hi...i just found this site yesterday....it looks like a great way to get to know people and find out current opinions about nursing issues....
i am currently working in a busy community hospital in a 12 bed icu....
we have visitation issues....our unit use to allow family in to see patients indiscriminately....then limited visitation fro 11 - 4 am and 8 - 10 pm. family members are getting use to these hours but we still have many problems.....
would like to get other opinions.....
do you think their is a relationship between family presence in the icu and positive outcomes fro confused and ventilated patients?
do you think the length of stay is decreased because of family presence?
are the incidents of injury reduced by family presence?
how often do you use restraints? do you find you need restraints less when family are allowed more visitation?
do you have open visitation?
ths is a hot topic in our unit....many nurses think visitors interfere with patient care....others think they are helpful....but i believe each situation should be looked at individually - not all situations can be treated the same way.
Our unit is hiring a customer service liasion to sit in the waiting room and talk with the families; act a go-between for families and nursing staff. I think it is a wonderful idea and I am sure it will help the day shift nurses since this is when the liasion will be working. What about night shift? Has anyone else heard of this type of position?
We have the same type of position....however it is primarily seen in the ER. There is a representative available at night too. I believe it is a successful effort to manage families that are in distress and becoming unruly...Before that the only answer was to call the supervisor and security.... That is what we have to do in the ICU. The only patient liason there is the nurse. She is the go between between the family and the phyisician...if a problem occurs we still call the supervisor and sometimes security to our ICU.
We have the same type of position....however it is primarily seen in the ER. There is a representative available at night too. I believe it is a successful effort to manage families that are in distress and becoming unruly...Before that the only answer was to call the supervisor and security.... That is what we have to do in the ICU. The only patient liason there is the nurse. She is the go between between the family and the phyisician...if a problem occurs we still call the supervisor and sometimes security to our ICU.
What would you consider to be the best time schedule for visitation.....?
Does your facility allow the families in room during a code?
Our physicians don't....once I had a daughter come back to the room unexpectedly while we were coding her mother.....It was not pretty...and luckily the nursing supervisor was there...she took her to the family room until the code finished......
We have the same type of position....however it is primarily seen in the ER. There is a representative available at night too. I believe it is a successful effort to manage families that are in distress and becoming unruly...Before that the only answer was to call the supervisor and security.... That is what we have to do in the ICU. The only patient liason there is the nurse. She is the go between between the family and the phyisician...if a problem occurs we still call the supervisor and sometimes security to our ICU.
Our O.R. has a nurse who acts as a liason (the position is rotated), it's a fantastic asset. She pokes her head in all the different rooms to see how things are going and then walks down to the family room periodically and updates families on how things are going. It is the surgeon's job to talk to the family after surgery and let them know how things went in detail, especially in cases where a diagnosis is being made. Unfortunately, there is no liason after surgery is done, and the surgeons are often lax about talking to family in a timely manner, so the PACU is often inundated with calls from family members wanting details which only the surgeon can provide.
What would you consider to be the best time schedule for visitation.....?
Does your facility allow the families in room during a code?
Our physicians don't....once I had a daughter come back to the room unexpectedly while we were coding her mother.....It was not pretty...and luckily the nursing supervisor was there...she took her to the family room until the code finished......
Honestly, I don't know the answer to that. I think it is great that family members are being allowed to spend more time with their loved ones while they are in ICU, I don't think it has to be 24/7. Maybe open between 10A-10P or something along those lines. That gives the nursing staff time to work and the patient time to rest. I definitely don't think families need to sleep in the pt's room. Right now we call family members between 6A-7A to update them on how their loved one did during the night and what the plan is for the next shift. We call one person only.
I ask family to leave at the first sign of trouble, would never allow someone to stay during a code however I don't think it is a policy.
I am very hopeful for this liasion position to help stabilize things between nurses and the family. Unfortunately I think we pick up the slack when doctors don't talk to the family...we get the majority of the anger that is really for the doctor. There are certain things nursing can't discuss (test results) and the docs need to step up and help us out too.
