Flexible ICU Visiting Policies

Most intensive care units (ICUs) worldwide adopt restrictive visiting policies. However, the evidence about the topic suggests that flexible visiting models are safe and associated with better outcomes among patients and family members. In this chapter, we will discuss the current practices regarding ICU visiting policies around the world and the effects of implementing a flexible visiting policy for family members in adult ICUs.

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References

  1. Vandijck DM, Labeau SO, Geerinckx CE, et al. An evaluation of family-centered care services and organization of visiting policies in Belgian intensive care units: a multicenter survey. Heart Lung. 2010;39(2):137–46. ArticleGoogle Scholar
  2. Ramos FJ, Fumis RR, de Azevedo LC, et al. Intensive care unit visitation policies in Brazil: a multicenter survey. Rev Bras Ter Intensiva. 2014;26:339–46. ArticleGoogle Scholar
  3. Garrouste-Orgeas M, Vinatier I, Tabah A, et al. Reappraisal of visiting policies and procedures of patient's family information in 188 French ICUs: a report of the Outcomerea Research Group. Ann Intensive Care. 2016;6:82. ArticleGoogle Scholar
  4. Giannnini A, Miccinesi G, Leoncino S. Visiting policies in Italian intensive care units: a nationwide survey. Intensive Care Med. 2008;17:1256–62. ArticleGoogle Scholar
  5. Haghbin S, Tayebi Z, Abbasian A, et al. Visiting hour policies in intensive care units, Southern Iran. Iran Red Crescent Med J. 2011;13:684–6. ArticleCASGoogle Scholar
  6. Noordermeer K, Rijpstra TA, Newhall D, et al. Visiting policies in the adult intensive care units in the Netherlands: survey among ICU directors. ISRN Critical Care 2013; article ID 137045. Google Scholar
  7. Escudero D, Martín L, Viña L, et al. Visitation policy, design and comfort in Spanish intensive care units. Rev Calid Asist. 2015;30(5):243–50. ArticleCASGoogle Scholar
  8. Hunter JD, Goddard C, Rothwell M, et al. A survey of intensive care unit visiting policies in the United Kingdom. Anaesthesia. 2010;65:1101–5. ArticleCASGoogle Scholar
  9. Liu V, Read JL, Scruth E, et al. Visitation policies and practices in US ICUs. Crit Care. 2013;17(2):R71. ArticleGoogle Scholar
  10. Kleinpell R, Heyland DK, Lipman J, et al. Patient and family engagement in the ICU: report from the task force of the World Federation of Societies of Intensive and Critical Care Medicine. J Crit Care. 2018;48:251–6. ArticleGoogle Scholar
  11. Berwick DM, Kotagal M. Restricted visiting hours in ICUs: time to change. JAMA. 2004;292:736–7. ArticleCASGoogle Scholar
  12. Giannini A, Garrouste-Orgeas M, Latour JM. What's new in ICU visiting policies: can we continue to keep the doors closed? Intensive Care Med. 2014;40:730–3. ArticleGoogle Scholar
  13. Rosa RG, Falavigna M, da Silva DB, et al. Effect of flexible family visitation on delirium among patients in the intensive care unit: the ICU visits randomized clinical trial. JAMA. 2019;322(3):216–28. ArticleGoogle Scholar
  14. Fumagalli S, Boncinelli L, Lo Nostro A, et al. Reduced cardiocirculatory complications with unrestrictive visiting policy in an intensive care unit: results from a pilot, randomized trial. Circulation. 2006;113:946–52. ArticleGoogle Scholar
  15. Nassar Junior AP, Besen B, Robinson CC, et al. Flexible versus restrictive visiting policies in ICUs: a systematic review and meta-analysis. Crit Care Med. 2018;46:1175–80. ArticleGoogle Scholar
  16. Davidson JE, Aslakson RA, Long AC, et al. Guidelines for Family-Centered Care in the Neonatal, Pediatric, and Adult ICU. Crit Care Med. 2017;45:103–28. ArticleGoogle Scholar
  17. Family visitation in the adult intensive care unit. Crit Care Nurse 2016;36:e15–8. Google Scholar
  18. Rosa RG, Tonietto TF, da Silva DB, et al. Effectiveness and safety of an extended ICU visitation model for delirium prevention: a before and after study. Crit Care Med. 2017;45:1660–7. ArticleGoogle Scholar
  19. Westphal GA, Moerschberger MS, Vollmann DD, et al. Effect of a 24-h extended visiting policy on delirium in critically ill patients. Intensive Care Med. 2018;44:968–70. ArticleGoogle Scholar
  20. Teixeira C, Rosa RG. The rationale of flexible ICU visiting hours for delirium prevention. JECCM. 2018;2:81. Google Scholar
  21. Siddiqi N, Harrison JK, Clegg A, et al. Interventions for preventing delirium in hospitalised non-ICU patients. Cochrane Database Syst Rev. 2016;3:CD005563. PubMedGoogle Scholar
  22. Goldfarb MJ, Bibas L, Bartlett V, et al. Outcomes of patient- and family-centered care interventions in the ICU: a systematic review and meta-analysis. Crit Care Med. 2017;45(10):1751–61. ArticleGoogle Scholar
  23. da Silva Ramos FJ, Fumis RR, Azevedo LC, et al. Perceptions of an open visitation policy by intensive care unit workers. Ann Intensive Care. 2013;3:34. ArticleGoogle Scholar
  24. Garrouste-Orgeas M, Philippart F, Timsit JF, et al. Perceptions of a 24-hour visiting policy in the intensive care unit. Crit Care Med. 2008;36:30–5. ArticleGoogle Scholar
  25. Giannini A, Miccinesi G, Prandi E, et al. Partial liberalization of visiting policies and ICU staff: a before-and-after study. Intensive Care Med. 2013;39:2180–7. ArticleGoogle Scholar
  26. Shirom A, Nirel N, Vinokur AD. Overload, autonomy, and burnout as predictors of physicians’ quality of care. J Occup Health Psychol. 2006;11:328–42. ArticleGoogle Scholar
  27. Reader TW, Cuthbertson BH, Decruyenaere J. Burnout in the ICU. Potential consequences for staff and patient well-being. Intensive Care Med. 2008;34:4–6. ArticleGoogle Scholar
  28. Rosa RG, Falavigna M, Robinson CC, et al. Study protocol to assess the effectiveness and safety of a flexible family visitation model for delirium prevention in adult intensive care units: a cluster-randomised, crossover trial (The ICU Visits Study). BMJ Open. 2018;8:e021193. ArticleGoogle Scholar

Author information

Authors and Affiliations

  1. Intensive Care Unit, Hospital Moinhos de Vento (HMV), Porto Alegre, RS, Brazil Regis Goulart Rosa
  2. Internal Medicine Department, Rehabilitation Department, Intensive Care Unit, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) Medical School, Hospital de Clínicas de Porto Alegre (HCPA), and Hospital Moinhos de Vento (HMV), Porto Alegre, RS, Brazil Cassiano Teixeira
  1. Regis Goulart Rosa