Opening visiting hours in the Intensive Care Unit Harmful or Helpful to the Patient
As the healthcare system starts making that move in the direction of a client-driven model, opening visiting hours are becoming a topic of discussion and interest. Studies that go all the way back to the 1970s has produced argument and conjecture over the perfect visiting practices in the adult intensive care unit. This literature explores the effects of having a policy that is for opening visiting hours and how it has an effect on the patients.
According to various studies, ever since the 1970s, there has been visiting practices in intensive care units (ICU) that goes all the way back to a time where it was not talked about much. Over the last 10 years, there has not been enough research or data that could measure this issue of opening visiting hours being harmful or helpful to the patients. Some experts have been able to puzzle together some evidences that it can be harmful and at the same time there is other research that proves that it can also be helpful as well. In putting together the literature review, most of the examination basically has come from the United States, United Kingdom and with few articles being created in South Africa, France, Germany or even Australia (Clifford, 2006).
According to the research, there are mixed emotions by hospital staff and workers on rather not these opening hours are beneficial or if they are really a big problem that can do more harm in the future instead of good. However, since the issue is growing, it is wise to get an overview of studies to see what directions other experts have been able to discover. The literature review will explore both sides of the issue. (Bunker, 2006).
The Concern of the Visitation Hours
It is important to dive deeper and gets a better understanding on what "visiting" is supposed to mean. Visiting is a general term that has a variety of suggestions in the hospital setting. For the most part of this paper the term will be used a lot. "Restricted" basically means that only so many people are allowed to visit at either a certain part of the day or at a particular time with permission which is normally set by hospital rules. "Open" means people that are family are able to visit anytime throughout the 24-hour day, and this can go on for as long as they desire (Bunker, 2006). Both of these "open" and "closed have cause quite an uproar in the good and bad light. Researchers would say having too much restriction can bring the spirits down on the patient, therefore causing there moods and even in some cases their health to start changing. Nurses have complained that too much interaction with patients because of the "open" policy has caused it to get in the way of their work. What they are saying is that it is impossible for them to do an accurate job with the patients if family members are coming in and out of the room 24/7. Nurse complains that they find it hard to concentrate and also blame that on the declining health of the patient. However, in this essay the word "flexible" will be utilized in order to explain the variety of visiting practices which will go up under the excesses of "open" and "restricted" policy (Biley, 2007).
Is current visiting policy an issue?
Most of the information comes from nurses and patients they that have or are already in a hospital. The research goes into the ICU that occurs in both places such as the private and public hospitals. The same issues that occur in private ICU are the same that go on in the public. Nurses have complained in both settings but much less in the public. It is not much of an issue in the public because a lot of restriction can apply depending on the hospital. The patients seem to be less joyful in the private because the policy is much different. Research shows that these patients in private have less joy because time is cut down on the visitation. Research shows that many of the private hospitals believe that too much family visitation can cause some stress on the patients. Therefore, a lot of these hospitals do not have the 24/7 policy because for health reason. However, for some individuals, who are nurses in and working in some of the private hospital ICU, have been noticing a lot of restrictive practices especially when the family comes to visit them (Bunker, 2006). These comprise of family associates being made to stand and wait for excessive periods of time. Some were even sent out, while other family members were deprived of the chance to help with personal hygiene care (Dracup, 2006). Equally, there have been other times when the attendance of family, for example, a family member crying irrepressibly at the side of the bed, can make the patient mad disturb care, or a huge amount of visitors to the patient, has lessened alongside ideal patient care (Bunker, 2006). Nurses are the ones that have the power to enforce or to be compassionate in regards to visiting limits. The apparent chance of visiting events confuses the family and could make their anxiety worse.
According to Biley (2007) right now in some places, the visiting rule for some hospitals is observed by experts to be restrictive for no reasons. They believe putting the unnecessary restriction for visiting hours, will have an effect on the patients. However, having visitation in the surgical wards is permitted just during time periods of11.00 am to 12.00 noon, 2:00 PM to 4:00 PM, and 7:00 PM to 8:00 PM with no limitations on the amount who could come and visit (Biley, 2007). Some patients still argue that this is not enough time for them. Some hospitals do offer the booklet for the family members that gives them material on the ICU setting, however this does not do them any good because it does not tell them any type of strategies for the visiting hours. (Biley, 2007). In reality, common practice for having visitations in the ICU is supposed to be "open" in that there are no orders to be able to put some restriction on visiting at any time or even how long. This in many hospitals, according to research does bring up a lot of various concerns as day-to-day choices are left to the discretion of the professional nurses that are having to work in this area. Open visiting according to research in some countries is encouraged by doctors and nurses. Studies do show that it does have some effect on the patients (Biley, 2007).
Cultural differences also have to be looked at when visiting policies are done. Although it was challenging for the Maori in New Zealand which lead to cultural safety turning out to be an essential portion of nursing exercise, its values are appropriate to whatever the culture could be. The knowledge is even more significant now with cumulative cultural diversity in patient and populations in New Zealand. Ramsden (Giuliano, 2004) makes the suggestion that cultural safety does happen when individuals are feeling safe to utilize a health service that is delivered by individuals from a different culture that is not their own, devoid of jeopardizing their own culture. She has the belief that has something to do with nurses that have an interaction with and paying attention to their patients, devoid of making judgments when it comes down to their social and cultural backgrounds. It is about patients that are feeling safe regardless of where they come from.
Are visiting practices an Issue?
Visitation that is Restrictive
In history, the set-up of the environment in critical care has been influencing rules that connect to visiting in these places. Hamner (1990) documents that in 1970 the Public Health Service in the United States circulated references that family that is doing the visiting be not be as open to instant family members for times that were short and that a waiting room be made available (Caine, 2005). In 1965, suggestions were being made to take away the restrictions in order to accomadate the patient (Fontaine, 2004). This was sort of normal of a lot of the critical care areas during this era. Usually, visiting practices most of the time were usually presented to allow hospitals to regulate and manage with relatives of the patients', than to advantage patients in expressions of rest and quietness (Milne, 1998). Despite these practices which are being presented in the 1960s, new research makes the point that restrictive visiting practices are still going on in many critical care regions today (Livesay, 2004).
A lot of different writers are showing that restrictive visiting is connected to beliefs that are traditional in place of evidence-based research. Hopping et al. (1992) did a survey with 40 coronary care units (CCU), and likened issues connected…