Visiting hours policies in New England intensive care units: Strategies for improvement

Lee, Melissa D; Friedenberg, Allison; Mukpo, David H; Conray, Kayla; Palmisciano, Amy; Levy, Mitchell M.

doi:10.1097/01.ccm.0000254338.87182.ac

Cited by 108 publications

(101 citation statements)

References 24 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. 22,[24][25][26] Since 2007, the policy for family visitation in the neuroscience intensive care unit at Emory University Hospital (Atlanta, Georgia) has allowed continuous visitation by patients' family members.…”

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confidence: 99%

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%

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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“…Research data 12,22,[31][32][33][34][35][36] on nurses' visitation preferences and satisfaction differ among countries and facilities. Current visiting practices also vary internationally, from closed ICUs to free visiting during the day, indicating that this topic is still controversial.…”

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confidence: 99%

“…Current visiting practices also vary internationally, from closed ICUs to free visiting during the day, indicating that this topic is still controversial. 35,[37][38][39][40][41][42][43][44] Nurses' concerns about liberalizing visiting hours range from the disorganization of care 8,22,31,[34][35][36] and the psychological burden that nurses receive from the stressed families of patients 8,22,[31][32][33][34][35]37 to the adverse effects on patients' physiological condition 19,20,22,31,35,43,[45][46][47][48] and infection control. 48,49 Despite the effort to address the need for more flexible policies, most general ICUs in Athens, Greece, restrict their visiting hours, as indicated on their official websites and information sheets, a situation that leads to conflicts between health professionals and patients' families.…”

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confidence: 99%

Family Visitation in Greek Intensive Care Units: Nurses’ Perspective

Athanasiou

Papathanassoglou

Patiraki

et al. 2014

American Journal of Critical Care

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Background Policies of flexible and open visiting in intensive care units benefit both patients and patients’ families. In Greek intensive care units, gaps exist between evidence and practice for family visitation, resulting in restricted visiting policies. Objectives To explore the beliefs of nurses in Greek intensive care units about the effects of visiting on patients, patients’ families, and unit staff and nurses’ attitudes toward visiting policies. Methods A descriptive correlational survey was conducted in 6 public hospitals in Athens, Greece, with a sample of 143 critical care nurses. Data were collected via an anonymous questionnaire consisting of 3 validated scales to assess the nurses’ beliefs about and attitudes toward visitation. Results Generally, nurses were resistant to family visiting and open visiting, and most (94.4%) did not want an open policy in their unit. Nurses think that open visiting policies are supportive for patients and patients families, but the overall effects of visiting depend on both the nurse and the patient (91.6%). Nurses reported that open visiting created increased physical and psychological burdens for them (87.5%) and hampered nursing care (75.5%). Years of work experience, staffing level, and number of night shifts worked by nurses per 15 days were factors predictive of nurses’ attitudes toward and beliefs about family visitation. Conclusions Nurses’ beliefs about and attitudes toward visitation are important factors in the implementation of more flexible visiting policies in Greek intensive care units. Well-staffed units with experienced nurses and fewer shifts per week may affect nurses’ negative attitude toward open visitation.

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“…80,[84][85][86] These concerns were distilled into 3 major groups in a recent study 87 of 171 hospitals, of which 32% had unrestricted, open visiting. The categories are (1) Space: interference with patients right to privacy and confidentiality in instance of shared rooms; (2) Conflict: crowding and traffic, hindering the ability to care for patients and loss of structure and authority for nurses; and (3) Burden: to provide care for both patients and their visitors.…”

Section: Related Beliefs and Current Evidencementioning

confidence: 99%