Implementation and evaluation of a liberalized visiting policy.

BACKGROUND

Visiting policies have been liberalized in ICUs, but the process and outcome of policy modifications have not been well described.

OBJECTIVES

To describe the process by which nurses in one critical care unit modified visiting from a restricted to a liberalized (i.e., modified open) policy, and to evaluate the nurses' perceptions about visiting before and after the policy was liberalized.

METHODS

A group of ICU/coronary care unit nurses met to discuss changes in their unit's visiting policy. Before the change was initiated, nurses (N = 36) in the unit were informally surveyed regarding their perceptions and attitudes about visiting. After a 3-month trial of liberalized visiting, in which visiting hours were increased at the discretion of the nursing staff, nurses (N = 32) were surveyed using a questionnaire about their beliefs, attitudes, level of satisfaction, and perceptions of their actual visiting policy.

RESULTS

Nurses confirmed that the visiting policy had become liberalized, and they believed that liberalized visiting had positive effects on patients' emotional well-being. Nurses had more positive attitudes about the effects of liberalized visiting on families than on patients and unit function. Most nurses were satisfied with liberalized visiting. However, attitudes differed about how liberalized visiting affected patients' physiological responses or the unit function.

CONCLUSIONS

Effective implementation of liberalized visiting depends on assessment of the following: nurses' beliefs, attitudes, and satisfaction about a change toward a more open visiting policy; staff involvement in determining the policy; and nurse manager and clinical nurse specialist support.