Concerns that family members could "interfere" with postanesthesia care unit (PACU) nurses' duties to pediatric patients with developmental disabilities were met and addressed by a new program in one pediatric hospital. The implementation of a "caregiver visitation program . . . has been successful largely because the psychosocial benefits of family presence appears to contribute to nurses' safe care of the PACU patient." The findings of this study are published in the August 2015 Journal of PeriAnesthesia Nursing. The presence of caregivers during phase I recovery was met with concern; therefore, nursing staff was tasked with creating guidelines that allow family visitation while addressing concerns, which included the privacy of other patients, pain management, emergency situations, caregiver behavioral expectations, and nurse workload. The implementation team found that the language of the current policy was vague. Revisions allowed for caregivers to be reunited with patients "within 30 minutes of the patient's arrival in the PACU" in most cases. All staff were educated about the new policy and how to enact it without disrupting workflow. Six months into the new program, feedback from caregivers was overwhelmingly positive. Staff likewise saw benefits of having caregivers present. "We have found substantial benefits of caregiver presence in the PACU for supporting safe management of patients with cognitive or communication disabilities," write the authors. "Caregivers can help PACU staff to more quickly distinguish pain from distress with these patients, while also providing calming reassurance. We have found similar benefits with neurotypical patients."

HRC Recommends: Defining the elements that are characteristic of patient-centered care is essential in order for healthcare organizations to be able to transform the concept from an amorphous ideal into a clearly attainable goal. Implementing policies and practices that improve patient satisfaction by engaging patients and their families in their healthcare support the goal of quality patient-centered care. Depending on the setting and care being provided, components of a family presence program may include evaluating current practice, exploring and planning to address healthcare providers' concerns, training and designating family presence facilitators, educating staff, identifying contraindications or specific situations that may be inappropriate for family presence (if any), assessing the appropriateness of offering family presence in each situation, and otherwise supporting family members as needed.