Restricted Visiting Hours in ICUs

Berwick, Donald M.; Kotagal, Meera

doi:10.1001/jama.292.6.736

Cited by 184 publications

(144 citation statements)

References 3 publications

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“…2,3,[15][16][17][18][19][20] Despite these recommendations, surveys of critical care unit administrators indicate that most critical care units continue to have moderately restrictive policies for family visitation. [21][22][23] Although it is not clear why such a disparity exists between the recommended visitation policy and actual practice, one likely reason is the negative attitude that many critical care nurses have toward "open" or less restrictive visitation policies.…”

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confidence: 99%

“…22 Several studies have involved surveys of nurses about visitation in ICUs with "open" visitation policies, 25,[27][28][29][30] but no studies have involved surveys of patients' family members about their needs and how well those needs have been met in ICUs with visitation policies that allow unrestricted or continuous visitation. Although staff in our neuroscience ICU and national experts 2,3,[15][16][17][18][19][20] believe that a continuous visitation policy should ensure that family members' needs for information about and presence with their loved one are completely met, to date, no data have validated that belief or assumption.…”

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confidence: 99%

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Needs of Patients’ Family Members in an Intensive Care Unit With Continuous Visitation

Jacob

Horton

Rance-Ashley

et al. 2016

American Journal of Critical Care

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Background Although many critical care experts and national organizations support open visitation in intensive care units (ICUs), most ICU visiting policies do not allow unrestricted presence of patients' family members. Objective To describe how well the needs of family members were met in an adult neuroscience ICU with a continuous visitation policy and an adjoining private suite for patients' family members. Methods An exploratory, descriptive study design was used to identify the effects of continuous family visitation in the neuroscience ICU on patients' family members and their needs and experiences during their time in the unit. A convenience sample of consenting family members completed a survey of family need items 72 hours after the patient was admitted to the unit. Results The most important needs identified by the 45 family members surveyed were items relating to information about the patient, visiting the patient, being given hope, talking with a doctor each day, and being assured that the best care is being given to the patient. Least important items were related to physical comforts for the family members. The vast majority of family members rated their needs as being met for all of the items in the survey and reported a high level of satisfaction with care. Conclusion In a neuroscience ICU with an open visitation policy and a private suite for patients' family members, family members rated their needs as being met at a high level, unlike in prior studies in units with limitations on family visitation. The rank order of the importance of each need in the survey was similar to rankings in prior studies in a variety of critical care units. (American Journal of Critical Care. 2016;25:118-125) In descriptive research studies [3][4][5][6][7] in the 1970s and 1980s, family members of ICU adult patients consistently identified similar high-priority needs during the time of the critical illness. Some of the highest ranked needs included the need for information about their loved one, to be geographically close to their loved one, and to know that their loved one is receiving the best care possible. About the AuthorsCynthia Horton, Sharon Rance-Ashley, Tera Field, Robbie Patterson, Claudette Johnson, Holly Saunders, Tracy Shelton, and Jessica Miller are staff nurses, Carmen Frobos is a family coordinator, and Mini Jacob is the nurse educator in the neuroscience intensive care unit,

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confidence: 99%

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Needs of Patients’ Family Members in an Intensive Care Unit With Continuous Visitation

Jacob

Horton

Rance-Ashley

et al. 2016

American Journal of Critical Care

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“…Es como decir que si no hay queja no hay intervención. Según expresa Berwick (22), "la visita de la enfermera aumenta el estrés en los pacientes": "¿Como me ayudaba? pensando allá, haciéndome la dormida para que no me jodieran.…”

Section: Resultsunclassified

“…Respecto a la restricción de la visita Berwick (22) expresa que "no es cuidado, no demuestra compasión y no es necesaria", y que el esquema restrictivo de visitas fue impuesto en los hospitales desde hace varios años basado en la pretensión de reducir en el paciente el estrés fisioló-gico atribuido a la presencia de la familia al lado de la cama, para controlar las interferencias en el cuidado reportadas especialmente por el personal de enfermería, y para prevenir el cansancio físico y mental en el paciente y la familia. Sin embargo, en contra de estos argumentos, el mismo autor afirma, y fue corroborado en este estudio, que la visita familiar calma la angustia del paciente, de los familiares y amigos; además, contribuye a aliviarlo, apoya en la estimulación sensorial, lo ayuda a familiarizarse con el ambiente en la UCI, y se reportan datos para la historia clínica cuando el paciente no puede hacerlo.…”

Section: Discussionunclassified

Coping with a Serious Illness

Beltrán-Salazar

2010

Aquichan

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RESUMENObjetivo: describir el significado de la experiencia de estar gravemente enfermo y hospitalizado en una Unidad de Cuidado Intensivo. Metodología: investigación cualitativa basada en la teoría fundada, realizada en Medellín, Colombia, de abril a octubre de 2006; incluyó a nueve personas adultas entre 24 y 80 años que estuvieron críticamente enfermas y hospitalizadas en UCI. La entrevista en profundidad se utilizó para la recolección de información. Los datos se analizaron según el esquema propuesto por Cohen, Kahan y Steeves. Resultados: poner de su parte es necesario para afrontar una enfermedad y hace referencia a los medios personales y externos que los participantes utilizaron para aceptar y adaptarse a la enfermedad y atenuar su condición amenazante. Discusión: vivir la experiencia de padecer una enfermedad grave significó que los participantes se valieran de recursos personales internos disponibles y de algunas formas de apoyo social como la familia, la religión, los enfermeros, los amigos y conocidos e incluso de personas desconocidas. Conclusión: los recursos personales y sociales ayudan a los pacientes a afrontar las emociones que despierta una situación que no pueden resolver por sí mismos como es el padecimiento de una enfermedad grave. PALABRAS CLAVEAtención de enfermería, apoyo social, relaciones enfermero-paciente, enfermedad crítica. (Fuente: DeCs, BIREME). Coping with a Serious Illness ABSTRACTObjective: Describe what it means to be seriously ill and hospitalized in an ICU. Methodology: This is a qualitative study based on grounded theory and conducted in Medellín, Colombia from April to October, 2006 with nine adults between the ages of 24 and 80 who were critically ill and hospitalized in an ICU. In-depth interviews were used to gather information, which was analyzed pursuant to the scheme proposed by Cohen, Kahan and Steeves. Results: Patients must do their part in order to cope with an illness. The study describes the personal and external means employed by the participants to accept and adapt to an illness and to lessen its threatening conditions. Discussion: Patients who experience a serious illness take advantage of internal personal resources and certain kinds of social support

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“…The advent of intensive care units during the 1960s saw restricted visiting implemented to protect patients and family from exhaustion caused by too many visitors. 77 The spectrum of "visiting" can be thought of as a continuum (Figure 2). Current attitudes and practices in critical care units span this continuum.…”

Section: Restricted Visiting Policies: a Thing Of The Past?mentioning

confidence: 99%