Award Date

8-1-2014

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Nursing

First Committee Member

Lori Candela

Second Committee Member

Michele Clark

Third Committee Member

Susan Kowalski

Fourth Committee Member

Richard Tandy

Number of Pages

176

Abstract

Family presence during resuscitation (FPDR) involves offering family members the option to remain with their loved one who is undergoing life-saving measures. FPDR has been shown to enhance comfort and facilitate grieving, and 90% to 100% of patients and family members support it as an option. However, critical care nurses are not fully supportive of FPDR and approximately only one-third implement it in their care of patients. The perceived risks of FPDR are cited as a primary reason for lack of support and implementation. Yet, the perceived risks have not been proven, while the benefits have been established in research. This demonstrates the importance of education to improve critical care nurses' perception of FPDR.

Few studies have investigated FPDR education with nurses. The few that exist have shown promise in improving perception, and also self-confidence which has been shown to influences nurses' FPDR implementation. Several gaps in the FPDR educational research have been identified; including use of measurement scales without established validity or reliability, restricted sample recruitment focused primarily on emergency department nurses despite the fact 45% of in-hospital resuscitation events occur in critical care settings, and methodological limitations such as the absence of a

control group. Additionally, no research has yet evaluated the potential impact of online learning despite its capability of reaching larger numbers of nurses. Therefore, the purpose of this quasi-experimental study was to evaluate the impact of an online learning module on critical care nurses' perception and self-confidence for FPDR of adult patients.

The frameworks utilized were Change Theory and Social Cognitive Theory to explain the choice of dependent variables and aid in the design of the FPDR online learning module as the independent variable. A two-group, quasi-experimental, pre- and post-test design was used. The sample consisted of critical care nurses (N = 74) recruited through online study advertisements facilitated by the American Association of Critical-Care Nurses (AACN). Subjects were randomly assigned to either the intervention group who received the FPDR online learning module or to the control group who received online learning about recent changes in resuscitative care. Established measurement scales were used to evaluate perception and self-confidence in this repeated-measures study. Data was collected online for four weeks and the two-factor, mixed-model factorial ANOVA was used for data analysis. Major findings demonstrated the FPDR online learning module was effective at improving critical care nurses' perception and self-confidence for FPDR. Mean scores in the intervention group increased significantly for both perception and self-confidence (p < .0005), while scores did not change significantly for the control group. Study results indicate online learning can improve critical care nurses' perception and self-confidence for FPDR and further strengthen the body of scientific evidence on FPDR education.

Keywords

Critical care; Family presence; Family presence during resuscitation; Intensive care nursing; Online learning; Patients – Family relationships; Resuscitation

Disciplines

Critical Care Nursing | Family, Life Course, and Society | Nursing

Language

English


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