[Missy CCRN]

I work in a ICU/PICU. We are working on new visitation policy. We are also going to lock the unit and allow visitors only after they call and are buzzed in. We are not limiting visting hours, just controling the visitors because we have to maintain the safety of our pediatric patients that are close to the entrance of the unit. I was wondering about other locked units and how they are working for you.
Please let me know what is working or not working for you.

[Dixielee]

I work in a locked ER and it is strictly enforced. You can not push open the doors. All doors in and out of the ER are controlled by a card you have with you at all times, your namebadge. All patients and visitors are allowed in only with a nurse escort and the only exit is by the discharge window, and it is locked from the outside. It works great. All visitors wear a badge that says ER visitor and we strictly enforce 1 visitor per patient, except of course in exceptional situations,

[RN4NICU]

Our NICU is locked - there is literally no entrance without the electronic keypad entry. There is one entry for visitors. They call in from the hall and identify who they are and who they are there to see. We buzz them in - unless the baby is having a procedure or we are admitting to the next bed, or something like that, or - of course - if it is not within visiting hours. We do close the unit for 3 hours at each shift change to allow for nurses report and walking rounds with the docs, as well as AM labs to get drawn, other procedures done, etc. Otherwise we would have nosy parents there listening to report on every baby in the unit and others pitching a fit because their baby's heel was getting stuck, etc.

Our lockdown system is very efficient and effective. The only problems we have are with parents and visitors that hang around the unit entrances and try to see the nurses punch in the door code!! I mean, why on earth??? If you have any business at all being in the unit, call in during visiting hours and we will let you in. If you go letting yourself in (like no one will notice? ) - we will call security and you may get your butt banned from the premises. If you don't belong in the unit to start with, we will call the real cops and have you arrested. Whenever this would happen and we would find out that someone knew the code, we would just change it. Did they really expect otherwise?? Duh!

Ah, visitors.

[BittyBabyGrower]

Our unit is a locked unit also. We use our badges to swipe in and out. Parents/visitors are only admitted after they buzz and receive a badge identifying which room they are going to and if they are a parent or visitor. Our peds floors are locked also. If we find someone without a badge, they are asked to leave.

The only problem we have is when we don't have a secretary up front..you can't hear the buzzer and we have to put the phone out so they can call the conference room...and hope someone who is running past answers it and can get to the desk to check them in.

[mayberry]

I work on a busy intermediate care unit and more often than not I wish we had a locked policy. Realisically, this type of policy will NEVER happen in the health system I work. Sounds like it works for the above posts and I wish you continued luck.

[Ruby Vee]

Like any other system, a locked ward works only as well as the staff works it. If you follow the rules, it works great. If not, not.

The locked unit I worked on didn't work really well. Visitors would hang out outside the door, and if you buzzed in one person, everyone out there followed them in. And then they were allowed to stay. Because there were no consequences (being asked to leave) they just continued to do it. And if you were the one nurse that tried to follow the rules as outlined, you were the one the families complained about. In this age of "customer service," that's the kiss of death. I've seen more than one nurse "counseled" for not making families feel welcome. Never happened to me, but I've seen a lot of good nurses get a lot of **** over this.

[sharann]

I'm all for controlling visitors access. This is a safety measure not a control issue. I think that we do need to be flexible with visitation (I work in a semi-locked unit and have had people sneak in the back door...invading all the other patients privacy!)

[RN4NICU]

We have a large sign outside the unit that instructs visitors not to let other people in. Everyone (each pair of visitors - since only 2 allowed per bedside) is to call in individually. The visitor entrance leads into the scrub area where the visitors must wash hands and put on a gown. Whoever buzzed them in is right there and if other people sneak in - they are sent back outside RIGHT THEN. We usually take all involved aside at some point and emphasize that for security reasons, we must know the identity of every person in the unit. Since it is the safety of their own babies at stake, for the most part, they are usually careful to comply after that.

[mattsmom81]

I love locked critical care areas when they are used properly...never felt so safe, and was able to provide the best care for my patients unhindered by constant flow of visitors and their demands..

[wam79]

I work in acute Psych so I am used to locked wards. I don't know why more areas are not locked for safety. My hospital has the pediatric and neonatal areas locked but the ER, ICU and other areas that should have limited access open. It is a military hospital which has some increased security,but controling the flow of visitors seems to be so important for the safety of all in critical care areas.