Marmo Suzanne, Milner Kerry A
Suzanne Marmo is an assistant professor of social work at Sacred Heart University, Fairfield, Connecticut.
Kerry A. Milner is a professor of nursing at Sacred Heart University, Fairfield, Connecticut.
Am J Crit Care. 2023 Jan 1;32(1):31-41. doi: 10.4037/ajcc2023365.
In March 2020, rising numbers of COVID-19 infections contributed to changes in intensive care unit visitation policies, with some facilities allowing no visitors.
To compare visitation policies of Magnet and Pathway to Excellence hospitals with prepandemic open visitation in adult intensive care units.
A mixed-methods study was conducted from January through March 2021. Quantitative data on visitation policies were extracted from websites of 96 Magnet and Pathway to Excellence hospitals that had allowed unrestricted visits in adult intensive care units before the pandemic. Qualitative data were collected via semistructured interviews with 9 nurse leaders from these hospitals.
More than 1 year after the start of the pandemic, all of the hospitals had instituted restricted visitation policies. The policies varied, with little to no evidence-based justification. Restrictions included 83% of hospitals (n = 80) allowing just 1 visitor per day and 69% of hospitals (n = 50 of 72) allowing no visits at all for patients with COVID-19 in the intensive care unit. Five themes were found when nurse leaders' interviews were analyzed: visitors not welcome, doing harm, external decisions at system level, visiting within limits, and changes in critical care nursing work.
Results of the study suggest that despite the vast amount of evidence supporting the benefits of visitation and the harms of restricted visitation and expert recommendations for returning safe visitation to hospitals, Magnet and Pathway to Excellence hospitals continue to enforce restricted visitation policies in intensive care units. Patients, families, and nursing and health care staff must partner to create pandemic-proof visitation policies.
2020年3月，新型冠状病毒肺炎（COVID-19）感染病例数不断增加，导致重症监护病房探视政策发生变化，一些机构禁止探视。
比较磁石认证医院和卓越之路医院在成人重症监护病房的探视政策与疫情前的开放探视政策。
于2021年1月至3月进行了一项混合方法研究。从96家磁石认证医院和卓越之路医院的网站上提取了疫情前在成人重症监护病房允许无限制探视的探视政策的定量数据。通过对这些医院的9名护士领导进行半结构化访谈收集定性数据。
疫情开始1年多后，所有医院都制定了限制探视政策。这些政策各不相同，几乎没有基于证据的理由。限制措施包括83%的医院（n = 80）每天只允许1名探视者，69%的医院（n = 72家中的50家）对重症监护病房中的COVID-19患者完全禁止探视。在分析护士领导的访谈时发现了五个主题：不欢迎探视者、造成伤害、系统层面的外部决策、有限制的探视以及重症护理工作的变化。
研究结果表明，尽管有大量证据支持探视的益处以及限制探视的危害，也有专家建议恢复医院的安全探视，但磁石认证医院和卓越之路医院在重症监护病房仍继续执行限制探视政策。患者、家属以及护理和医护人员必须合作制定防疫情探视政策。
