You are leading a work group

charge with revising the ICU

visitation. The majority of staff
skeptical.

What are some

objections you
might encounter
and how you would
address them?

Group Members:
Nur Syafiqah bt Kamaruzaman
Aniza bt Saim
Ku Nur Faezah binti ku zainal
Nur Shahida Johari
Siti rosidah binti Idris
Irwina mustika bt Md Mustapha

Revising ICU Visitation??

When a patient is critically ill, the family
members are often in crises, dealing with the
lots of emotions associated with the threat of
a serious illness and trying to make sense of
a foreign and sometimes frightening intensive
care
unit (ICU)
environment
.
Hennesy,
D. (2005)
says that:
The family is an integral part of healing
process of the critically ill patient and
critical care nursing interventions must also
focus on family. Family-centered care is the
concept of treating the patient and family
as an inseparable entity, recognizing that
illness and injury of one family members

Objections that might arise

towards the visitation changes:
Interruption of nursing care delivery.
Affects the function of unit by creating
chaotic events.
Increase risk of infection
Increase stress among healthcare members
and family
Interrupt patients rest

Interruption of nursing care delivery.

Berti, D., Ferdinande, P., Moons, P. (2007)
said that:
The majority of the ICU nurses believed that
open visiting policies interfered with the
nursing care process, namely by hampering
adequate nursing care planning, by
interfering with direct nursing care, by
making the nurses spend more time in
providing information to the family, and by
being of no help to support caregivers.

Affects the function of unit by creating

chaotic events.

Kirchhoff et al (1993) says that Open

visiting policies were believed by some
nurses to contribute to increased chaos and
noise in the unit and leave the nurses less
time to take care of patients.

Livesay, S (2005) says

that:
The conservative attitudes toward the
number of persons visiting a patient
may be attributed to environmental and
practical aspects, such as limited space
in the patients room, guaranteeing the
privacy of other patients, limiting the
noise on the unit, the number of
patients per nurse, and other various
factors.

Increase risk of infection

Brown, A. (1976) stated that

Family members were an added
risk because of the possibility of
infecting patients, of interrupting
rest and of causing physiological
changes such as tachycardia,
arrhythmia, hypertension, anxiety,
etc.
Berwick,
D. (2004) mentioned that
Open visitation will expose the
vulnerable patient to an increase
risk of infection.

Kirchhoff, K. T., (1993) studied

that almost half of the nurses they
surveyed still believed that harmful
physiological harm would occur to
their patients when visitors were at
the bedside.

Increase stress among healthcare

members and family
Berwick, D., Kotagal, M. (2004) claimed
that Reasons nurses cited for opposition
to
liberal
visitation
included
the
presumed increase psychological stress
for the patients, family interference with
the provision of care, and physical and
mental exhaustion of family and friends.

How to overcome the skeptical staff

regarding the visitation issues?
Briefly explain to the staff on the
importance and the benefits of family
presence.
Encourage and educate staff to participate
family members to achieve optimal patient
care synergy model.

Briefly explain to the staff on the importance

and the benefits of family presence.
Benefits of family presence are:
Removed doubt about the patient condition
Witness that everything possible was done
Decrease their anxiety and fear about what
was happening to their loved one.
Sense of closure and grieving should death
American
occur association of Critical- Care Nurses. Family
presence: Visitation in the adult ICU.(2010)

Halm, M. (2005) mentioned in his research

that:
Allowing family members to observe
invasive procedures and resuscitation
efforts promote increase knowledge of the
patients condition. In additional
observation allow the family to witness that
everything was done, reduce fear and
anxiety, and promotes adaptation.

Moseley, M. J., Jones, A.(1991) says

that Flexible visiting allows for
family members to plan more
convenient visits and provides family
members time to take care of
themselves and renew their energy.

Hickey, M. (1988) says that,

When a loved one is critically ill, the
family members are often in crisis,
dealing with the roller coaster of
emotions associated with the threat of
a serious illness and trying to make
sense of a foreign and sometimes
frightening intensive care unit (ICU)
environment.

