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Erschienen in: Intensive Care Medicine 7/2008

01.07.2008 | Original

Visiting policies in Italian intensive care units: a nationwide survey

verfasst von: Alberto Giannini, Guido Miccinesi, Stefania Leoncino

Erschienen in: Intensive Care Medicine | Ausgabe 7/2008

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Abstract

Objective

To investigate visiting policies in Italian intensive care units.

Design and setting

Descriptive survey: a questionnaire was sent to all 303 units of the Italian Group for the Evaluation of Interventions in Intensive Care Medicine.

Results

Response rate was 85% (257/303). All ICUs except one had restricted visiting-hour policies. In five ICUs (2%) visits were not allowed. Median daily visiting time was 60 min (range 15 min–18 h); 55% of ICUs had one daily visiting slot. There were restrictions on number (92% of units) and type (17%) of visitors, and on child visits (69%). Policies were not modified for child patients in 9% of ICUs, nor for a dying patient in 21%. No waiting room was provided by 25% of ICUs. Gowning procedures were compulsory for visitors in 95% of units. In 35% of ICUs visitors were not required to wash their hands. A formal process for revision of visiting policies was underway in 33% of ICUs. In 66% of ICUs informative material on the unit was provided to the family on patient admission. Phone information on the patient was given relatively frequently (often/always, 34% of ICUs). Regional area and volume of admissions significantly influenced visiting hours. A visiting period longer than 60 min/day was significantly associated with more “open” attitudes towards visitors.

