Visits of children to patients being cared for in adult ICUs: policies, guidelines and recommendations

Knutsson, Susanne; Otterberg, Cecilia L; Bergbom, Ingegerd

doi:10.1016/j.iccn.2004.06.004

Cited by 48 publications

(52 citation statements)

References 20 publications

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“…The results have been extraordinary, with patient survival steadily improving over time [14-16]. Because of the complexity of ICU care, prior small studies have raised concerns that open ICU visitation policies could harm patients by increasing physiologic stress, interfering with timely and safe care delivery, infringing on patient privacy, increasing exposure to infection, leading to caregiver exhaustion, and negatively impacting interactions with families [4,17-26]. …”

Section: Discussionmentioning

confidence: 99%

Visitation policies and practices in US ICUs

et al. 2013

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IntroductionPrior reports suggest that restrictive ICU visitation policies can negatively impact patients and their loved ones. However, visitation practices in US ICUs, and the hospital factors associated with them, are not well described.MethodsA telephone survey was made of ICUs, stratified by US region and hospital type (community, federal, or university), between 2008 and 2009. Hospital characteristics were self-reported and included the hospitals' bed number, critical care unit number, and presence of ICU leadership. Hospital and ICU visitation restrictions were based on five criteria: visiting hours; visit duration; number of visitors; age of visitors; and membership in the patient's immediate family. Hospitals or ICUs without restrictions had open visitation policies; those with any restriction had restrictive policies.ResultsThe study surveyed 606 hospitals in the Northeast (17.0%), Midwest (26.2%), South (36.6%), and West (20.1%) regions; most were community hospitals (n = 401, 66.2%). The mean hospital size was 239 ± 217 beds; the mean percentage of ICU beds was 11.6% ± 13.4%. Hospitals often had restrictive hospital (n = 463, 76.4%) and ICU (n = 543, 89.6%) visitation policies. Many ICUs had ≥ 3 restrictions (n = 375; 61.9%), most commonly related to visiting hours and visitor number or age. Nearly all ICUs allowed visitation exceptions (n = 474; 94.8%). ICUs with open policies were more common in hospitals with < 150 beds. Among restrictive ICUs, the bed size, hospital type, number of critical care units, and ICU leadership were not associated with the number of restrictions. On average, hospitals in the Midwest had the least restrictive policies, while those in the Northeast had the most restrictive.ConclusionIn 2008 the overwhelming majority of US ICUs in this study had restrictive visitation policies. Wide variability in visitation policies suggests that further study into the impact of ICU visitations on care and outcomes remains necessary to standardize practice.

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Section: Discussionmentioning

confidence: 99%

Visitation policies and practices in US ICUs

et al. 2013

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“…However, the literature gives an inhomogeneous picture of visiting policies in the critical care setting. The latest available percentages of adult ICUs without restrictions on visiting hours are 70% in Sweden (11), 32% in the United States (12), 23% in France (13), 22% in the United Kingdom (14), 3.3% in Flanders (Belgium) (15) and only 0.4% in Italy (8).…”

Section: Discussionmentioning

confidence: 99%

Parental presence and visiting policies in Italian pediatric intensive care units: A national survey*

Giannini

Miccinesi

2011

Pediatric Critical Care Medicine

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“…Restricted visiting hours are neither longer recommended, nor are other restrictions such as exclusion of small children or on the grounds of risk of infection (Knutsson et al, 2004). The patient and family feel best if the interplay between them is as normal as possible.…”

Section: Introductionmentioning

confidence: 99%

The experiences of patients and their families of visiting whilst in an intensive care unit – A hermeneutic interview study

Eriksson

Bergbom

Lindahl

2011

Intensive and Critical Care Nursing

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SummaryAim: The aim of this study was to interpret and understand the meanings of the lived experiences of visiting of patients in an ICU and their families. Method: The research design was hermeneutic, based on interviews. This study includes 12 interviews with seven patients and five relatives who had been in an ICU. The interview text was interpreted in a Gadamerian manner as different plays with actors and plots. Findings: Patients' narratives could be divided into two parts; recall of real life and unreal life experiences, the unreal being more common. Relatives' narratives are described as being on stage and being backstage, i.e. in the room with the patient and outside it. Conclusion: The final interpretation elucidated the experience of visiting as the sudden shift between being present in real life vs. being present in the real life of unreality. It was a process whereby the patient and the family build a new understanding of life that creates a new form of interplay within the family. The pre-critical illness life is no longer there -a new life has begun. To support patients and their families in this process of change a family-centred care perspective is necessary.

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Visits of children to patients being cared for in adult ICUs: policies, guidelines and recommendations

Cited by 48 publications

References 20 publications

Visitation policies and practices in US ICUs

Visitation policies and practices in US ICUs

Parental presence and visiting policies in Italian pediatric intensive care units: A national survey*

The experiences of patients and their families of visiting whilst in an intensive care unit – A hermeneutic interview study

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