Visitation during handoff

Specialties NICU

Published

How does everyone's unit handle parent visitation during handoff and change of shift? Are the units closed? If not, how do you handle the HIPPA issues especially in non single patient rooms

We're open 24/7 and encouraged to include parents in report. Makes it a little difficult sometimes, especially if other family members are there and interrupting, but we just have to go with it. We have semi-private pods so it's not a huge deal, and we try to avoid talking about the other babies in hearing range of visitors

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Specializes in NICU.

We close from 0630 to 0700 and 1845 to 1915. We are a 23-bed level III NICU with most bedspaces in an open area. We also sometimes close from 1430 to 1500 if we have more than one nurse change at that time. Our families are pretty understanding about it.

If a family member is kangarooing or nursing at that time, we just move away from that baby's bed space to avoid issues with confidentiality.

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Specializes in NICU.

We close from 05-07 and 17-19. It's a small nursery and gets very crowded.

Unfortunately, there are HIPPA issues if family members stay through report. It's not so much family members hearing about their baby, but there is a lot of interest in everything else that's going on. Of course there are times when we have new admissions with a parent or significant other at the bedside, and they are allowed to stay as they usually want to see what is going on with their baby.

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Specializes in Retired NICU.

NICUGal wrote: "Open. Our legal department deems it "incidental overhearing". Alrighty. Parents and visitors can be at the bedside, but we do have a letter we give them upon admission to please try to not interrupt us so that we don't forget anything important. If there is sensitive info or something the family doesn't know we tell the other nurse away from the bedside. We used to have an hour between shifts but too many families complained so we had to open. Bad ju-ju on the surveys :("

Same here, and do not like it. Invariably, we get interupted by family members while trying to give report, even with pre-report instructions to them. Plus, we (nurses) know that others overhear things they shouldn't. It was so much easier to finish the shift and start the shift with the hour break at shift change. :no:

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Our unit used to be closed and now it's open (for several months) and it was the worst decision ever made.

First, there is no HIPAA violation because of the close proximity of the quarters and that is an exception. Yes, it is uncomfortable to hand off a baby to a nurse and tell them, "Baby has a systemic herpes infection" while ghetto-Mom interrupts and says she never had herpes when a spinal tap reveals otherwise and the list of drugs she tested positive for. You get the picture.

We also have the eavesdroppers, nurse wannabes, etc. We end up getting yelled at by management when we redirect a parent to focus on their baby instead of seeing how much of the report they can hear on another baby.

Personally, open reporting, if I was an administrator, is where I would draw the line. It is causing nothing but problems. Report is a nightmare and we have tried to revamp it every way we know how. Even when we try to talk about sensitive subjects away from the bedside (such as a suspected domestic situation)....parents complain that we are "talking about them behind their back."

You can't win.

Our scores have actually went down since we went to open reporting, yet, they won't change it back.

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Hi! I can relate. We had a system that worked very well, however. Visiting hours were 24/7 EXCEPT 6:30-7:30, for report to both oncoming am and pm shifts. If we had a parent staying because baby was so unstable that death appeared imminent, we pulled the door closed most of the way (we had a few private rooms, 6 on each end, each with the conventional ICU breakaway see through glass with curtain for privacy). Each nurse gave report to the oncoming nurse face to face during that time. Report to the charge nurse was given around 5-6 am/pm, away from any people who happened to be in the unit. Oncoming report was given at the bedside, but if a parent was present was present, details that would cause distress/argument were communicated away from that room. It worked very well.

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Specializes in Newborn ICU, Trauma ICU, Burn ICU, Peds.

We are all private rooms (Level IIIc) and visitors are allowed at all times. We have now also moved to bedside report (standing in the patient room, parents and visitors present!) to allow parents to feel more a part of the process, and to force double checking of pumps/drips.

Our legal eagles also call it "incidental disclosures."

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Specializes in Nurse Scientist-Research.

Our newest manager wants our unit "family friendly" and parents are allowed to stay during report. We're still getting used to it. It's possible to be discreet. I've been known to write things down or bring up a social work note (where most of the drama is!) on the computer and point at it.

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We have two open step-down areas with 8 and 13 beds and 6 pods with 3-4 beds each. We are closed 7a-8a, 3p-4p, and 7p-8:30p (sterile line changes). Sometimes we are lenient and let families stay over a bit or through it if there's no staff changing in that pod.

I am SO grateful we have closed hours. I agree with the others that we all know situations that other families shouldn't be privy to "overhear" and frankly because I believe a nurse should know what she's getting into with an assignment (like a "needy" parent). And I hate to say it, but sometimes you need that hour of "downtime" to sit down and read over the kardex/history and collect fluids, etc until they come back in. Maybe that's just the attitude in our unit?

I can definitely see us moving toward open hours if enough parents speak up about it. Our unit is very engaged in patient satisfaction surveys now.

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