Open visitation, defined as unrestricted access (24 h/d) of patients in the adult intensive care unit (ICU) to chosen support persons, is an expected practice according to the American Association of Critical-Care Nurses.1 Evidence indicates that unrestricted visitation can improve communication, facilitate a better understanding of the patient, advance patient and family-centered care, and enhance staff satisfaction.2In our adult ICU, conflict was increasing between nurses who allowed family to visit anytime and to stay overnight, and nurses who adhered to the existing visitation policy (ie, visitors allowed with the patient for 10 minutes of each hour, and visits restricted between 7:30 and 8:30 am and between 3 and 4 pm). Several nurses wanted to develop a more family-centered approach to care, and a review of the literature supported open visitation as a strategy for promoting such care in adult ICUs.1,3We used the Institute for Healthcare Improvement’s Model for Improvement to guide the planning, implementation, and evaluation phases of this evidence-based practice (EBP) quality improvement (QI) project. This model starts with forming the project team and obtaining buy-in from stakeholders. The next 6 steps include setting project aims, establishing measures, selecting changes, testing changes, implementing changes, and spreading changes.4A core group of bedside nurses working in the adult ICU drove this practice change with the support of the nurse manager and an EBP mentor from a nearby college of nursing, Sacred Heart University. We obtained buy-in from other nurses, unit secretaries, and physicians by sharing with them the American Association of Critical-Care Nurses and the Society for Critical Care Medicine recommendations for open visitation in an adult ICU,1,5 and by asking them whether they would want unrestricted access if the patient were their family member or friend—they all said yes. This project had the full support of administrators and leadership. We used a tool that differentiates clinical research from QI to determine that this was a QI project6; therefore, institutional review board approval was not necessary.Our aim for this project was to implement open visitation in our adult ICU and to track staff adherence to the new policy. Our adult unit has 10 beds and is part of an 88-bed acute care community hospital in Connecticut. The ICU is staffed by 13 full-time and 12 per diem registered nurses, 1 full-time licensed practical nurse, 3 full-time and 1 per diem unit secretary, and a full-time nurse manager. The mean daily patient census is 7.3, and the mean daily visitor census is 14.6. Common critical care diagnoses include acute respiratory failure with hypercapnia, chronic obstructive pulmonary disease exacerbation, acute or chronic kidney injury, diabetic ketoacidosis, suicide ideation, alcohol withdrawal/delirium tremens, non–ST elevation myocar-dial infarction, and cardiac arrest.The outcome of interest was staff adherence to the new open visitation policy. Because there are no national benchmarks for open visitation, we used the hospital benchmark policy, starting at 70% staff adherence for the first month, 80% for the second month, and 90% thereafter.During a journal club that met every 2 weeks for 2 months, monthly for 4 months, and bimonthly for 4 months, nurses reviewed evidence from the literature and open visitation policies from outside organizations to create an open visitation policy for our hospital. In the new policy, the patient defines who is considered “family.” Children of any age are welcome, but if younger than age 14, they must be accompanied by an adult who is not the patient. Visitors are encouraged to refrain from visiting if they are displaying symptoms of illness. Nurses have the discretion to limit, as necessary, the number of visitors or the duration of visitation on the basis of factors such as the patient’s condition or the unit environment.The patient has the right to designate whether they consent to receive visitors; if they do, they can withdraw that consent at any time. Visitors are allowed 24 h/d, except between 7 and 8 am; this hour was excluded because of the high volume of confidential patient information exchanged between nurses and physicians during hand-off communication between shifts. If, however, visitors are already present in a patient’s room before this hour and wish to remain, they may stay with the door closed.Kozub et al7 found that scripted prompts ease nurses’ anxiety over addressing common safety (eg, interruptions during intravenous pump changes), environmental (eg, visitors congregating in hallways), and communication challenges (eg, discussing with family that a child should be accompanied by an adult) and improve effective communication when implementing open visitation. Therefore, we developed scripted prompts as an implementation strategy to facilitate nurse adoption of the new policy.The practice change rollout involved small-group (3 or 4 staff members) education sessions about the new policy. Staff also trained through role-playing, taking turns as the nurse or family and acting out the scripted prompts. Staff signed and dated a form to indicate that education had been provided. The nurse manager created an audit tool to track staff adherence to the open visitation policy and, through one-on-one education, taught unit secretaries how to use it. Unit secretaries signed and dated a form to indicate that education had been provided.The signage in the ICU waiting room and on the ICU doors was changed to reflect the new open visitation policy. A welcome card given to patients, their families, or both when they arrive in the ICU was updated to include the new visitor