Conclusions

Italian ICUs have very restrictive visiting policies, which are only partially liberalized when the patient is dying or is a child. However, one-third of ICUs are rethinking their policies. This survey may contribute towards the liberalization of visiting policies in Italy's ICUs.
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Literatur
2.
Zurück zum Zitat Berwick DM, Kotagal M (2004) Restricted visiting hours in ICUs: time to change. JAMA 292:736–737PubMedCrossRef Berwick DM, Kotagal M (2004) Restricted visiting hours in ICUs: time to change. JAMA 292:736–737PubMedCrossRef
3.
Zurück zum Zitat Nelson JE, Meier DE, Oei EJ, Nierman DM, Senzel RS, Manfredi PL, Davis SM, Morrison RS (2001) Self-reported symptom experience of critically ill cancer patients receiving intensive care. Crit Care Med 29:277–282PubMedCrossRef Nelson JE, Meier DE, Oei EJ, Nierman DM, Senzel RS, Manfredi PL, Davis SM, Morrison RS (2001) Self-reported symptom experience of critically ill cancer patients receiving intensive care. Crit Care Med 29:277–282PubMedCrossRef
4.
Zurück zum Zitat Biancofiore G, Bindi ML, Romanelli AM, Urbani L, Mosca F, Filipponi F (2005) Stress-inducing factors in ICUs: what liver transplant recipients experience and what caregivers perceive. Liver Transpl 11:967–972PubMedCrossRef Biancofiore G, Bindi ML, Romanelli AM, Urbani L, Mosca F, Filipponi F (2005) Stress-inducing factors in ICUs: what liver transplant recipients experience and what caregivers perceive. Liver Transpl 11:967–972PubMedCrossRef
5.
Zurück zum Zitat Molter NC (1979) Needs of relatives of critically ill patients: a descriptive study. Heart Lung 8:332–339PubMed Molter NC (1979) Needs of relatives of critically ill patients: a descriptive study. Heart Lung 8:332–339PubMed
6.
Zurück zum Zitat Leske JS (1986) Needs of relatives of critically ill patients: a follow-up. Heart Lung 15:189–193PubMed Leske JS (1986) Needs of relatives of critically ill patients: a follow-up. Heart Lung 15:189–193PubMed
7.
Zurück zum Zitat Mendonca D, Warren NA (1998) Perceived and unmet needs of critical care family members. Crit Care Nurs Q 21:58–67PubMed Mendonca D, Warren NA (1998) Perceived and unmet needs of critical care family members. Crit Care Nurs Q 21:58–67PubMed
8.
Zurück zum Zitat Bijttebier P, Vanoost S, Delva D, Ferdinande P, Frans E (2001) Needs of relatives of critical care patients: perceptions of relatives, physicians and nurses. Intensive Care Med 27:160–165PubMedCrossRef Bijttebier P, Vanoost S, Delva D, Ferdinande P, Frans E (2001) Needs of relatives of critical care patients: perceptions of relatives, physicians and nurses. Intensive Care Med 27:160–165PubMedCrossRef
9.
Zurück zum Zitat Davidson JE, Powers K, Hedayat KM, Tieszen M, Kon AA, Shepard E, Spuhler V, Todres ID, Levy M, Barr J, Ghandi R, Hirsch G, Armstrong D, American College of Critical Care Medicine Task Force 2004–2005, Society of Critical Care Medicine (2007) Clinical practice guidelines for support of the family in the patient-centered intensive care unit: American College of Critical Care Medicine Task Force 2004–2005. Crit Care Med 35:605–622PubMedCrossRef Davidson JE, Powers K, Hedayat KM, Tieszen M, Kon AA, Shepard E, Spuhler V, Todres ID, Levy M, Barr J, Ghandi R, Hirsch G, Armstrong D, American College of Critical Care Medicine Task Force 2004–2005, Society of Critical Care Medicine (2007) Clinical practice guidelines for support of the family in the patient-centered intensive care unit: American College of Critical Care Medicine Task Force 2004–2005. Crit Care Med 35:605–622PubMedCrossRef
10.
Zurück zum Zitat Fumagalli S, Boncinelli L, Lo Nostro A, Valoti P, Baldereschi G, Di Bari M, Ungar A, Baldasseroni S, Geppetti P, Masotti G, Pini R, Marchionni N (2006) Reduced cardiocirculatory complications with unrestrictive visiting policy in an intensive care unit: results from a pilot, randomized trial. Circulation 113:946–952PubMedCrossRef Fumagalli S, Boncinelli L, Lo Nostro A, Valoti P, Baldereschi G, Di Bari M, Ungar A, Baldasseroni S, Geppetti P, Masotti G, Pini R, Marchionni N (2006) Reduced cardiocirculatory complications with unrestrictive visiting policy in an intensive care unit: results from a pilot, randomized trial. Circulation 113:946–952PubMedCrossRef
11.
Zurück zum Zitat Simon SK, Phillips K, Badalamenti S, Ohlert J, Krumberger J (1997) Current practices regarding visitation policies in critical care units. Am J Crit Care 6:210–217PubMed Simon SK, Phillips K, Badalamenti S, Ohlert J, Krumberger J (1997) Current practices regarding visitation policies in critical care units. Am J Crit Care 6:210–217PubMed
12.
Zurück zum Zitat Roland P, Russell J, Culpepper Richards C, Cox Sullivan S (2001) Visitation in critical care: processes and outcomes of a performance improvement initiative. J Nurs Care Qual 15:18–26PubMed Roland P, Russell J, Culpepper Richards C, Cox Sullivan S (2001) Visitation in critical care: processes and outcomes of a performance improvement initiative. J Nurs Care Qual 15:18–26PubMed
13.
Zurück zum Zitat Youngner SJ, Coulton C, Welton R, Juknialis B, Jackson DL (1984) ICU visiting policies. Crit Care Med 12:606–608PubMedCrossRef Youngner SJ, Coulton C, Welton R, Juknialis B, Jackson DL (1984) ICU visiting policies. Crit Care Med 12:606–608PubMedCrossRef
14.
Zurück zum Zitat Biley FC, Millar BJ, Wilson AM (1993) Issues in intensive care visiting. Intensive Crit Care Nurs 9:75–81PubMedCrossRef Biley FC, Millar BJ, Wilson AM (1993) Issues in intensive care visiting. Intensive Crit Care Nurs 9:75–81PubMedCrossRef
15.
