The Influence of Family Presence During Resuscitation on Health Care Providers’ Performance

Family members’ (FM) presence during cardiopulmonary resuscitation (CPR) is recommended, yet it may reduce healthcare providers’ (HCP) performance in patient care (Fernandez et al. 2009). Insufficient personnel resources could further compromise performance. Simulation-based training, followed by structured debriefing, may help HCP develop strategies to minimize any negative impact of FM presence. This study aims to investigate whether simulation-based training can enable resuscitation teams to perform equally well with or without FM present. Twenty-eight resuscitation teams (56 HCP) from a Swiss University Hospital consented to participate. Each two-person team included one HCP with over 10 years of clinical CPR experience. All teams obtained a pre-course assignment reviewing CPR guidelines and received an orientation to the simulation. After an initial CPR scenario featuring FM presence, HCP participated in a structured debriefing. Teams then performed two additional scenarios - randomized to either FM or no-FM first – without a second debriefing in between. Primary outcome measures (time to first defibrillation and time to onset of chest compressions) were analyzed from video recordings. Secondary outcomes (CPR quality indicators) were calculated by the Laerdal Session Viewer © software. All 56 HCP (28 teams) completed three scenarios each. A significant learning effect was observed by comparing the same FM scenario before and after debriefing: Time to onset of chest compressions as well as time to defibrillation decreased significantly (p=0.000023/ p=0.000063). Of the 28 teams, 14 performed the FM scenario first and then the no-FM scenario, while the other 14 did the reverse. Secondary outcome, CPR quality parameters, were analyzed for 26 teams (drop out of 2 teams due to recording problems with the simulator). In the two post-debriefing scenarios, no significant difference emerged between FM presence and no-FM for onset of chest or time to defibrillation. Our findings demonstrate a significant learning effect regarding both the onset of chest compressions and time to defibrillation, as well as certain CPR quality measures. Crucially, once participants had completed simulation-based training, there was no performance gap between scenarios with or without FM present.