed to be present during a resuscitation attempt. However, ED personnel of urban settings were less likely to support FWR (38.9% urban versus 62.7% suburban; p < 0.001). Likewise, fewer urban than suburban personnel thought that the psychological impact of witnessing a failed resuscitation attempt would be beneficial for a family member (37.6% versus 61.7%; respectively, p = 0.001). Of note, a minority, yet substantial percentage of all ED personnel believed that the practice would increase the potential for malpractice litigation (28.7% urban versus 21.8% suburban; p = 0.242).ConclusionOverall, there is divided support among ED personnel for FWR. The hospital setting appears to influence this support strongly, as well as the perceived benefit of FWR.