Some hospitals ease ICU visitor restrictions: 3 key points

According to survey of more than 600 hospitals published in the Journal of Critical Care in 2013, 90 percent of intensive care units had visitation restrictions. Recently, some hospitals — motivated by academic literature and personal experience — are changing course, according to The Wall Street Journal.

Here are three key points regarding the case for relaxing visitor restrictions in the ICU.

1. Patient perspective: Pamela Bell, director of patient and family centered care at the Valley Hospital in Ridgewood, N.J., experienced restrictive visitation when her partner died in a Boston-area ICU in 2014. Ms. Bell told the Wall Street Journal she had to call every time she wanted to visit the ICU and that she was never able to stay overnight.

Ms. Bell's experience inspired her to try to bring open visitation to Valley Hospital. Kathleen Sayles, RN, manager of clinical trials and research at Valley Hospital, supported her colleague's efforts. Prior to the implementation of open visitation at the hospital, Ms. Sayles was permitted to stay by her son one night when he was hospitalized at Valley and couldn't breathe.

"I can't imagine if they had told me I had to go home," Ms. Sayles told the Wall Street Journal.

2. New research: In 2015, a practice alert published by the American Association of Critical Care Nurses argued for relaxed restrictions regarding family visitation in the adult ICU.

Citing a myriad of studies, the alert reads, "Evidence does suggest that for patients, flexible visitation decreases anxiety, confusion and agitation, reduces cardiovascular complications, decreases length of ICU stay, makes the patient feel more secure, increases patient satisfaction and increases quality and safety."

3. In practice: To prepare for open visitation, Valley Hospital added more hand-sanitizer dispensers and installed panic buttons in case visitors became disruptive and disorderly. While nurses at Valley Hospital were initially hesitant about open visitation, unrest among the staff calmed after Bettyann Kempin, an assistant vice president who oversees the ICU at Valley, made the case for the new policy.

Ms. Kempin told the Wall Street Journal nurses realized visitors weren't going to disrupt the calm of the ICU by having "parties at the bedside with 20 people and pizza." Ms. Kempin added that patients "do better when families are at the bedside holding their hand or being there. You will see a calm come over them. Their vital signs look a little better."

The panic buttons installed in the ICU at Valley hospital have yet to be used.

More articles on quality: 
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UW-Madison, Johns Hopkins, Yale launch patient experiences website 
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