Chapman Diane K, Collingridge Dave S, Mitchell Lorie A, Wright Elizabeth S, Hopkins Ramona O, Butler Jorie M, Brown Samuel M
At the time this article was researched Diane K. Chapman was a staff nurse in the shock trauma intensive care unit and a member of the Center for Humanizing Critical Care at Intermountain Medical Center, Murray, Utah. Dave S. Collingridge is a statistician in the Statistical Data Center, Intermountain Healthcare, Murray, Utah. Lorie A. Mitchell is nurse manager of the shock trauma intensive care unit and a nursing researcher in the Center for Humanizing Critical Care. Elizabeth S. Wright was assistant nurse manager of the shock trauma intensive care unit at Intermountain Medical Center. Ramona O. Hopkins is a research psychologist in the Center for Humanizing Critical Care; a professor in the Psychology Department and Neuroscience Center, Brigham Young University, Provo, Utah; and a researcher in the Department of Medicine, Pulmonary and Critical Care Division, Intermountain Medical Center. Jorie M. Butler is a health psychologist in the Center for Humanizing Critical Care; associate director for education and evaluation at GRECC, core investigator at the IDEAS 2.0 at the Salt Lake Veterans Affairs Medical Center, Salt Lake City, Utah; and an assistant professor in the Division of Geriatrics, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, Utah. Samuel M. Brown is director of the Center for Humanizing Critical Care, Intermountain Healthcare, Murray, Utah; an assistant professor in the Department of Pulmonary and Critical Care Medicine, University of Utah, Salt Lake City; and an intensivist in the Department of Medicine, Pulmonary and Critical Care Division, Intermountain Medical Center.
Am J Crit Care. 2016 Jan;25(1):46-50. doi: 10.4037/ajcc2016789.
Open and patient-tailored guidelines have been recommended as the preferred visitation model in critical care settings; however, many critical care units continue to restrict visitation.
To determine whether a transition from minimally restrictive to unrestricted visitation hours improves satisfaction of patients' family members and whether such a transition affects nurses' satisfaction and nurses' perceptions of satisfaction among patients' families.
Using a prospective, observational design in a 24-bed intensive care unit in a tertiary care hospital, validated instruments were used to survey family members visiting patients and all nurses working in the unit before and after a change in the visitation policy. Visitation hour guidelines were changed from closed during nursing hand-off report (3 hours daily) to open at all times, depending on patients' preference and clinical status.
One hundred three family members (50 before and 53 after the change in visitation guidelines) and 128 nurses (61 before and 67 after the policy change) were surveyed. Unrestricted visitation hours significantly improved family members' satisfaction with the convenience of visitation hours and waiting room ambiance, and nurses' perceptions of families' satisfaction also improved.
Elimination of even minimal restrictions on visitation hours improved family satisfaction and improved nurses' perceptions of family satisfaction with the visitation policy. Nurses' satisfaction did not change. These findings support open and patient-centered visitation guidelines in critical care settings.
开放且针对患者个体需求的探视指南已被推荐为重症监护环境中的首选探视模式；然而，许多重症监护病房仍继续限制探视。
确定从最低限度限制探视时间转变为无限制探视时间是否能提高患者家属的满意度，以及这种转变是否会影响护士的满意度和护士对患者家属满意度的认知。
在一家三级医院的24张床位的重症监护病房采用前瞻性观察设计，使用经过验证的工具对探视政策改变前后探视患者的家属和该病房所有工作的护士进行调查。探视时间指南从护理交接班报告期间关闭（每天3小时）改为根据患者意愿和临床状况随时开放。
共调查了103名家属（探视指南改变前50名，改变后53名）和128名护士（政策改变前61名，改变后67名）。无限制探视时间显著提高了家属对探视时间便利性和候诊室氛围的满意度，护士对家属满意度的认知也有所提高。
即使消除对探视时间的最低限度限制也能提高家属满意度，并改善护士对家属对探视政策满意度的认知。护士的满意度没有变化。这些发现支持重症监护环境中开放且以患者为中心的探视指南。
