Perceptions of a 24-hour visiting policy in the intensive care unit.
OBJECTIVE
To examine perceptions by intensive care unit (ICU) workers of unrestricted visitation, to measure visiting times, and to determine prevalence of symptoms of anxiety and depression in family members.


METHODS
Observational, prospective, single-center cohort.


METHODS
Medical-surgical ICU in a 460-bed tertiary-care hospital.


METHODS
Two hundred nine consecutive patients hospitalized >3 days were studied over the first 5 ICU days.


METHODS
None.


RESULTS
Characteristics of patients (n = 209), families (n = 149), and ICU workers (n = 43) were collected. ICU workers reported their perceptions of unrestricted visitation, and family members completed the Hospital Anxiety and Depression Scale. Daily severity scores (Simplified Acute Physiology Score II and Logistic Organ Failure) and a workload score (Nine Equivalents of Nursing Manpower) were computed. Maximum median visit length was 120 mins per patient per day and occurred on days 4 and 5. No correlations were found among severity of illness, workload, and visit length. For 115 patients, both nurse and physician questionnaires were available; although several differences were noted, neither nurses nor physicians perceived open visitation as disrupting patient care. The median rating for delay in organizing care was "never" for physicians and "occasionally" for nurses. Nurses perceived more disorganization of care than physicians (p = .008). Compared with nurses, the physicians reported greater family trust (p = .0023), more family stress (p = .047), and greater unease when examining the patient (p = .02). The Hospital Anxiety and Depression Scale indicated symptoms of anxiety in 73 (49%) family members and depression in 44 (29.5%).


CONCLUSIONS
The 24-hr visitation policy was perceived favorably by families. It induced only moderate discomfort among ICU workers, due to the potential for care interruption, in particular for nurses.
Garrouste-Orgeas
Maité
M
Medical Surgical Intensive Care Unit, Saint Joseph Hospital Network, Paris, France. mgarrouste@hpsj.fr
Philippart
François
F
Timsit
Jean François
JF
Diaw
Frédérique
F
Willems
Vincent
V
Tabah
Alexis
A
Bretteville
Ghylaine
G
Verdavainne
Aude
A
Misset
Benoit
B
Carlet
Jean
J
D000368:Aged; D001007:Anxiety / Q000453:epidemiology; D001291:Attitude of Health Personnel; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology; D005190:Family / Q000523:psychology; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D016134:Organizational Policy; D010297:Paris / Q000453:epidemiology; D015995:Prevalence; D011368:Professional-Family Relations; D011446:Prospective Studies; D013997:Time Factors; D014789:Visitors to Patients / Q000523:psychology / Q000706:statistics & numerical data*