Perceptions of a 24-hour visiting policy in the intensive care unit

被引:111
作者
Garrouste-Orgeas, Maite [1 ]
Philippart, Francois
Timsit, Jean Francois
Diaw, Frederique
Willems, Vincent
Tabah, Alexis
Bretteville, Ghylaine
Verdavainne, Aude
Misset, Benoit
Carlet, Jean
机构
[1] St Joseph Hosp Network, Med Surg Intens Care Unit, Paris, France
[2] Albert Michallon Univ Hosp, Med Intens Care Unit, Albert Bonniot Inst, Res Unit, Grenoble, France
关键词
visitation; intensive care unit; critical care; family-centered care; family relations;
D O I
10.1097/01.CCM.0000295310.29099.F8
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objective: To examine perceptions by intensive care unit (ICU) workers of unrestricted visitation, to measure visiting times, and to determine prevalence of symptoms of anxiety and depression in family members. Design. Observational, prospective, single-center cohort. Setting. Medical-surgical ICU in a 460-bed tertiary-care hospital. Patients. Two hundred nine consecutive patients hospitalized >3 days were studied over the first 5 ICU days. Interventions; None. Measurements and Main Results. Characteristics of patients (n = 209), families (n = 149), and ICU workers (n = 43) were collected. ICU workers reported their perceptions of unrestricted visitation, and family members completed the Hospital Anxiety and Depression Scale. Daily severity scores (Simplified Acute Physiology Score 11 and Logistic Organ Failure) and a workload score (Mine Equivalents of Nursing Manpower) were computed. Maximum median visit length was 120 mins per patient per day and occurred on days 4 and 5. No correlations were found among severity of illness, workload, and visit length. For 115 patients, both nurse and physician questionnaires were available; although several differences were noted, neither nurses nor physicians perceived open visitation as disrupting patient care, The median rating for delay in organizing care was "never" for physicians and "occasionally" for nurses. Nurses perceived more disorganization of care than physicians (p = .008). Compared with nurses, the physicians reported greater family trust (p = .0023), more family stress (p = .047), and greater unease when examining the patient (p = .02). The Hospital Anxiety and Depression Scale indicated symptoms of anxiety in 73 (49%) family members and depression in 44 (29.5%). Conclusions. The 24-hr visitation policy was perceived favorably by families. It induced only moderate discomfort among ICU workers, due to the potential for care interruption, in particular for nurses.
引用
收藏
页码:30 / 35
页数:6
相关论文
共 43 条
[1]   Risk of post-traumatic stress symptoms in family members of intensive care unit patients [J].
Azoulay, E ;
Pochard, F ;
Kentish-Barnes, N ;
Chevret, S ;
Aboab, J ;
Adrie, C ;
Annane, D ;
Bleichner, G ;
Bollaert, PE ;
Darmon, M ;
Fassier, T ;
Galliot, R ;
Garrouste-Orgeas, M ;
Goulenok, C ;
Goldgran-Toledano, D ;
Hayon, J ;
Jourdain, M ;
Kaidomar, M ;
Laplace, C ;
Larché, J ;
Liotier, J ;
Papazian, L ;
Poisson, C ;
Reignier, J ;
Saidi, F ;
Schlemmer, B .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2005, 171 (09) :987-994
[2]   Meeting the needs of intensive care unit patients' family members: Beyond satisfaction [J].
Azoulay, E .
CRITICAL CARE MEDICINE, 2002, 30 (09) :2171-2171
[3]   Meeting the needs of intensive care unit patient families - A multicenter study [J].
Azoulay, E ;
Pochard, F ;
Chevret, S ;
Lemaire, F ;
Mokhtari, M ;
Le Gall, JR ;
Dhainaut, JF ;
Schlemmer, B .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2001, 163 (01) :135-139
[4]   Impact of a family information leaflet on effectiveness of information provided to family members of intensive care unit patients - A multicenter, prospective, randomized, controlled trial [J].
Azoulay, E ;
Pochard, F ;
Chevret, S ;
Jourdain, M ;
Bornstain, C ;
Wernet, A ;
Cattaneo, I ;
Annane, D ;
Brun, F ;
Bollaert, PE ;
Zahar, JR ;
Goldgran-Toledano, D ;
Adrie, C ;
Joly, LM ;
Tayoro, J ;
Desmettre, T ;
Pigne, E ;
Parrot, A ;
Sanchez, O ;
Poisson, C ;
Le Gall, JR ;
Schlemmer, B ;
Lemaire, F .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2002, 165 (04) :438-442
[5]   Family participation in care to the critically ill:: opinions of families and staff [J].
Azoulay, É ;
Pochard, F ;
Chevret, S ;
Arich, C ;
Brivet, F ;
Brun, F ;
Charles, PE ;
Desmettre, T ;
Dubois, D ;
Galliot, R ;
Garrouste-Orgeas, M ;
Goldgran-Toledano, D ;
Herbecq, P ;
Joly, LM ;
Jourdain, M ;
Kaidomar, M ;
Lepape, A ;
Letellier, N ;
Marie, O ;
Page, B ;
Parrot, A ;
Rodie-Talbere, PA ;
Sermet, A ;
Tenaillon, A ;
Thuong, M ;
Tulasne, P ;
Le Gall, JR ;
Schlemmer, B .
INTENSIVE CARE MEDICINE, 2003, 29 (09) :1498-1504
[6]   Family-physician interactions in the intensive care unit [J].
Azoulay, E ;
Sprung, CL .
CRITICAL CARE MEDICINE, 2004, 32 (11) :2323-2328
[7]   Restricted visiting hours in ICUs - Time to change [J].
Berwick, DM ;
Kotagal, M .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2004, 292 (06) :736-737
[8]   The validity of the Hospital Anxiety and Depression Scale - An updated literature review [J].
Bjelland, I ;
Dahl, AA ;
Haug, TT ;
Neckelmann, D .
JOURNAL OF PSYCHOSOMATIC RESEARCH, 2002, 52 (02) :69-77
[9]  
Brilli RJ, 2004, JAMA-J AM MED ASSOC, V292, P2721, DOI 10.1001/jama.292.22.2721-a
[10]  
Carlet J, 2003, UPD INT CAR, V39, P297