• Article
  • October 30, 2017

Family Presence During Pediatric Trauma Care Benefits Patients, Families and Medical Teams

Allowing families to be with their child during trauma care helps parents fulfill their role as an advocate for their child.

Research details

You work every day to deliver the best care to kids. But imagine being on the other side and receiving that phone call you never want to get. Hearing those words you never want to hear: Your child has been in a terrible accident. You're told your child has been transported to the emergency room.  All you want to do is get there—fast—so you can be by your child's side as medical teams work to treat the injuries, and perhaps save your child's life.

While this is a natural parental reaction, not every hospital allows parents to stay in the room with their child during trauma care. But new research out of Children's Health in Dallas; Children's National Health System in Washington, D.C.; and Children's Hospital of Philadelphia highlights a hospital policy that does allow it—bringing benefits to patients, families and medical teams.

The study found that:

  • 94 percent of families present with their child during trauma care said they provided emotional support to their child
  • 92 percent said they gave health care information about their child to the medical team
  • 81 percent recalled having an interactive relationship with the trauma team, asking questions about their child's care

"It's my job"

In general, the findings show that parents felt being present was an opportunity to fulfill their role as a supporter of and an advocate for their child.

"Families feel they have a right to be present with their child during trauma care," says Lori Vinson, senior director of trauma, emergency services, EMS, PESN, emergency management and injury prevention at Children's Health in Dallas.

"They feel they have a better understanding of the prognosis for their child by watching and observing," Vinson says. "They feel less anxious by being in the room as opposed to being somewhere else, where they are not aware of what may be happening. And they feel they are providing support to their child just by being physically present."

Benefits for health care teams

Vinson says having families in the room also helps medical teams better explain to them what is happening because the family has witnessed the child's condition and care. It also can help teams better prepare and support families as their child undergoes trauma care, she says.

Good policy but not widely accepted  

While family-centered care is a pillar of children's hospitals nationwide, the practice of family presence during pediatric trauma care still lags behind areas of care for children who have been diagnosed with a medical condition. This is because, Vinson says, of the nature of trauma itself.  

"With trauma, most of these children have never been sick, and they usually don't have any kind of long-term condition, so their families may have never been to an emergency room before," she says. "And with trauma, there's blood; there are visible injuries; there can be distortion of the way a child looks. Those things aren't there in medical conditions the way they are in trauma."

Building on past research

In 2006, Vinson co-authored a study in the Journal of Emergency Nursing that evaluated family presence during resuscitation interventions and other trauma procedures, finding that:

  • In 100 percent of cases where the family was present, patient care was uninterrupted
  • Parents believed their presence helped their child and said it eased their fears
  • 92 percent of nurses and 78 percent of physicians supported family presence

An everyday practice at Children's Health

The emergency services department at Children's Health in Dallas has a policy that allows family presence during pediatric trauma care, and Vinson and the team there wouldn't have it any other way.

"We really want to put the family at the center of everything we do, so to put families at the center, we really need to involve them in the care right from the beginning," she says. "We don't think about it too much anymore—it's just what we do."

Creating a policy that allows family presence in trauma care

Vinson's tips:

  • Find your champions. You need a physician champion and a nurse champion.
  • Identify your family liaison. You need a dedicated individual who explains things to the family, answers their questions and assesses their well-being and ability to be present with their child over the course of care. At Children's Health, this individual is a social worker.
  • Develop your policy. Collaborate with your team to set your protocol and educate staff accordingly.

Send questions or comments to magazine@childrenshospitals.org.