Intensive care unit visitation policies in Brazil: a multicenter survey

Ramos, Fernando José da Silva; Fumis, Renata Rego Lins; Azevedo, Luciano César Pontes; Schettino, Guilherme

doi:10.5935/0103-507x.20140052

Cited by 29 publications

(24 citation statements)

References 27 publications

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“…(39) Among 289 French ICUs, only 24% were open for family visits 24 hours per day. (40)Similarly, most of our respondents (65%) reported their units are not open 24 hours per day, with most ICUs (74%) open from 5 hours per day or less.…”

Section: Discussionmentioning

confidence: 99%

Worldwide Survey of the “Assessing Pain, Both Spontaneous Awakening and Breathing Trials, Choice of Drugs, Delirium Monitoring/Management, Early Exercise/Mobility, and Family Empowerment” (ABCDEF) Bundle

Morandi

Piva

Ely

et al. 2017

Critical Care Medicine

191

135

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Objective To assess the knowledge and use of the ABCDEF bundle to implement the Pain, Agitation, Delirium (PAD) guidelines. Design Worldwide On-line Survey. Setting Intensive care. Intervention A cross-sectional online survey using the Delphi method was administered to intensivists worldwide, to assess the knowledge and use of all aspects of the ABCDEF bundle (Assessment, prevention and management of pain; spontaneous awakening and Breathing trials; Choice of analgesia and sedation; Delirium assessment; Early mobility and exercise and Family engagement and empowerment.) Measurement and Main Results There were 1521 respondents from 47 countries, 57% had implemented the ABCDEF bundle, with varying degrees of compliance across continents. Most of the respondents (83%) used a scale to evaluate pain. SATs and SBTs are performed in 66% and 67% of the responder ICUs respectively. Sedation scale was used in 89% of ICUs. Delirium monitoring was implemented in 70% of ICUs, but only 42% used a validated delirium tool. Likewise, early mobilization was “prescribed” by most but 69% had no mobility team and 79% used no formal mobility scale. Only 36% of the respondents assessed ICU acquired weakness. Family members were actively involved in 67% of ICUs, however only 33% used dedicated staff to support families and only 35% reported that their unit was open 24 hours/day for family visits. Conclusions The current implementation of the ABCDEF bundle varies across individual components and regions. We identified specific targets for quality improvement and adoption of the ABCDEF bundle. Our data reflect a significant but incomplete shift towards patient- and family-centered ICU care in accordance with the PAD guidelines.

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Section: Discussionmentioning

confidence: 99%

Worldwide Survey of the “Assessing Pain, Both Spontaneous Awakening and Breathing Trials, Choice of Drugs, Delirium Monitoring/Management, Early Exercise/Mobility, and Family Empowerment” (ABCDEF) Bundle

Morandi

Piva

Ely

et al. 2017

Critical Care Medicine

191

135

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“…Similarly, in 69 US hospitalbased maternity units, only 5.8% did not allow any children to visit. [9] While only 1 out of the 5 nursing managers (who were aware of a visitor's policy) indicated that their policy allowed children to visit [10] and in 44% of French units that fixed a minimum age limit for visits; the mean age limit was also 12 years. [7] Similarly, some children's hospitals in the USA only allow child visitors above 12 years old, while others screen for illness before allowing visitation.…”

Section: Discussionmentioning

confidence: 99%

The existence of policies, practices and perceptions regarding children as visitors to public hospitals in uMgungundlovu, KwaZulu-Natal Province

