The Impact of Opening Visitation Access on Patient and Family Experience

Nuss, Terri; Kelly, Kecia M.; K, Campbell; Pierce, Cathy; Entzminger, Janna K.; Blair, Brenda K.; Wissinger, Laurie; Bryant, Lona; Walker, James B.

doi:10.1097/nna.0000000000000090

Cited by 7 publications

(5 citation statements)

References 8 publications

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“…Such reports are often press releases with minimal outcome data reported. However, despite evidence that presence of families/ carers can reduce anxiety and improve patient outcomes, implementation of open visiting has proven difficult [14,30]. Attitudes and beliefs of nursing staff have been demonstrated to influence implementation, with many concerns expressed in relation to control over access and timings [14,16,31,32].…”

Section: Discussionmentioning

confidence: 99%

“…These reported barriers relate to individual and workload effects, organisational and policy barriers (including lack of clarity), lack of education, support and training, and HCP desire for control over visiting hours [2,12,13]. In particular, there are reported concerns regarding interruptions, lack of privacy and lack of control over the environment underpinning a preference for set visiting times [13,14]. Implementation therefore needs to be approached carefully and in consultation with the HCPs directly involved.…”

Section: Introductionmentioning

confidence: 99%

“…The USA had a new statute introduced in 2011 to provide visitation privileges; this was a system-wide policy for a primary support person to have visitation access 24 h per day 7 days per week. A review by Nuss (2014) regarding the implementation of this statute identified that over 50% of hospitals did not have robust guidelines in place; however those that had introduced policies emphasised the importance of influencing cultural change [14].…”

Section: Introductionmentioning

confidence: 99%

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A realist evaluation of the implementation of open visiting in an acute care setting for older people

Hurst

Griffiths

Hunt

2019

BMC Health Serv Res

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Background: Open visiting refers to the principle of unrestricted visiting hours in the hospital setting to enable relatives, families and carers to visit at any time. There has been recognition that open visiting supports the principle of patient and family supported care and improves communication. Despite this there has been difficulty in implementing open visiting and barriers identified. The aims of this study were therefore to evaluate the implementation of open visiting, the barriers to implementation, sustainability and the impact of open visiting on communication between health care professionals, families and carers. Methods: The study was conducted on two large acute wards for the older person. Realist evaluation methods were used to understand 'what works well, how, for whom and to what extent.' Mixed methods were employed including qualitative interviews and descriptive analyses of routine data sets. Following the methodology of realist evaluation, programme theories were identified a long with the context, mechanisms and outcomes of implementation, to better understand the implementation process. Results: The results of this study identified some key findings, demonstrating that open visiting does improve communication and can help to build trusting relationships between families/carers and health care professionals (HCP). Barriers to implementation were based on the belief that it would impinge on routines within the ward setting. To achieve the principles of patient and family/carer centred care, the key mechanisms are the confidence and skills of individual nurses and health care assistants to engage with relatives/carers, whilst retaining a sense of control, particularly when care is being delivered to other patients. Conclusion: In summary, open visiting creates a positive culture which fosters better relationships between families/carers and HCPs. Involving families/carers as partners in care does not happen automatically in an environment where open visiting is the policy, but requires engagement with staff to encourage and support relatives/carers.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A realist evaluation of the implementation of open visiting in an acute care setting for older people

Hurst

Griffiths

Hunt

2019

BMC Health Serv Res

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“…Regarding nurses’ perceptions, the research seems divided between studies suggesting that visitation has either a negative or positive influence. Studies of negative influence focus on the perceived effect of visitors on nurses and patients, identifying that some nurses perceive visitors make the environment unsafe by interfering with nurse roles/procedures (Nuss et al, 2014), increasing risk of infection for patients (Hart et al, 2013), and overstimulating the patient (Voncina & Newcomb, 2016). Studies showing a positive influence identify visitors as valuable resource, particularly when family members assist in taking a patient history (Cappellini, Bambi, Lucchini, & Milanesio, 2014) and provide the patient with emotional support (Segaric & Hall, 2015; Voncina & Newcomb, 2016).…”

