Literature Review: Open Visitations in ICU
Studies have shown that open ICU visitation is an asset rather than a hindrance with respect to a patient’s wellbeing. Since the 1950s, visiting has changed from a strict nurse-controlled regime to a more flexible patient-centered approach (Taylor, 2008, p. 30). Family inclusion in patient care is evolving into a collaborative model between patient, family and healthcare providers. In response to this collaboration of patient and family-centered care (PFCC), this method has been encouraged in order to achieve the most beneficial outcomes for patients and their families. Open visitation in the ICU should be encouraged, not because of the pressure of growing social awareness, but because it can provide comprehensive responses to the needs of patients and their families. Many studies are being conducted on this subject garnering a great deal of support prompting the implementation of PFCC, which encourages open visitation in ICU.
The following is a brief summary of research studies concerning the current state of knowledge related to the promotion and benefits of open visitation in the ICU.
Literature Sources
The main purpose of conducting a literature review is to obtain the most usable and reliable studies that pertain to the topic of the interest. High reliability and quality of evidence-based studies are provided by filtered sources. For my review I was able to find systematic reviews and individual articles. All of these reviews pertain to the dilemma of open visitation vs. restricted visitation in Intensive Care Units. With multiple views from different perspectives I was able to utilize the comparison and trials approaches. Also, to prepare for this project I was able to utilize unf...
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...ithin the context of patient- and family- centered care.
International Journal of Evidence Based Healthcare, 9: 362-387. doi:10.1111/j.1744-1609.2011.00229.x Clarke, C., Harrison, D. (2001). The needs of children visiting on adult ICU: a review of the literature and recommendations for practice. Journal of Advanced Nursing, 34(1), 61-68.
Giannini, A. (2007). Open intensive care units: the case in favor. Minerva Anestesiologica,
73(5), 299-304.
Hoye, S., Severinsson, E. (2007). Methodological aspects of rigor in qualitative nursing research on families involved in ICU: A literature review. Nursing and Health Sciences, 9, 61-68 doi:10.1111/j.14422018.2007.00300.x Taylor, A. (2008). Exploring patient, visitor and staff views on open visiting. Nursing Times,
104, 30-33.
...the patient’s family more within the assessment after obtaining the patients consent, but my main aim in this case was to concentrate the assessment, solely on the patient, with little information from the family/loved ones. This is a vital skill to remember as patients family/loved ones can often feel unimportant and distant toward nursing staff, and no one knows the patient better than they do, and can tell you vital information. Therefore involvement of family/ carers or loved ones is sometimes crucial to patient’s further treatment and outcomes.
...to communicate with your patient in order for them to be updated with their family’s sickness. And also have compassion towards them. You are likely to see a lot of injuries and scenarios play out among patients that have been admitted to the hospital. There are many achievements in this field that you may accomplish. And priorities that you have to deal with. For instants your time you have to adjust your schedule.
The Patient and Family will always held in the highest regard. Patient and Family Center Care and Relationship-Based Care promote a culture of caring and a ways that identifies and respects the patient 's perspective concerning of what matters the most to them. It is the beneficial partnership that leads to the highest quality of care and the safest outcome (St. Vincent Medical Center, 2012).
Family centred care and comfort care theory both work for the well being of patient. Family centred care focus to work with family while providing care for the sick child. Family and pediatric staff works in collaboration to make care plan that works the best for sick child (Coyne, O'Neill, Murphy, & Costello, 2011). Similarly, comfort care theory focus on child’s physical, psychospiritual, sociocultural, and environmental aspects. “When comfort needs are addressed in one context, total comfort is enhanced in the remaining context” (Kolcaba & Dimarco, 2005, p. 190). When nurses apply comfort care theory, it is to achieve holistic care of sick children by focusing on all aspects (Kolcaba
At the beginning of the day all of the nurses have a meeting to discuss the patients and the patients families. This meeting is a lot like report at the hospital, except they are discussing the patient’s family as somebody that they are there to care for as well. These nurses are available to talk to 24 hours
Two potential barriers to the Patient-Family Centered Care model are time and patient/family expectations. Nursing is a demanding job that is known for it's fast paced and often hectic environment. While caring for several patients at a time, it might be difficult to make time to discuss and involve patients and their family in all aspects of their care. This could lead to the patient/family feeling left out or even lead to fear about why information if being kept from them. To address this barrier I will set aside time to spend with each of my patients solely dedicated to discussion about the care they are receiving as well as provide an opportunity to voice questions and concerns.
