Flexible visiting positively impacted on patients, families and staff in an Australian Intensive Care Unit: A before-after mixed method study

Abstract

Background: The admission of a relative to intensive care is stressful for families. To help them support the patient, families need assurance, information and an ability to be near their sick relative. Flexible visiting enables patient access but the impact of this on patients, families and staff is not clear.

Objective: To assess the impact of flexible visiting from the perspective of patients, families, and Intensive Care Unit (ICU) staff.

Methods: A before-after mixed method study was used with interviews, focus groups and surveys. Patients were interviewed, family members completed the Family Satisfaction in ICU survey and ICU staff completed a survey and participated in focus groups following the introduction of 21h per day visiting in a tertiary ICU. The study was conducted within a philosophy of family-centred care.

Results: All interviewed patients (n=12) positively evaluated the concept of extended visiting hours. Family members' (n=181) overall 'satisfaction with care' did not change; however 85% were 'very satisfied' with increased visiting flexibility. Seventy-six percent of family visits continued to occur within the previous visiting hours (11am-8pm) with the remaining 24% taking place during the newly available visiting hours. Families recognised the priority of patient care with their personal needs being secondary. Three-quarters of ICU staff were 'satisfied' with flexible visiting and suggested any barriers could be overcome by role modelling family inclusion.

Conclusion: Patients, families and ICU staff positively evaluated flexible visiting hours in this ICU. Although only a minority of families took advantage of the increased hours they indicated appreciation for the additional opportunities. Junior staff may benefit from peer-support to develop family inclusion skills. More flexible visiting times can be incorporated into usual ICU practice in a manner that is viewed positively by all stakeholders.

Keywords: Critical care; Family-centred care; Intensive Care; Staff satisfaction; Visiting hours.