title: Perceptions of a 24-hour visiting policy in the intensive care unit.
abstract: 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.
authors: Medical Surgical Intensive Care Unit, Saint Joseph Hospital Network, Paris, France. mgarrouste@hpsj.fr
authors: Maité
authors: M
authors: Garrouste-Orgeas
authors: François
authors: F
authors: Philippart
authors: Jean François
authors: JF
authors: Timsit
authors: Frédérique
authors: F
authors: Diaw
authors: Vincent
authors: V
authors: Willems
authors: Alexis
authors: A
authors: Tabah
authors: Ghylaine
authors: G
authors: Bretteville
authors: Aude
authors: A
authors: Verdavainne
authors: Benoit
authors: B
authors: Misset
authors: Jean
authors: J
authors: Carlet
mesh_terms: 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*