I think one of the chief problems is that their is no "ONE" definition of OPEN visitation.... Just the uttering of the phrase can bring nurses to attention...most say they do not want it....but they might actually have a form of open visitation with restrictions.... So what is "CLOSED" visitation?
I like the idea of calling family members in the morning with an update. I think I will implement that in my stanard of care. Thanks for the suggestion.
Linda
Right now we call family members between 6A-7A to update them on how their loved one did during the night and what the plan is for the next shift. We call one person only.
I like the idea of calling family members in the morning with an update. I think I will implement that in my stanard of care. Thanks for the suggestion.
Linda
Friendly advice: Never call anything your standard of care; miss it and you've violated what you say is a standard of care. Plaintiff attorneys love when that happens.
Friendly advice: Never call anything your standard of care; miss it and you've violated what you say is a standard of care. Plaintiff attorneys love when that happens.
We are going to have a 4 week trial of open visitation....
Would love to hear some guidelines from other places...
What kind of restrictions do you recommend....
How are your guidelines received by your families?
We have four - thirty minute visiting hours each day. Almost all of the families respect our schedule.... and there are times when we need to have the families in the rooms to help keep a patient calm.
Some famlies don't understand our visiting schedule.
Not many of our rooms are very large.... we have very very sick patients who often times have prisma, nitric, vent, keane bed, all the iv poles, random machines for cooling/warming, traction at the end of the bed.... so on and so forth.... sometimes there is hardly any room for more than a few people, and when these families don't respect TWO visitors at a time and try to crowd 10 people in the room for visiting hours, it makes it difficult to get to the patient.... I'm not sure if more or longer visiting would cure this problem.....
Visitation time is always a difficult topic, because different ICUs take care of different patients with different needs......
We try to be a good judge of when to bend the rules.... but in general, all of our familes tend to agree that they want us focused on their family member, not them.
We are going to have a 4 week trial of open visitation....
Would love to hear some guidelines from other places...
What kind of restrictions do you recommend....
How are your guidelines received by your families?
:)
-No visiting during shift change...7-8am and 7-8pm
-No more than 2 visitors in the room
-No food in the room
-No children under 13 without an adult
-No sleeping in the rooms
-No cell phones
We are going to start being a little stricter because night shift is getting walked all over. These are the biggest rules we have that are going to be inforced. Not enough in my opinion but it is a start.
In 2003 we allowed visitation every two hours for 30 minutes around the clock...there were many problems and this past year (2004) we switched to 11 am to 4 pm and 8 pm to 10 pm...and that seemed to be working well but AACN is recommending open visitation and our administration is rethinking the visitation policy again...that is why we are doing the trial...in an attempt to see what works best....
Many hospitals define open visitation differently... I haven't seen many places that actually offer 24/7 visitation to families.... and so many nurses are critical of open visitation - it will be interesting to see the results of the study...
-No visiting during shift change...7-8am and 7-8pm
-No more than 2 visitors in the room
-No food in the room
-No children under 13 without an adult
-No sleeping in the rooms
-No cell phones
We are going to start being a little stricter because night shift is getting walked all over. These are the biggest rules we have that are going to be inforced. Not enough in my opinion but it is a start.
......but AACN is recommending open visitation and our administration is rethinking the visitation policy again...that is why we are doing the trial...in an attempt to see what works best....
I keep hearing this also...that AACN is recommending open visitation. Can anyone direct me to a link with this recommendation? I can't seem to find it on the AACN website and would like to read these recommendations myself... In particular, I'm curious as to how they define "open visitation".
bfjworr
66 Posts
We have the same type of position....however it is primarily seen in the ER. There is a representative available at night too. I believe it is a successful effort to manage families that are in distress and becoming unruly...Before that the only answer was to call the supervisor and security.... That is what we have to do in the ICU. The only patient liason there is the nurse. She is the go between between the family and the phyisician...if a problem occurs we still call the supervisor and sometimes security to our ICU.