Current practices regarding visitation policies in critical care units

Abstract

Previous research has emphasized the importance of visitation in critical care units and its beneficial effects on patients and their families. However, nurses' attitudes and beliefs about visitation did not correlate with those of patients and their families, nor did actual visitation practices correlate with written policy. To investigate nurses' perceptions about open vs restricted visiting hours and the effects on the patient, the patient's family, and the nurse. Quantitative and qualitative data were collected from 201 nurses who completed a survey instrument about nurses' perceptions of visitation at five metropolitan hospitals in a midwestern city. Seventy percent of official policies for visitation were restrictive. In practice, 78% of nurses were nonrestrictive in their visitation practices. Variables that affected practices regarding visiting hours were the patient's need for rest, the nurse's workload, and the beneficial effects of visitation on patients. Requests from patients and their families were ranked least important. Significant differences in practices were found regarding restriction of visiting by immediate family members and of the number of visitors. Restricted hours were perceived to decrease noise (83%) and promote patients' rest (85%). Open visitation practices were perceived to beneficially affect the patient (67%) and the patient's family (88%) and to decrease anxiety (64%). Perceptions of ideal visiting hours included restrictions on the number of visitors (75%), hours (57%), visits by children (55%), and duration of visits (54%), but no restriction on visitation by immediate family members (60%). Qualitative data revealed recurrent themes in visitation practices, policies and exceptions, control of visitation by patients, and nurses' wishes. Data indicate that most nurses do not restrict visitation, regardless of whether restrictive policies are in place. Most nurses base their visitation decisions on the needs of the patient and the nurse. Needs of the family were ranked as less important in decision making about family visitation.