open visitation/ 24/7

rockabye · Mar 3, 2011

I hope my hospital will not have open visitation during shift report for these exact reasons. Sometimes if report takes too long and family is at the bedside, we will move to an area out of earshot, but you don't seem to have this option. I don't see how this isn't a HIPPA violation either. :/

umcRN, BSN, RN · Mar 3, 2011

we have open visitation, but we also have private rooms so we are always able to go out of ear shot of the family, and parents are not involved in report. I also think that would be really difficult in situations with family issues, would be hard to pass that on with them sitting right there

SmashleyRN · Mar 3, 2011

We are open visitations anytime (to the parents) except between 7 and 7:30 am/pm. All parents/visitors must leave the unit so we can handover our kids to the next shift.

Love_2_Learn · Mar 3, 2011

This seems like overkill to me too. My wise Mother said, "Everything in moderation except murder and stealing." She is right. Sounds like the pendulum has swung too far in one direction and needs to come back to a more moderate point. Good luck! I can see myself giving report to the oncoming nurse with the parents present and then saying, "Goodbye" and 5 minutes later calling the nurse from my cell phone on my way out to my car to give her/him the details I wanted to share but not share in front of parents. This is really crazy the more I think about it.. Whew!

RainDreamer, BSN, RN · Mar 3, 2011

We tried this in the past and it didn't work too well. We have an old unit with limited space, so the parents can hear everything going on around them. Because of this we ended up going back to how it was before, which is having the unit closed for 20 minutes during each shift change.

Unless there are private rooms or a guaranteed way to keep parents from hearing report, I think it's ridiculous to not just ask them to step out for 20 minutes. Hopefully your 24/7 open unit policy ends up like ours and you switch it back before long lol. Good luck!

NicuGal, MSN, RN · Mar 3, 2011

We have open visitation, actually I believe that a lot of this is coming down from JCHAO in the phrase of "Patients/families reserve the right to be involved in rounds, plans of care, etc" Yadda, yadda.

We went to this a few years back....we have adapted to this and it is how it is . We say what we need to (our computers are at each beside and we have 10 pods with 6 beds in each), and any overhearing by other families is considered incidental overhearing and not in violation of HIPAA (we went to legal about this). If we have anything really bad/super important to say, we will leave the room or go to an empty bedspot and use that computer.

We have a sheet in our admission packet that says that while we allow parents to be at the bedsides 24/7, while the nurses are reporting off, please don't interrupt them and that we need 30 minutes at least to do so. If a family is disruptive we either leave the bedside or ask them to leave. We gave them the chance to be there, but if you can't play by the rules you can't play. We have found that many parents do decide to leave and get something to eat or drink or go pump or make phone calls during report. We always introduce the oncoming nurse adn tell them it is report time. Sure, it isn't perfect, but for the most part it works out.

We asked several times to change back and we were told no, so we gave up lol

walkingrock, ADN · Mar 5, 2011

NICUGal's situation sounds similar to ours. We went to parents visiting 24/7 relatively recently, in the last year I think. We have been instructed to also point out some things in the computer. Somehow, it doesn't seem to be violating HIPPA to those who are making this happen, although it sure seems like it is, at the bedside level. Also, long-term parents frequently seem to specifically be there at change of shift, and we know of instances of them overhearing things. I would REALLY not like to have a parent at the computer with me while I'm giving report :eek: I find it personally wearing to not have that 30 or 60 minute buffer time at change of shifts to try to get everything efficiently completed/charted for the next shift and give them an adequate report AND get off on time, when parents are present at change of shift. Even though they are supposed to be self-sufficient and not ask for things during our report, it still happens...then you have those cares/feedings due @ 15 min before the next shift comes, if the parents do cares/feeding on a slow feeder, I can barely get numbers to chart, let alone chart it.... :rolleyes:

Mags4711, RN · Mar 7, 2011

I work across the state from you, Kalamazoo, and we have open visitation 24/7. We have been that way for at least six years and I still dislike it. Only the parents are allowed to stay in the rooms for the half hour at shift change, though. But anyone can be at the bedside during rounds, which IMHO is *ridiculous*! We have 9 to 13 babies in each room and "try" to give report away from the bedside, but...it is *very* limited space. When I contacted our HIPPA attorneys about this, I was told it's considered "incidental disclosure" which is covered. I disagree, it is not "incidental." we could ask them to step out and voila! It's not an issue. But we do this "Patient and Family Centered care" stuff and it's parents first, parents first, parents first.

I mention the rounds thing because there are occasions when a family member or grandparent may be visiting and hear something or a plan for the baby before mom and dad do. I personally think only parents should be allowed at the bedside during rounds as well.

Later this year we'll be in a new facility and all the rooms will be private, so the HIPPA thing won't be a huge issue. But then they'll be able to room in 24/7...

zoebaily · Apr 19, 2011

"Do you have a paper clip?" Sure! Just let me stop giving report to the oncoming nurse, so I can go find a paperclip for you (visitor). No problem there. People use your brains.