Abstract
ObjectivesTo provide insights into visiting policies and family-centred care practices with a focus on children as visitors in Intensive Care Units in German-speaking countries. Methods/DesignOnline-survey with a mixed methods approach. Leading clinicians (n = 1943) from German-speaking countries were invited to participate. Outcomes included the percentage of intensive care units with open visiting policies, age restrictions, family-centred care activities and barriers. SettingPaediatric, mixed and adult units ResultsIn total, 19.8% (n = 385) of the clinicians responded. Open visiting times were reported by 36.3% (n = 117), with significant differences between paediatric (79.2%), adult (21.3%) and mixed-age (41.2%) units (p < 0.01). Two-thirds of clinicians stated that their units had no age restrictions for children as visitors (n = 221, 68.4%). The family-centred care activities most frequently implemented were open visiting times and dissemination of information. Significantly more German units have open visiting policies and more Swiss units allow children as visitors, compared to the other countries (both p < 0.001). Barriers to family-centred care were concerns about children being traumatized, infection and workload. ConclusionThe majority reported that family-centred care policies had been implemented in their units, including open visiting policies, allowing children as visitors without age restriction and other family-centred care activities.
Highlights
The role of the families of patients in Intensive Care Units (ICUs) has changed in recent decades
The main facilitators to improving familycentred care practices reported by the respondents were convincing evidence, education and communication. In this survey about the practice of family-centred care involving nearly 400 critical care clinicians, carried out in autumn 2019 and before the Covid crisis, we found that there are differences in visiting policies between adult and paediatric ICUs
Paediatric ICUs more commonly have open visiting policies, offer more visiting hours per day and employ more family-centred care practices compared to adult ICUs
Summary
The role of the families of patients in Intensive Care Units (ICUs) has changed in recent decades. Members may be perceived as a burden for patients and staff, as a source of avoidable microbiological contamination, or as initiators of violence or legal complaints against healthcare providers and the team (Athanasiou et al, 2014; Chapman et al, 2016; Ramos et al, 2014; Riley et al, 2014; Li et al, 2020) All these different aspects can lead to different extents of familycentred care activities. A recent survey by the World Federation of Societies of Intensive and Critical Care Medicine (WFSICCM) in 40 countries reported varying family-centred care practices, with many ICUs implementing aspects to differing extents (Kleinpell et al, 2018). The aim of the present study is to gain insights into visiting policies and familycentred care practices with a focus on children as visitors in paediatric, mixed and adult ICUs, in Germanspeaking countries in Europe (Austria, Germany, Luxembourg and the German-speaking part of Switzerland) prior to the Covid-19 pandemic
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