Overnight visitation in psych hospital??

[NurseMT504]

I am a mental health nurse in Louisiana on an acute inpatient mental health unit. Our managers have told us of a "new law" that states we cannot deny family the right to stay overnight (or outside of visiting hours) with their family members. Does anyone have any information about this law. It seems extremely unsafe for the patients, staff members, etc. These family members are not subjected to any type of search. Very concerned. Any information/advice would be helpful! Thanks.

[NRSKarenRN, BSN, RN]

CMS Regulations: 42 CFR 482.13(h),

https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R75SOMA.pdf

482.13(h) Standard: Patient visitation rights. A hospital must have written policies and procedures regarding the visitation rights of patients, including those setting forth any clinically necessary or reasonable restriction or limitation that the hospital may need to place on such rights and the reasons for the clinical restriction or limitation….

Interpretive Guidelines, 482.13(h)...

Hospitals are required to develop and implement written policies and procedures that address the patient’s right to have visitors. If the hospital’s policy establishes restrictions or limitations on visitation, such restrictions/limitations must be clinically necessary or reasonable. Furthermore, the hospital’s policy must include the reasons for any restrictions/limitations. The right of a patient to have visitors may be limited or restricted when visitation would interfere with the care of the patient and/or the care of other patients. The regulation permits hospitals some flexibility, so that health care professionals may exercise their best clinical judgment when determining when visitation is, and is not, appropriate. Best clinical judgment takes into account all aspects of patient health and safety, including the benefits of visitation on a patient’s care as well as potential negative impacts that visitors may have on other patients in the hospital....

Written patient or support persons notice of visitation required. See examples provided in article.

[tyvin, BSN, RN]

Basically what it's saying is that the faciltiy better have a good written P&P regarding visitation for all and all staff need to know what that policy is. What I get from scanning it is that they are really trying to make sure every patient has an POA and every facility has a detailed P&P on visistation. It isn't saying that people get to spend the night, your facility has to write policy and be ready to defend why it's bad/not acceptable for the business to allow visitors coming in at all times of the day and night.

There are plenty of reasons to limit hours...safety issues, staff numbers, etc... Especially in a psych setting where the environment...milieu is crucial to patient outcome. In a psych setting a schedule is the key to the units success.

[amoLucia]

Don't be surprised of a sudden increase of 'long lost' and 'extended' family members who start appearing for these visits and

looking for 'hots and cots'. As other posts point out, there needs to be very explicit visiting P&P with beefed up security.

I know I sound cynical but I didn't go to school to be a front desk concierge or a bouncer. And I'm no good to anybody if my safety is compromised. PS---Get a copy of that 'new law'. Reasonable exceptions to visiting hours (think therapeutic) are already permitted.

[GitanoRN, BSN, MSN, RN]

please don't anyone misunderstand me when i say this could be a good thing and a bad thing at the same time, for the nurses trying to deliver a high caliber of care while multiple interruptions come into play by the families at all times, not to mentioned all of the extra hats that you will be required to wear besides nursing, i shall keep you in my prayers....aloha~

[amygarside]

This is quite common in other countries, but can sound daunting and scary for nurses here. If that law is ever implemented, I think it would be best for managers and subordinates to create better or stricter visitation rules for visitors who want to stay in the hospital overnight.

[GitanoRN, BSN, MSN, RN]

furthermore, i neglected to say on my previous post that i was one of many responsible for declining this new rule when it came to light at the facility where i work. therefore, i took it upon myself to collect over 10 thousand signatures opposing to this so called costumer service rule. unquestionably, i'm all for pleasing our patients and making them feel more comfortable during their time of need, however, compromising their high caliber of nursing care is not part of my goal.