Satisfaction With Elimination of all Visitation Restrictions in a Mixed-Profile Intensive Care Unit

Abstract

Background Open and patient-tailored guidelines have been recommended as the preferred visitation model in critical care settings; however, many critical care units continue to restrict visitation. Objectives To determine whether a transition from minimally restrictive to unrestricted visitation hours improves satisfaction of patients' family members and whether such a transition affects nurses' satisfaction and nurses' perceptions of satisfaction among patients' families. Methods Using a prospective, observational design in a 24-bed intensive care unit in a tertiary care hospital, validated instruments were used to survey family members visiting patients and all nurses working in the unit before and after a change in the visitation policy. Visitation hour guidelines were changed from closed during nursing hand-off report (3 hours daily) to open at all times, depending on patients' preference and clinical status. Results One hundred three family members (50 before and 53 after the change in visitation guidelines) and 128 nurses (61 before and 67 after the policy change) were surveyed. Unrestricted visitation hours significantly improved family members' satisfaction with the convenience of visitation hours and waiting room ambiance, and nurses' perceptions of families' satisfaction also improved. Conclusions Elimination of even minimal restrictions on visitation hours improved family satisfaction and improved nurses' perceptions of family satisfaction with the visitation policy. Nurses' satisfaction did not change. These findings support open and patient-centered visitation guidelines in critical care settings.

Open visitation and nurse job satisfaction: An integrative review

“…Many hospitals throughout the country have opened their ICUs to visitors in attempts to improve patient satisfaction scores (Liu, Read, Scruth, & Cheng, ; Ramona, ; Chapman et al., ). Studies show patients in an ICU experience multiple benefits when their loved ones are close by (Hinkle & Fitzpatrick, ; Obringer, Hilgenberg, & Booker, ; Al‐Mutair, Plummer, Clerehan, & O'Brien, ; Wong, Liamputtong, Koch, & Rawson, ).…”

Managing Visitors During the Hospital Stay: The Experience of Family Caregivers of Patients With Traumatic Brain Injury

“…The general literature on visitation focuses on other acute health conditions and shows that most family members have preferences about visitors, preferring immediate and extended family members over other visitors (Wu et al, 2015). Research on visitation for other acute health conditions shows that family caregivers attempt to support the patient during the hospital stay through physical presence and comfort (Chapman et al, 2016). Family caregivers’ perception that their physical presence is beneficial to the patient increases their desire to be physically present with the patient on regular and frequent basis (Chapman et al, 2016).…”

“…Research on visitation for other acute health conditions shows that family caregivers attempt to support the patient during the hospital stay through physical presence and comfort (Chapman et al, 2016). Family caregivers’ perception that their physical presence is beneficial to the patient increases their desire to be physically present with the patient on regular and frequent basis (Chapman et al, 2016). As impairments caused by moderate-to-severe TBI often preclude the patient from being able to make decisions during the hospital stay (Steward et al, 2016) or to state their visiting preferences, family caregivers of these patients often make decisions about visitors on the patient’s behalf.…”

Family Satisfaction in the ICU

“…The recommend model for family visiting in critical care is an unrestricted visiting guideline, which allows patients and families to personalize visitation (9). A recent study found that a change to unrestricted visitation from minimally restricted visitation improved family satisfaction in a large mixed-profile ICU (10). The change in visitation to unrestricted visiting also improved the nurse's perceptions of family satisfaction with no associated change in nurse-reported interference with clinical care (10).…”

“…A recent study found that a change to unrestricted visitation from minimally restricted visitation improved family satisfaction in a large mixed-profile ICU (10). The change in visitation to unrestricted visiting also improved the nurse's perceptions of family satisfaction with no associated change in nurse-reported interference with clinical care (10). To improve patient and family satisfaction, it is imperative to remove barriers such as restricted visitation to create open engagement and inclusion of families in medical decision making and care of their loved one (11).…”