Section: Discussionmentioning

confidence: 99%

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

Oyesanya

Bowers

2017

J Fam Nurs

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Family caregivers of patients with moderate-to-severe traumatic brain injury (TBI) regularly visit the patient during the hospital stay and are involved in their care. As impairments caused by the TBI often preclude the patient from stating preferences for visitors, family caregivers often make decisions about visitors during the hospital stay. However, limited literature investigates this process. The purpose of this study was to describe family caregivers’ experience of visitors while the patient with moderate-to-severe TBI is hospitalized. Authors used grounded theory to conduct 24 interviews with 16 family caregivers. Findings showed family caregivers manage welcome and unwelcome visitors throughout the hospital stay to protect the patient’s physical and emotional safety and to conserve their own energy. Staff had limited involvement in management of unwelcome visitors. These findings have practice implications for educating hospital staff about the providing family nursing and assisting families to manage unwelcome visitors and policy implications for improving hospital visiting policies.

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“…Education of parents to understand subtle signs and signals from their tiny, preterm-born infants is considered an investment in an optimal home environment for the child. From being forced to separate from their newborn infant due to restrictions of visiting hours in NICUs, parents are now generally encouraged to stay with their infant as much as possible [17, 18]. …”

Section: Introductionmentioning

confidence: 99%

Early skin-to-skin contact or incubator for very preterm infants: study protocol for a randomized controlled trial

Kristoffersen

Støen

Rygh

et al. 2016

Trials

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BackgroundSkin-to-skin care immediately following delivery is a common practice for term infants and has been shown to improve cardiorespiratory stability, facilitate early bonding, and promote breastfeeding. Since 2007, the use of skin-to-skin care has been practiced for preterm infants from 32 weeks of gestation in the delivery room at St. Olav’s University Hospital. In the present study we aim to investigate whether skin-to-skin care following delivery is safe, and how it affects early and late outcomes compared to standard care for very preterm infants.Methods/DesignA randomized controlled trial (RCT) of skin-to-skin care in the delivery room for very preterm infants born at gestational age 280–316 weeks with birth weight >1000 grams. Infants with severe congenital malformations or need of intubation in the delivery room are excluded. A detailed checklist and a flowchart were prepared for the study, and all involved professionals (neonatologists, neonatal nurses, obstetricians, anesthesiologists, midwives) participated in medical simulation training prior to study start on February 1, 2014. A consultant in neonatology and a neonatal nurse are present at all deliveries. Infants with birth weight <1500 grams receive an intravenous line with glucose, amino acids, and caffeine citrate in the delivery room. Infants with gestational age <30 weeks are routinely put on continuous positive airway pressure (CPAP). After initial stabilization, infants are randomized to skin-to-skin care or are transferred to the nursery in an incubator. Primary outcome is cognitive development at 2 years measured with the Bayley Scales of Infant Development, Third Edition. Secondary outcomes are safety defined as hypothermia, respiratory failure, and/or cardiopulmonary resuscitation, physiological stability after birth and motor, language and cognitive development at 1 year for the child, and mental health measured with the State-Trait Anxiety Inventory (STAI) at discharge, and at 3 months and 2 years after expected date of delivery for the mothers.DiscussionThe study may have important implications for the initial care for very preterm infants after delivery and increase our understanding of how early skin-to-skin care affects preterm infants and their mothers.Trial registrationClinicalTrials, NCT02024854. Registered on 19 December 2013.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1730-5) contains supplementary material, which is available to authorized users.

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The Impact of Opening Visitation Access on Patient and Family Experience

Cited by 7 publications

References 8 publications

A realist evaluation of the implementation of open visiting in an acute care setting for older people

A realist evaluation of the implementation of open visiting in an acute care setting for older people

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

Early skin-to-skin contact or incubator for very preterm infants: study protocol for a randomized controlled trial

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