Staff perceptions of family access and visitation policies in Australian and New Zealand intensive care units: The WELCOME-ICU survey.
Family nursing
Healthcare workers
Intensive care
Visiting hours
Visiting policies
Journal
Australian critical care : official journal of the Confederation of Australian Critical Care Nurses
ISSN: 1036-7314
Titre abrégé: Aust Crit Care
Pays: Australia
ID NLM: 9207852
Informations de publication
Date de publication:
07 2022
07 2022
Historique:
received:
10
02
2021
revised:
22
06
2021
accepted:
23
06
2021
pubmed:
31
8
2021
medline:
22
6
2022
entrez:
30
8
2021
Statut:
ppublish
Résumé
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. 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. 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. 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. 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.
Sections du résumé
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.
Identifiants
pubmed: 34456125
pii: S1036-7314(21)00108-9
doi: 10.1016/j.aucc.2021.06.014
pii:
doi:
Types de publication
Journal Article
Langues
eng
Pagination
383-390Investigateurs
Elizabeth Doyle
(E)
Elizabeth Yarad
(E)
Kirsty Masters
(K)
Elaine McGlion
(E)
Kim Bonnici
(K)
Amy Hartley
(A)
Rand Butcher
(R)
Gail Hanger
(G)
Nadia Badawi
(N)
Abby McClintock
(A)
Joanne Hallam
(J)
Chris Waite
(C)
Sheena Tom
(S)
Cath Townsend
(C)
Sunil Sane
(S)
Mandy Stanley
(M)
Neeraj Bhadange
(N)
Judy Smith
(J)
Natalie Soar
(N)
Phillipa Hillard
(P)
Allison Bone
(A)
Sue Cossar
(S)
Jenny Dennett
(J)
Shakira Spiller
(S)
Amanda O'Donnell
(A)
Tor Topping
(T)
Annamaria Palermo
(A)
Kim Lawrence
(K)
Janet Ferrier
(J)
Sandra Colica
(S)
Sharon Waterson
(S)
Emer Slattery
(E)
Lewis Campbell
(L)
Paul Young
(P)
Informations de copyright
Copyright © 2021 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of interest Ms R Bailey has nothing to disclose. Dr. Ramanan has nothing to disclose. Dr. Tabah has nothing to disclose. Dr. Litton has nothing to disclose. Dr. Ssi Yan Kai has nothing to disclose. Pr Coyer has nothing to disclose. Dr Garrouste-Orgeas has nothing to disclose.