Let Them In: Family Presence during Intensive Care Unit Procedures.

Area of Science:

• Critical Care Medicine
• Patient-Centered Care
• Family Engagement in Healthcare

Background:

• Families have long advocated for increased access and partnership within intensive care units (ICUs).
• Despite progress, family members are often excluded from bedside procedures in adult ICUs, even when patients desire their presence.
• Physician concerns include trainee education, legal risks, procedural distractions, and sterility, though evidence supporting these is limited.

Purpose of the Study:

• To evaluate the benefits and feasibility of family presence during invasive bedside procedures in the ICU.
• To address historical objections and current evidence regarding family presence during ICU procedures.
• To provide an implementation framework for family procedural presence.

Main Methods:

• Review of current evidence on family presence during ICU procedures.
• Consideration of historical objections and physician concerns.
• Reporting of clinical experience with implementing family procedural presence.

Main Results:

• Family presence, when desired by patient and family, aligns with patient-centered care principles.
• Anticipated benefits include increased family engagement, improved patient and family satisfaction, and reduced psychological distress.
• The practice is believed achievable without compromising care quality, significantly increasing provider burden, or elevating litigation risks.

Conclusions:

• Family presence during ICU procedures is a valuable component of patient-centered care.
• Implementation can enhance patient and family experience and well-being.
• Evidence suggests benefits can be realized without negative impacts on care quality or increased risks.