Stillwell. (1984) has mentioned in his

article
that
Family
members
permitted to see their loved ones
frequently might be an effective
coping mechanism at a time when
fears over threatening changes in
family roles and responsibilities are a
major concern.

Encourage staff to participate family

members to achieve optimal patient care
synergy model.

Gonzalez, C. et al. (2004) says that

Visitors provide information that
helps nurses to better understand the
patients personality and coping
style.

impson T. (1992) highlighted that:

Visitation fostered a link between the
patient and the outside environment. It
also facilitated cognitive processing of
concerns related to the patient's health,
provided physical assistance or verbal
encouragement, and fostered positive
relationships between visitors and
patients.

Moseley, M., Jones, A. (1991)

stated
that
Although
family
members ask questions and seek
information, they also provide the
patient with emotional support and
may
actually
facilitate
communication between patient
and staff.

Tughan L. (1992) found that family

members can provide sensory
organization and stabilization to
the
sensory-overloaded,
sleepdeprived patient since they provide
familiar voices and touch to help
patient in recovery process.

Clowry, M. (1992) stated that:

Less restrictive, open and flexible
policies would facilitate the reduction
of stress and frustration felt by
patients and families and serve to
improve relationships and information
sharing with the caregivers.

Conclusion
As the conclusion, nurses should change
their lame beliefs on the change of the
visitation policies. They should think
holistically especially towards things that
might
beneficial
to
their
patients
improvement. In additional, changes in
nurses perception towards the stated
matter in significant as nurses is the
primary domain in ensuring patients will
deliver the optimum patient care synergy
model.

Livesay, S., Gilliam, A., Mokracek, M.,

Sebastian,
S.,
(2005)
successful
adoption and implementation of open
visiting policies depends on nurses
beliefs and attitudes about and
satisfaction with visitation and visiting
policies, it is important to explore
nurses views on visitation.

Reference List

Brown A. (1976). Effect of family visits on the

blood pressure and heart rate of patients in the
coronary care unit. Heart Lung; 5: 291296.
Berwick DM, Kotagal BA (2004) Restricted visiting
hours in ICUs. Time to change. 292:736737
Clowry, M. (1992). Family functioning during a
critical illness: A systems theory perspective. Critical
Nursing Clinics of North America, 4. 559

Gonzalez, C., (2004) Visiting preferences of patients

in the intensive care unit and in a complex care medical
unit. Am J Crit Care 13:194198
Halm, M. Family presence during resuscitation: A
critical Review of the literature. American Journal of
Critical Care(2005); 14 (6): 494-512
Hennessy D. Outcomes of elderly survivirs of
intensive care: a review of literature. Chest.
(2005);127(5): 1764-1774
Hickey, M. (1988) Critical Care nurses role with
families: a descriptive study. Heart Lung 17:670676
Livesay, S. (2005) Nurses perceptions of open
visiting hours in neuroscience intensive care unit. J Nurs
Care Qual 20:182189

Simpson, T. Visitors' verbal behavior with coronary care

unit patients. West J Nurs Res. 1992;14:482-497.
Stillwell, S. (1994) Importance of visitation needs as
perceived by family members of patients in the intensive
care unit. Heart Lung 13:238242
Titler, M.G. (1995). Impact of adult critical care
hospitalization: Perceptions of patients, spouses,
children,and nurses.Heart & Lung,20 (2), 174182.
Tughan L. (1992). Visiting in the PICU: a study of the
perceptions of patients, parents, and staff members.
Critical Care Nursing Quaterly; 15: 5768.
Kirchhoff, K.T., Hansen CB, Evans P, Fullmer N. (1985).
Open visiting in the ICU: a debate. Dimensions of Critical
Care Nursing; 4:296306.

THANK YOU

ANY QUESTIONS
FROM THE
FLOOR?