policy and explain what families should expect when visiting a patient in the ICU.We tracked adherence to the open visitation policy for 3 months (June through August 2018). Unit secretaries used the audit tool to collect data from day and evening shifts (no unit secretary staffed the night shift, and thus no data were collected then). The unit secretary circled “yes” or “no” to indicate whether nurses followed the open visitation policy. If the unit secretary selected “no,” she wrote a brief description of why family visitation was restricted so the nurse manager could follow up the next day. A communication log was kept on the unit, and staff and physicians were encouraged to document any issues or questions related to the practice change. The nurse manager frequently checked the communication log for new entries, and the team discussed these at staff meetings. The nurse manager also asked about any policy-related issues during the 7 am safety huddles, which occurred daily, Monday through Friday.A 1-page executive summary was distributed to the hospital leadership. We planned to present the project results at the hospital’s annual 1-day Continuing Education Symposium, but this event was canceled due to the hospital merger. A manuscript was submitted to Critical Care Nurse.Resources required for this project were minimal because nurses completed most of the work during scheduled shifts. The nurse manager who facilitated the journal club was on duty for all meetings, and the EBP mentor provided EBP-related leadership free of charge. The nurses attended the journal club meetings during scheduled shifts, and the chief nurse officer approved paying the nurses who attended the meetings on their days off (a total of $572). The redesign and printing of the “Welcome to the ICU” information card and the new signage for the ICU door and waiting room cost $185. Unit secretaries performed audits during their shifts.We successfully implemented open visitation in our 10-bed adult ICU. The unit secretaries conducted a total of 54 audits during day and evening shifts from June through August 2018. These audits revealed that staff followed the open visitation policy 100% of the time, exceeding our 1-, 2-, and 3-month benchmarks. Issues communicated during the daily safety huddle and entries from the communication log centered on staff needing to be reassured that they were following the new policy correctly and staff asking for more strategies—in addition to those included in the original scripted prompts—for effectively communicating with visitors. These issues were resolved by letting the staff vent to the nurse manager and their peers, working with them to create new scripted prompts, and facilitating role-playing to practice communication. About 8 months after the practice change, we felt the culture shift within our 10-bed ICU—open visitation had been fully adopted as the new norm. Nurses, patients, and visitors verbally expressed increased satisfaction with the new policy.We used journal club as a strategy to engage nurses in reviewing the evidence and creating the open visitation policy. Nurses initially came to the journal club prepared and were eager to discuss and critique the articles. The initial time line aimed to review and appraise the evidence within 4 months, and to write the evidence-based open visitation policy within the subsequent 2 months. As time passed, however, nurses began arriving unprepared. The group decided to change the journal club to a working group and to use the meeting time to review the evidence and create the policy, which took 10 months.Another challenge was implementing a practice change when a hospital merger was announced. Morale was low among nurses; some resigned, and those who stayed worried about job security. To address these issues, we communicated frequently and checked in with staff through daily huddles and meetings that allowed us to address issues related to the practice change in real time. We had planned a celebration to recognize the nurses for successfully completing this EBP QI project, but changes caused by the merger prevented it. Instead, the nurse manager recognized each nurse individually in person, in their performance evaluation.Emailing staff and posting on the education board flyers highlighting the evidence for and advantages of open visitation was an additional strategy that kept the team together and focused on the goal of implementing open visitation. Displaying inspirational quotes, handwriting thank you notes, and posting and highlighting the cards and gifts that shared positive feedback from families of patients in the ICU were other beneficial strategies that kept staff focused.Our EBP mentor from the nearby university provided helpful leadership throughout the EBP process. This person had excellent EBP skills and was knowledgeable about and proficient in individual and organizational change strategies that were needed to guide the implementation and sustainability of open visitation in our adult ICU.Open visitation is a best practice that supports family-centered care and patients in adult ICUs. We reviewed the evidence regarding visitation practices in the adult ICU and developed an open visitation policy that we successfully implemented in our adult ICU. This new policy improved satisfaction among nurses, patients, and visitors. Our use of EBP implementation strategies facilitated our ability to implement and sustain open visitation in our adult ICU.The authors recognize Bobbi Allen, bsn, rn, Nancy Lang, bsn, rn, Michele Travis, bsn, rn, and Rebecca Riznyk, msn, rn, for helping to critique the evidence and Sandra Milewski and Lisa Squezello (the unit secretaries) for collecting the data.