Doors to patient rooms: open or closed?

[ktliz]

This might seem like a silly question, but I was just wondering whether it is the norm on your unit to leave the doors to patients' rooms open or closed?

All my hospital experiences have been with 2 facilities. At the hospital where I volunteered, all rooms are private, and most patients kept their door fully closed. At my local hospital, most rooms are shared, and doors seem to be left open.

Do you have a specific policy on your unit for whether doors are to be left open or closed? Do you leave it up to the patient? Or do you keep doors open as a convenience or safety measure?

-Katee, pre-nursing student

[7student7]

I've thought about this an abnormal amount - I think my job makes me paranoid, lol. I have to do 15 min checks at night and we have really loud, old doors. I close all of the doors but don't latch them since the hallway lights don't go out at night. I don't want to wake them up with the lights or the sound of the door latch. Some rooms have weird doors that like to swing open and slam into the wall though, so I'll leave those wide open unless they complain. Sometimes I'll purposely keep a door latched if I want to hear if a specific person gets up. I'm just sneaky like that. That trick works with the bathroom door too if you have the good fortune of working at a hospital as old and creaky as mine. :)

[pers]

I go by patient preference, can be tricky in double rooms when one wants the door open and the other prefers it closed though! Our only policy on door position is for isolation patients (door closed) and suicide precautions (door open). Of course, common sense applies as well! I won't close the door if I have someone in restraints or a confused patient even if that's their preference unless someone will be in the room with them.

[coolpeach]

All our rooms are private, and we close the doors unless the patient asks for us to leave it open. We also knock before entering. If the patient is confused, really sick etc then we leave the door cracked or fully open.

[casi, ASN, RN]

I prefer patients keep their doors open, much easier to see and hear what is going on in a room. However I tend to leave it up to patient preference unless they are confused, then the door has to stay at least cracked so I can hear the bed alarm/tabs alarm going off.

[linearthinker, DNP, RN]

I close them if the pt is dead and the family is in there with the body or something.... otherwise, generally leave them open. We have all privates, but our walls and doors (sliding) are all clear glass anyway, so we usually leave them open.

[blondy2061h, MSN, RN]

Our policy is that doors must remain closed.

[creativemom, BSN, RN]

It totally depends on the situation. If it's during the day we leave the doors open as MD's, PA's, RN's etc go in and out to provide care, consultation, etc all through the day. Then you have kitchen coming in for 3 meals. Transport coming in to take pt's to testing, etc. Visitors coming in and out.

Well you get the idea. It's more of a hassle to keep doors closed during the day.

At night it's a different story. We have a policy for keeping things quiet from 9:30 ish to about 6 am or a bit later. We start opening doors when the docs start doing rounds.

If a pt wants the door open then we keep it open however most want it closed so they don't hear us taking at the nurses station and disrupting their sleep. Also the lights just outside the doors (even when we dim them at night) glare off the floor and if the doors are not closed it lights up the room a bit.

My own reason to keep the doors closed is that I can hear if they open and then go peak to see who went in. We've had a few visitors come in that were intruders. Luckily each time I've called the police and they've been escorted out.

Another reason I might keep a door open during the day is if I want to keep tabs on a pt at night. Perhaps they are a fall risk, or they may need a sitter but don't yet fall into the category requiring one. Or it might be a pt that is receiving blood and I want to monitor the pumps and pt.

It all depends. You have to consider the time/date/pt situation, etc to decide.

[Caffeine_IV]

I ask them if they are A&Ox3.

Confused/fall risk patients..the door is left open unless a trusted family member is in the room even then I prefer it to be cracked.

[Belle Epoque]

Is it safe to have the door closed? I randomly walked by and noticed a patient (not mine) who was choking on his food, if it wasn't for quick intervention he would have been dead. Had the door been closed he would only have been found too late. Doors should remain open unless there's a really good reason they need it closed.

[NurseKatie08, MSN]

Open, about 99% of the time. All of the rooms on my assignment are semi-private. My patients are nearly all frail elderly, high fall risk or confused (or some combination of the three) There have been instances when I have allowed doors closed, for A&Ox3 patients with no roommate, or two A&Ox3 patients in the same room. Other than that, the only times I'll close a door are if I'm doing a procedure and don't want any old Tom, Dick or Harry walking in, or for post-mortem care/family visiting the body.

[coolpeach]

"Is it safe to have the door closed? I randomly walked by and noticed a patient (not mine) who was choking on his food, if it wasn't for quick intervention he would have been dead. Had the door been closed he would only have been found too late. Doors should remain open unless there's a really good reason they need it closed"

I thought the same thing as a new nurse, but the hospital treats the patient as a guest and this means they have a right to privacy. We use nursing judgment of course. If the patient is really ill or confused I would leave the door open. All of our patients had ortho surgery, all pretty much are on PCA's or some other Narc so all are a fall risk, and a good % are elderly, but we close the door, and knock before entering unless they request otherwise.

[RNperdiem, RN]

My ICU is an open door unit. How else are you going to hear the vent alarms?