Colloboration For Leadership in Applied Health Research Greater Manchester (NIHR), Greater Manchester, UK.
The University of Manchester, Manchester Academic Health Sciences Centre, Manchester University NHS Foundation Trust, Manchester, UK.
BMC Health Serv Res. 2019 Nov 21;19(1):867. doi: 10.1186/s12913-019-4653-5.
Open visiting refers to the principle of unrestricted visiting hours in the hospital setting to enable relatives, families and carers to visit at any time. There has been recognition that open visiting supports the principle of patient and family supported care and improves communication. Despite this there has been difficulty in implementing open visiting and barriers identified. The aims of this study were therefore to evaluate the implementation of open visiting, the barriers to implementation, sustainability and the impact of open visiting on communication between health care professionals, families and carers.
The study was conducted on two large acute wards for the older person. Realist evaluation methods were used to understand 'what works well, how, for whom and to what extent.' Mixed methods were employed including qualitative interviews and descriptive analyses of routine data sets. Following the methodology of realist evaluation, programme theories were identified a long with the context, mechanisms and outcomes of implementation, to better understand the implementation process.
The results of this study identified some key findings, demonstrating that open visiting does improve communication and can help to build trusting relationships between families/carers and health care professionals (HCP). Barriers to implementation were based on the belief that it would impinge on routines within the ward setting. To achieve the principles of patient and family/carer centred care, the key mechanisms are the confidence and skills of individual nurses and health care assistants to engage with relatives/carers, whilst retaining a sense of control, particularly when care is being delivered to other patients.
In summary, open visiting creates a positive culture which fosters better relationships between families/carers and HCPs. Involving families/carers as partners in care does not happen automatically in an environment where open visiting is the policy, but requires engagement with staff to encourage and support relatives/carers.
开放探视是指在医院环境中实行无限制探视时间的原则，以使亲属、家属和护理人员随时可以探视。人们已经认识到，开放探视支持患者和家属支持护理的原则，并改善了沟通。尽管如此，在实施开放探视方面仍存在困难，并确定了障碍。因此，本研究的目的是评估开放探视的实施情况、实施障碍、可持续性以及开放探视对医护人员、家属和护理人员之间沟通的影响。
该研究在两家大型老年急性病房进行。采用现实主义评估方法来了解“哪些方面有效、如何有效、对谁有效以及在何种程度上有效”。采用混合方法，包括定性访谈和常规数据集的描述性分析。根据现实主义评估的方法，确定了方案理论，以及实施的背景、机制和结果，以更好地理解实施过程。
本研究的结果确定了一些关键发现，表明开放探视确实可以改善沟通，并有助于在家庭/护理人员和医疗保健专业人员（HCP）之间建立信任关系。实施障碍基于这样一种信念，即它会影响病房环境中的常规工作。为了实现以患者和家庭/护理人员为中心的护理原则，关键机制是个别护士和保健助理的信心和技能，以便与亲属/护理人员进行互动，同时保持控制感，特别是在为其他患者提供护理时。
总之，开放探视营造了一种积极的文化氛围，促进了家庭/护理人员和 HCP 之间更好的关系。在开放探视是政策的环境中，让家属/护理人员作为护理伙伴参与并不自动发生，而是需要与员工接触，以鼓励和支持亲属/护理人员。
