Visiting Policies in the Adult Intensive Care Units in the Netherlands: Survey among ICU Directors

Abstract

Introduction. Admission to the ICU is a significant event for patients and their families and is often accompanied by stress, anxiety and depression. Literature shows that implementation of “unrestricted visiting policy” (UP) can potentially alleviate psychologically distressing elements of ICU admission.Methods. A web-based questionnaire was sent to all ICU’s concerning three main topics: general ICU information, detailed visiting policy information, and rationale for the chosen policy.Results. 87.1% of ICU’s retain “restricted visiting policies” (RVP; ≤five visiting hours per day). Knowledge about the current literature was overall 60.8%. There is an UP in two academic hospitals and a “partly restricted policy” (PRP; >5 visiting hours per day but <24) in two academic, two large teaching and five general hospitals. Mean permissible duration in ICU’s with a RVP was min versus min in the PRP.Conclusion. Nine out of ten ICU’s still have a restricted visiting policy. The main reasons cited for a restricted visiting policy were potential interference with the daily clinical routine and privacy. A better knowledge of the current literature in combination with infrastructural changes might improve patients’ outcome by reducing stress for the patient and its family.

New visiting policy: A step toward nursing ethics

“…However, liberal visitation policy reduces stress in patients and families and leads to significant improvement in patients. 15…”

A Review of Visiting Policies in Intensive Care Units

“…Several studies have shown that patients prefer flexible visiting strategies. Open visiting hours realize the families’ needs and have a positive impact on the patients, improve patient satisfaction and may even reduce the stay in hospital ( Davidson et al, 2007 ; Noordermeer, Rijpstra, Newhall, Pelle, & van der Meer, 2013 ; Soumagne et al, 2011 ; Whitton & Pittiglio, 2011 ). Gonzalez et al (2004) have shown that visiting is a non-stressful experience for visitors.…”

“…Members of the family also provide more effective feedback to patients than nurses and doctors, which lead to better working conditions. Family members can be politely asked to temporarily leave the room in urgent cases or for specific procedures ( Garrouste-Orgeas et al, 2008 ; Noordermeer et al, 2013 ).…”

Implementation and sustainment strategies for open visitation in the intensive care unit: A multicentre qualitative study

“…Ten years later, open visitation in US hospitals recognised for nursing excellence was only 18.6% ( Milner et al, 2020 ). Outside the US a similar pattern of restrictive visitation has been observed ( Garrouste-Orgeas et al, 2016 , Giannini et al, 2008 , Haghbin et al, 2011 , Noordermeer et al, 2013 ) despite being recommended by World Federation of Critical Care Nurses ( WFCCN Review Group, 2019 ).…”