A survey of intensive care unit visiting policies in the United Kingdom

Hunter, Joy; Goddard, Chris; Rothwell, M.; Ketharaju, S.; Cooper, Howard A.

doi:10.1111/j.1365-2044.2010.06506.x

Cited by 63 publications

(55 citation statements)

References 31 publications

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“…This is the third report of venous air embolism caused by laceration of a central venous catheter by a razor [1,2]. We were unaware of the previous cases and suspect that this occurs more commonly than is reported.…”

Section: K S Kimmentioning

confidence: 79%

“…Hunter et al stated that unrestricted visiting on the intensive care unit (ICU) improved rates of anxiety, depression and satisfaction among family members [1]. Communication is highlighted as a key theme in their paper.…”

Section: K S Kimmentioning

confidence: 99%

“…We read with great interest the succinct survey of intensive care unit (ICU) visiting policies in the UK by Hunter et al [1]. Although comprehensive in their conduct of the survey, we were disappointed to note that they had omitted to survey the practice of allowing animals in various ICUs in the UK.…”

Section: Canine Visit! In Icu?mentioning

confidence: 99%

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Visiting hours impact on medical care

Marr

Laws

2011

Anaesthesia

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Section: K S Kimmentioning

confidence: 79%

Section: K S Kimmentioning

confidence: 99%

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Visiting hours impact on medical care

Marr

Laws

2011

Anaesthesia

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“…Entretanto, para que possa ter suas necessidades atendidas e oferecer suporte para o paciente, a família também requer cuidados da equipe de saúde (1)(2)(3)(4)(5) . A internação na UTI é um evento considerado estressante pelos familiares que acompanham esse processo (6) . Segundo pesquisa (2) realizada com profissionais de saúde, os dispositivos da Política Nacional de Humanização (PNH), visita aberta, a ambiência e o acolhimento, ainda não foram implementados na UTI pesquisada, o que as autoras alertam poder ser uma realidade também em outras UTIs do Brasil.…”

unclassified

“…Segundo pesquisa (2) realizada com profissionais de saúde, os dispositivos da Política Nacional de Humanização (PNH), visita aberta, a ambiência e o acolhimento, ainda não foram implementados na UTI pesquisada, o que as autoras alertam poder ser uma realidade também em outras UTIs do Brasil. As UTIs, tradicionalmente, possuem estrutura fechada, com políticas de visitação restritivas, limitando a presença de familiares (6)(7) . No contexto brasileiro observou-se o mesmo e não se identificaram diferenças significativas entre os hospitais públicos e privados (8) .…”

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Percepção De Familiares Sobre Visitas a Pacientes E Regras Em Unidade De Terapia Intensiva

Nunes¹,

Gabarra²

2017

ACS

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Conflito de interesses: NãoContribuição dos autores: MEPN delineamento do estudo, coleta, tabulação, redação do manuscrito, revisão crítica. LMG orientação do projeto, delinea-mento do estudo, discussão dos achados, elaboração do manuscrito, revisão crítica. Contato para correspondência: Maria Emília Pereira Nunes Abstract Introduction:Intensive Care Unit (ICU) is a facility related to the imminent risk of death. The constant presence of family members is considered a form of support for patient recovery. However, the ICU has the characteristic of being a closed unit, with restricted visitation. Objective: To know the perception of family members regarding patients' visitors and the rules in Intensive Care Unit. Patients and Methods: This is a qualitative field research. We conducted semi-structured interviews from October to November 2014 involving ten relatives of patients who were hospitalized in the ICU Adult General. Individual interviews were recorded, transcribed, and analyzed according to thematic content analysis of Bardin. Results: The visit was perceived as a source of support to the patient. It also contributed to the improvement of the emotional state of the family member. It was observed that feelings, such as fear, anguish, and tranquility emerged from the visit. The study also showed interference between the relationship with health professionals, and the assessment family members make about the visit itself. Rules for patient visits were indicated as strictly necessary. However, a greater flexibility of these rules was considered relevant in special situations. Conclusion: Both, patients' visits and ICU rules were perceived as important by family members. Nonetheless, it is emphasized that not everyone is prepared to the visit and that the team can assist them in this process.

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Effect of Flexible Family Visitation on Delirium Among Patients in the Intensive Care Unit

Rosa

Falavigna²,

Silva

et al. 2019

JAMA

140

124

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IMPORTANCE The effects of intensive care unit (ICU) visiting hours remain uncertain. OBJECTIVE To determine whether a flexible family visitation policy in the ICU reduces the incidence of delirium. DESIGN, SETTING AND PARTICIPANTS Cluster-crossover randomized clinical trial involving patients, family members, and clinicians from 36 adult ICUs with restricted visiting hours (<4.5 hours per day) in Brazil. Participants were recruited from April 2017 to June 2018, with follow-up until July 2018. INTERVENTIONS Flexible visitation (up to 12 hours per day) supported by family education (n = 837 patients, 652 family members, and 435 clinicians) or usual restricted visitation (median, 1.5 hours per day; n = 848 patients, 643 family members, and 391 clinicians). Nineteen ICUs started with flexible visitation, and 17 started with restricted visitation. MAIN OUTCOMES AND MEASURES Primary outcome was incidence of delirium during ICU stay, assessed using the CAM-ICU. Secondary outcomes included ICU-acquired infections for patients; symptoms of anxiety and depression assessed using the HADS (range, 0 [best] to 21 [worst]) for family members; and burnout for ICU staff (Maslach Burnout Inventory). RESULTS Among 1685 patients, 1295 family members, and 826 clinicians enrolled, 1685 patients (100%) (mean age, 58.5 years; 47.2% women), 1060 family members (81.8%) (mean age, 45.2 years; 70.3% women), and 737 clinicians (89.2%) (mean age, 35.5 years; 72.9% women) completed the trial. The mean daily duration of visits was significantly higher with flexible visitation (4.8 vs 1.4 hours; adjusted difference, 3.4 hours [95% CI, 2.8 to 3.9]; P < .001). The incidence of delirium during ICU stay was not significantly different between flexible and restricted visitation (18.9% vs 20.1%; adjusted difference, −1.7% [95% CI, −6.1% to 2.7%]; P = .44). Among 9 prespecified secondary outcomes, 6 did not differ significantly between flexible and restricted visitation, including ICU-acquired infections (3.7% vs 4.5%; adjusted difference, −0.8% [95% CI, −2.1% to 1.0%]; P = .38) and staff burnout (22.0% vs 24.8%; adjusted difference, −3.8% [95% CI, −4.8% to 12.5%]; P = .36). For family members, median anxiety (6.0 vs 7.0; adjusted difference, −1.6 [95% CI, −2.3 to −0.9]; P < .001) and depression scores (4.0 vs 5.0; adjusted difference, −1.2 [95% CI, −2.0 to −0.4]; P = .003) were significantly better with flexible visitation. CONCLUSIONS AND RELEVANCE Among patients in the ICU, a flexible family visitation policy, vs standard restricted visiting hours, did not significantly reduce the incidence of delirium.

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A survey of intensive care unit visiting policies in the United Kingdom

Cited by 63 publications

References 31 publications

Visiting hours impact on medical care

Visiting hours impact on medical care

Percepção De Familiares Sobre Visitas a Pacientes E Regras Em Unidade De Terapia Intensiva

Effect of Flexible Family Visitation on Delirium Among Patients in the Intensive Care Unit

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