Bailey, Rachel L

Ramanan, Mahesh

Litton, Edward

Yan Kai, Nathalie Ssi

Coyer, Fiona M

Garrouste-Orgeas, Maite

Tabah, Alexis

2021-08-26

BACKGROUND: Family-centred critical care recognises the impact of a loved one's critical illness on his relatives. Open visiting is a strategy to improve family satisfaction and psychological outcomes by permitting unrestricted or less restricted access to visit their family member in the intensive care unit (ICU). However, increased family presence may result in increased workload and a risk of burnout for ICU staff. OBJECTIVES: The objective of this study was to evaluate ICU staff perceptions regarding visiting hours and family access in Australian and New Zealand ICUs. Secondary outcomes included an evaluation of current visiting policies, witnessed events in ICUs, and barriers to implementing open visiting policies. DESIGN: A web-based survey open to all healthcare workers in Australia and New Zealand ICUs was distributed through local, state-based, and national critical care networks. Open visiting was defined as ICUs open for visiting >14 h per day. MAIN RESULTS: We received 1255 valid responses. Most respondents were nurses (n = 930, 74.1%) with a median critical care experience of 10 y. Most worked in open visiting ICUs (n = 749, 59.7%). Reported visiting hours varied greatly with a median of 20 h per day (interquartile range: 10-24 h). Open visiting was perceived as beneficial for the relatives, but less so for patients and staff (relatives: n = 845, 67.3%, patients: n = 561, 44.7%, staff: n = 257, 20.5%, p < 0.0001). Respondents from closed visiting units and nurses identified more risks from open visiting than other professional groups. Generally, staff preferred not to change from their current practice. CONCLUSION: We report that staff perceived open visiting as beneficial for relatives, but also identified risks to themselves, including increased workload, a risk of burnout, and a risk of occupational violence. Reluctance to change highlights the importance of addressing staff perceptions when implementing an open visiting policy.

Intensive Care Outreach, Caboolture Hospital, Caboolture, QLD, Australia. Electronic address: Rachel.Bailey@health.qld.gov.au.

Intensive Care Units, Caboolture and Prince Charles Hospitals, Queensland, Australia; School of Medicine, University of Queensland, Australia; The George Institute for Global Health, Sydney, Australia; University of New South Wales, Sydney, Australia. Electronic address: Mahesh.Ramanan@health.qld.gov.au.

Intensive Care Unit, Fiona Stanley Hospital, Perth, WA, Australia; School of Medicine, University of Western Australia, Perth, WA, Australia. Electronic address: ed_litton@hotmail.com.

Queensland University of Technology, Kelvin Grove, Queensland, Australia. Electronic address: tanleesyk@gmail.com.

Joint Appointment Intensive Care Services, Royal Brisbane and Women's Hospital and School of Nursing, Queensland University of Technology, Herston, Queensland, Australia. Electronic address: f.coyer@qut.edu.au.

IAME, INSERM, Université de Paris, F-75018, Paris, France; Palliative Care Unit, Reuilly Diaconesses Fondation, Rueil Malmaison. Medical Unit, French British Hospital, Levallois-Perret, France. Electronic address: maite.garrouste@ihfb.org.

Intensive Care Unit, Redcliffe Hospital, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia. Electronic address: Alexis@tabah.org.

Copyright © 2021 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

Aust Crit Care. 2021 Aug 26:S1036-7314(21)00108-9. doi: 10.1016/j.aucc.2021.06.014.

https://pubmed.ncbi.nlm.nih.gov/34456125/?otool=iaurydwlib

https://hdl.handle.net/10137/11848

Staff perceptions of family access and visitation policies in Australian and New Zealand intensive care units: The WELCOME-ICU survey.

Journal Article

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