Satisfaction With Elimination of all Visitation Restrictions in a Mixed-Profile Intensive Care Unit

Chapman, Diane K.; Collingridge, Dave S.; Mitchell, Lorie A.; Wright, Elizabeth S.; Hopkins, Ramona O.; Butler, Jorie M.; Brown, Samuel M.

doi:10.4037/ajcc2016789

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Families in Critical Care| January 01 2016

Satisfaction With Elimination of all Visitation Restrictions in a Mixed-Profile Intensive Care Unit

Diane K. Chapman, DNP, APRN, CCRN, FNP-C;

Diane K. Chapman, DNP, APRN, CCRN, FNP-C

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.

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Dave S. Collingridge, PhD;

Dave S. Collingridge, PhD

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.

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Lorie A. Mitchell, RN, MSN;

Lorie A. Mitchell, RN, MSN

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.

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Elizabeth S. Wright, RN, MSN;

Elizabeth S. Wright, RN, MSN

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.

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Ramona O. Hopkins, PhD;

Ramona O. Hopkins, PhD

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.

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Jorie M. Butler, PhD;

Jorie M. Butler, PhD

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.

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Samuel M. Brown, MD, MS

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.

Corresponding author: Samuel M. Brown, md, Shock Trauma Intensive Care Unit, Intermountain Medical Center, 5121 South Cottonwood Street, Murray, UT 84107 (e-mail: samuel.brown@imail.org).

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Am J Crit Care (2016) 25 (1): 46–50.

https://doi.org/10.4037/ajcc2016789

Background

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.

Objectives

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.

Methods

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.

Results

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.

Conclusions

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.

2016

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