Appalsamy

McKerrow

2016

S Afr J CH

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Disruption of the family unit by hospitalisation can cause major physical and psychological stress for patients and their families, particularly children. Flexible visiting policies are advocated as a positive intervention to help families cope with the stress of illness. Current surveys, conducted in the adult critical care setting in wellresourced countries, have shown that children are still restricted from visiting. [1] Reasons for such restrictions stem from children disrupting the running of the unit, nurses being unable to cope with their queries and emotions, physicians disapproving of visits and the risk of infection. However, no evidence has been found that visiting children are more prone to infection. [2] Knutssen et al. [3] showed that children actually benefit from visits through increased understanding and involvement in the wellbeing of their family as well as reduced feelings of separation, guilt, fear, helplessness and abandonment. In South Africa (SA), hospital visiting policies are available to the public online. In Groote Schuur Hospital, [4] a maximum of three visitors are allowed per patient in the general ward and two in the maternity wards and intensive care unit (ICU). Children <12 years old are not permitted to visit unless the patient is the parent or sibling and only if supervised by an accompanying adult. If a patient's condition deteriorates, visiting is at the discretion of the sister in charge and the duration of the visit restricted if it is considered to be detrimental to the patient's wellbeing. Steve Biko Academic Hospital [5] does not allow children to visit paediatric wards for infection control purposes. Similarly, Inkosi Albert Luthuli Central Hospital [6] does not allow children <12 years in the hospital. While hospitals allow both adult and paediatric patients to be visited by family and friends, most exclude children as visitors. Existing literature [1-3,7-9] regarding children as visitors to hospitals is limited to ICUs in well-resourced countries. No studies are available on current policies or practices regarding child visitors locally, in SA, or in other resource-limited, non-critical-care settings. This study was undertaken to describe current policies, practices and perceptions of healthcare workers (HCWs) to child visitors in public sector hospitals in the uMgungundlovu district of KwaZulu-Natal (KZN) Province, SA. Methods uMgungundlovu comprises 7 municipalities, within which there are 9 state hospitals-4 are general hospitals, 2 are for TB and 3 are psychiatric hospitals. All four general state hospitals agreed to participate in the study but two private hospitals that were invited to participate declined the invitation. This descriptive study was Background. Current policies and practices regarding child visitors in hospitals in uMgungundlovu, KwaZulu-Natal Province, South Africa, are unknown. Existing literature focuses on provision for child visitors in specialised units in well-resourced countries. Objective. To identify policies, describe current practices...

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“…Internationally, healthcare professionals have always adopted a somewhat flexible policy when visitors experience practical problems adhering to the hospital policies and/or when a patient suffers from emotional problems (Baning, 2009;Berti et al, 2007). (Berti et al, 2007;da silva Ramos et al, 2014).…”

Section: Age Gender Employment Status Status In Family Religion Ethnimentioning

confidence: 99%

Family members' beliefs and attitudes towards visiting policy in the intensive care units of Ghana

Yakubu

Navab

2019

Nursing Open

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Aim This study aimed to investigate family members' beliefs and attitudes towards the visiting policies of intensive care units (ICUs). Design It employed a descriptive cross‐sectional quantitative design. Method This study recruited four public hospitals in Ghana with a sample of 200 family members. The study was conducted using a self‐administered questionnaire. The data were collected and analysed with SPSS version 16. Results This study revealed that while family members believed in the beneficial effect of adhering to open visiting policies in ICUs, their attitudes were sceptical and restrictive. Most family members preferred the acceptable number of visitors within 24 hr to be two, and according to them, only one person should be allowed to enter at a time. There was a meaningful relationship between the families' beliefs and religion ( p = 0.02), educational level ( p = 0.03) and family status ( p = 0.02). Furthermore, a meaningful relationship was also observed between the families' attitudes and status ( p = 0.04) and their level of education ( p = 0.05). The studied family members showed concern in this regard and did not want the community style of visiting to be implemented, which could hinder patients' recovery.

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Intensive care unit visitation policies in Brazil: a multicenter survey

Cited by 29 publications

References 27 publications

Worldwide Survey of the “Assessing Pain, Both Spontaneous Awakening and Breathing Trials, Choice of Drugs, Delirium Monitoring/Management, Early Exercise/Mobility, and Family Empowerment” (ABCDEF) Bundle

Worldwide Survey of the “Assessing Pain, Both Spontaneous Awakening and Breathing Trials, Choice of Drugs, Delirium Monitoring/Management, Early Exercise/Mobility, and Family Empowerment” (ABCDEF) Bundle

The existence of policies, practices and perceptions regarding children as visitors to public hospitals in uMgungundlovu, KwaZulu-Natal Province

Family members' beliefs and attitudes towards visiting policy in the intensive care units of Ghana

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