Perceptions of Adult Hospitalized Patient on Family Presence During Cardiopulmonary Resuscitation. American Journal of Critical Care, 26(2), 102-110. doi:10.4037/ajcc20175550
Cypress discusses a study on how one ICU unit developed interpersonal relationships between the patient and their loved ones. The Roy Adaptation model was used to provide the best quality care for the patient. The staff encouraged families to talk and assist in care of their loved ones. ICU patients are sometimes unable to speak due to oral intubation and alteration in level of consciousness or neurological changes related to medications and acute critical condition (Cypress, 2011, 4). This often affects communication and relationships with family members and friends. Family members were kept updated on any changes with the patient. The nurses, physicians, therapist and families all worked together for the benefit of the
It is important to preserve the dignity of all patients in the care of nurses and to not make them feel as though they are worthless. For example, when someone is incontinent and cannot care for themselves anymore, such as some residents in long-term care, it is important to help them remain dignified. The resident should be able to feel as though they are respected and are given the appropriate amount of privacy as we are working in their home. With this being said, it is very crucial for nurses to provide residents’ in long-term care, as well as patients in the hospital, with great care while still preserving their dignity and maintaining their privacy. It is important for the client to feel as comfortable as they would if they were in their own home. With this, Registered nurses must appreciate and respect each person in whom they care for. This respect is seen through the nurse as they explain to the patient what they will be doing as they are caring for them, as well as providing care within the wishes of the person. Patients in the hands of the Registered Nurse, appreciate caring as a core value during their stay in the hospital. This is proved as Davis (2005) states, “From a patient perspective, the caring presence that emanates from nurses, positively impacts patients’ hospital experience,” (p.127) As nurses, caring is the absolute root of nursing practice. Preserving patients’ privacy and dignity involves aspects such as closing doors or screens and making sure they are covered while doing so, (Royal College of Nursing, 2015). The Code of Ethics outlines the importance of Registered Nurses supporting the person, family, group, population or community receiving care in maintaining their dignity and integrity, (Canadian Nurses Association, 2008). All these factors involved with the Code of Ethics greatly impact the nursing practice of
The many concepts are very complex and have many dimensions. Concepts developed by Leininger, Watson, Gaut, Benner and Wrubel, Ihde, and many more were discussed and how they relate to ICU nurses and their caring practices. It is stressed in this article that ICU nurses have an important role of making sure they have insight into their specific behaviors so that nursing practices can be developed. Once these nursing practices are developed, ICU nurses can successfully care for their critically ill patients. Wilkin (2003) claims that caring is a, “dual component of attitudes/values and activities, which create an ongoing challenge for the ICU nurses” (p.
Nursing should focus on patient and family centered care, with nurses being the patient advocate for the care the patient receives. Patient and family centered care implies family participation. This type of care involves patients and their families in their health care treatments and decisions. I believe that it is important to incorporate this kind of care at Orange Regional Medical Center (ORMC) because it can ensure that we are meeting the patient’s physical, emotional, and spiritual needs through their hospitalization.
Participant 4 stated, “I think just basically being there for the family as well…I think even just a cup of tea can go a long way with any family (McCallum & McConigley, 2013). Another theory that intertwines with Watson’s is Barbara Dossey’s Theory of Integral Nursing. Dossey articulates, “Healing is not predictable, it is not synonymous with curing but the potential for healing is always present even until one’s last breath,” (Parker and Smith, 2015, p. 212). Dossey believes that integral nursing is a comprehensive way to organize different situations in fours perspectives (nurse, health, person and environment) of reality with the nurse as an instrument in the healing process by bringing his or her whole self into a relationship with another whole self. In the HDU, the RN’s interacted with each patient while providing high quality care to create a healing environment for the patient and family even when their prognosis was otherwise. Patient 3 specified that “We still have to provide care...and make the family feel that they are comfortable and looked after” (McCallum & McConigley, 2013). These theories ultimately show the importance of a nurse through the aspects of caring to create and maintain a healing environment that is not only beneficial to the patient but to their loved ones as
Rushforth, H. (1999). Practitioner review: Communicating with hospitalised children: Review and application of research pertaining to children’s understanding of health an illness. Journal of Child Psychology and Psychiatry, 40(5), 683-91.
This paper is an academic critique of an article written by Lautrette, et al. (2007) titled: “A Communication Strategy and Brochure for Relatives of Patients Dying in the ICU” and accurately reflected the content of the article and the research study itself. The abstract explained the article in more detail, while remaining concise. The type of research study, sample size, variables, intervention, measurement method, findings, and conclusion were all mentioned in the abstract.
In a pre-hospital setting, there are few moments that are as intense as the events that take place when trying to save a life. Family presence during these resuscitation efforts has become an important and controversial issue in health care settings. Family presence during cardiopulmonary resuscitation (CPR) is a relatively new issue in healthcare. Before the advent of modern medicine, family members were often present at the deathbed of their loved ones. A dying person’s last moments were most often controlled by his or her family in the home rather than by medical personnel (Trueman, History of Medicine). Today, families are demanding permission to witness resuscitation events. Members of the emergency medical services are split on this issue, noting benefits but also potentially negative consequences to family presence during resuscitation efforts.