A Visit to the Intensive Cares Unit

Abstract

To guide family adjustment, an effort was made to facilitate pediatric visitation in an adult intensive care unit (ICU). Goals were to improve customer satisfaction and to raise staff comfort level with child visitation. After implementing an open visitation policy, concerns around pediatric visitation in the ICU remained. Fears centered on risks to both patient and child. Literature was reviewed before a book was written entitled A Visit to the ICU. It contained information about what a child visiting the ICU would see, hear, and feel when visiting a loved one. The book provided reassurance for caregivers and children, informing them about what to expect when visiting. The goal of the book was to provide caregivers with a framework for age-appropriate education. Staff education was provided on developmental stages, including a child's understandings of illness and death. Nursing interventions were reviewed and resources provided. A survey demonstrated that the book increased staff comfort level with children visiting the unit, was a positive tool for patients and families, and eased fears among children while helping to facilitate coping mechanisms. The article will describe the practice change of pediatric visitation in an ICU and how it could be applied to other critical care settings.

Reappraisal of visiting policies and procedures of patient’s family information in 188 French ICUs: a report of the Outcomerea Research Group

“…However, tools have been set up for facilitating the children visits. A book containing information on what children would see, hear, and feel can be used to reassure staff and families and to address coping mechanisms [24]. However, few data are available on the impact of children presence in the ICUs [25, 26] and most of the literature is about siblings visiting pediatrics patients.…”

Hospital visiting policies – impacts on patients, families and staff: A review of the literature to inform decision making

“…According to our assessment, the methodological quality of three of the seven reviews presented here [8,12,16] was good, while that of the other four [11,[13][14][15] was average to poor. This was primarily due to the lack of information on the literature search methodology, the absence of information provided either on inclusion criteria or quality of the included studies.…”

“…Policies regarding children visits appear to vary considerably internationally. Hanley and Piazza [14] concluded that when they were well prepared and supervised by an adult, these visits can have a positive impact in helping children manage and understand a stressful life event. However, they also insisted on the fact that nurses should be supported and trained to help them manage children visitors.…”

“…Among the seven papers included in our study, we found that only three were of good quality; [8,12,16] the others were of low-to-medium quality. [11,[13][14][15] Main limitations of the later were the poor research methodology descriptions, as well as poor descriptions and poor critical assessment of the primary studies they included. A brief description of the reviews we included in our synthesis and a summary of their results are presented in Table 2.…”

“…Eleven documents were included, seven literature reviews [8,[11][12][13][14][15][16] and four practice guidelines. [1,4,17,18] Among the seven reviews included, five were exclusively focussed on intensive care units (ICUs), [11,12,[14][15][16] while the other two were not confined to a specific type of unit. [8,13] While most of the reviews had the overarching goal of assessing and synthesizing evidence on the perceived impacts on patients, visitors and staff of open or flexible visiting policies, they varied in types of studies they included, indicators and methodologies they used to assess impacts.…”