Family Presence on Rounds in Adult Critical Care: A Scoping Review

Family presence on rounds involves allowing family members to participate in daily healthcare team rounds and is recommended by critical care professional societies. Yet, family presence on rounds is not performed in many institutions. There is a need to synthesize the current evidence base for this practice to inform healthcare providers of the potential benefits and challenges of this approach. The main objective of this study was to explore the impact of family presence on adult ICU rounds on family and healthcare providers. DATA SOURCES: Ovid Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, and PubMed databases were last searched on January 28, 2022. Studies published during the COVID-19 pandemic were included. STUDY SELECTION: Studies involving family presence during rounds that included family or healthcare provider perspectives or outcomes were selected. There were no limitations on study design. DATA EXTRACTION: Qualitative and quantitative family and provider perspectives, barriers and challenges to family presence, and study outcomes were extracted from studies. The JBI Manual for Evidence Synthesis published guidelines were followed. DATA SYNTHESIS: There were 16 studies included. Family reported family presence on rounds as a means of information transfer and an opportunity to ask care-related questions. Family presence on rounds was associated with increased family satisfaction with care, physician comfort, and improved physician-family relationship. Healthcare providers reported a positive perception of family presence on rounds but were concerned about patient confidentiality and perceived efficacy of rounds. Family presence was found to increase rounding time and was felt to negatively impact teaching and opportunities for academic discussions. CONCLUSIONS: Family presence on rounds has potential advantages for family and healthcare providers, but important challenges exist. Further studies are needed to understand how to best implement family presence on adult ICU rounds.