Zurück zum Zitat Plowright CI (1996) Revisiting visiting in intensive therapy units. Intensive Crit Care Nurs 12:231–238PubMedCrossRef Plowright CI (1996) Revisiting visiting in intensive therapy units. Intensive Crit Care Nurs 12:231–238PubMedCrossRef
16.
Zurück zum Zitat Quinio P, Savry C, Deghelt A, Guilloux M, Catineau J, de Tinteniac A (2002) A multicenter survey of visiting policies in French intensive care units. Intensive Care Med 28:1389–1394PubMedCrossRef Quinio P, Savry C, Deghelt A, Guilloux M, Catineau J, de Tinteniac A (2002) A multicenter survey of visiting policies in French intensive care units. Intensive Care Med 28:1389–1394PubMedCrossRef
17.
Zurück zum Zitat Knutsson SE, Otterberg CL, Bergbom IL (2004) Visits of children to patients being cared for in adult ICUs: policies, guidelines and recommendations. Intensive Crit Care Nurs 20:264–274PubMedCrossRef Knutsson SE, Otterberg CL, Bergbom IL (2004) Visits of children to patients being cared for in adult ICUs: policies, guidelines and recommendations. Intensive Crit Care Nurs 20:264–274PubMedCrossRef
18.
Zurück zum Zitat Lautrette A, Darmon M, Megarbane B, Joly LM, Chevret S, Adrie C, Barnoud D, Bleichner G, Bruel C, Choukroun G, Curtis JR, Fieux F, Galliot R, Garrouste-Orgeas M, Georges H, Goldgran-Toledano D, Jourdain M, Loubert G, Reignier J, Saidi F, Souweine B, Vincent F, Barnes NK, Pochard F, Schlemmer B, Azoulay E (2007) A communication strategy and brochure for relatives of patients dying in the ICU. N Engl J Med 356:469–478PubMedCrossRef Lautrette A, Darmon M, Megarbane B, Joly LM, Chevret S, Adrie C, Barnoud D, Bleichner G, Bruel C, Choukroun G, Curtis JR, Fieux F, Galliot R, Garrouste-Orgeas M, Georges H, Goldgran-Toledano D, Jourdain M, Loubert G, Reignier J, Saidi F, Souweine B, Vincent F, Barnes NK, Pochard F, Schlemmer B, Azoulay E (2007) A communication strategy and brochure for relatives of patients dying in the ICU. N Engl J Med 356:469–478PubMedCrossRef
19.
Zurück zum Zitat Lee MD, Friedenberg AS, Mukpo DH, Conray K, Palmisciano A, Levy MM (2007) Visiting hours policies in New England intensive care units: strategies for improvement. Crit Care Med 35:497–501PubMedCrossRef Lee MD, Friedenberg AS, Mukpo DH, Conray K, Palmisciano A, Levy MM (2007) Visiting hours policies in New England intensive care units: strategies for improvement. Crit Care Med 35:497–501PubMedCrossRef
20.
Zurück zum Zitat Berti D, Ferdinande P, Moons P (2007) Beliefs and attitudes of intensive care nurses toward visits and open visiting policy. Intensive Care Med 33:1060–1065PubMedCrossRef Berti D, Ferdinande P, Moons P (2007) Beliefs and attitudes of intensive care nurses toward visits and open visiting policy. Intensive Care Med 33:1060–1065PubMedCrossRef
21.
Zurück zum Zitat Bertolini G, Rossi C, Anghileri A, Livigni S, Addis A, Poole D (2007) Use of Drotrecogin alfa (activated) in Italian intensive care units: the results of a nationwide survey. Intensive Care Med 33:426–434PubMedCrossRef Bertolini G, Rossi C, Anghileri A, Livigni S, Addis A, Poole D (2007) Use of Drotrecogin alfa (activated) in Italian intensive care units: the results of a nationwide survey. Intensive Care Med 33:426–434PubMedCrossRef
22.
Zurück zum Zitat Beccaro M, Costantini M, Giorgi Rossi P, Miccinesi G, Grimaldi M, Bruzzi P; ISDOC Study Group (2006) Actual and preferred place of death of cancer patients. Results from the Italian survey of the dying of cancer (ISDOC). J Epidemiol Community Health 60:412–416PubMedCrossRef Beccaro M, Costantini M, Giorgi Rossi P, Miccinesi G, Grimaldi M, Bruzzi P; ISDOC Study Group (2006) Actual and preferred place of death of cancer patients. Results from the Italian survey of the dying of cancer (ISDOC). J Epidemiol Community Health 60:412–416PubMedCrossRef
23.
Zurück zum Zitat Azoulay E, Pochard F, Chevret S, Jourdain M, Bornstain C, Wernet A, Cattaneo I, Annane D, Brun F, Bollaert PE, Zahar JR, Goldgran-Toledano D, Adrie C, Joly LM, Tayoro J, Desmettre T, Pigne E, Parrot A, Sanchez O, Poisson C, Le Gall JR, Schlemmer B, Lemaire F (2002) Impact of a family information leaflet on effectiveness of information provided to family members of intensive care unit patients: a multicenter, prospective, randomized, controlled trial. Am J Respir Crit Care Med 165:438–442PubMed Azoulay E, Pochard F, Chevret S, Jourdain M, Bornstain C, Wernet A, Cattaneo I, Annane D, Brun F, Bollaert PE, Zahar JR, Goldgran-Toledano D, Adrie C, Joly LM, Tayoro J, Desmettre T, Pigne E, Parrot A, Sanchez O, Poisson C, Le Gall JR, Schlemmer B, Lemaire F (2002) Impact of a family information leaflet on effectiveness of information provided to family members of intensive care unit patients: a multicenter, prospective, randomized, controlled trial. Am J Respir Crit Care Med 165:438–442PubMed
24.
Zurück zum Zitat Cuttini M, Rebagliato M, Bortoli P, Hansen G, de Leeuw R, Lenoir S, Persson J, Reid M, Schroell M, de Vonderweid U, Kaminski M, Lenard H, Orzalesi M, Saracci R (1999) Parental visiting, communication, and participation in ethical decisions: a comparison of neonatal unit policies in Europe. Arch Dis Child Fetal Neonatal Ed 81:F84–F91PubMedCrossRef Cuttini M, Rebagliato M, Bortoli P, Hansen G, de Leeuw R, Lenoir S, Persson J, Reid M, Schroell M, de Vonderweid U, Kaminski M, Lenard H, Orzalesi M, Saracci R (1999) Parental visiting, communication, and participation in ethical decisions: a comparison of neonatal unit policies in Europe. Arch Dis Child Fetal Neonatal Ed 81:F84–F91PubMedCrossRef
25.
Zurück zum Zitat Meyer EC, Kennally KF, Zika-Beres E, Cashore WJ, Oh W (1996) Attitudes about sibling visitation in the neonatal intensive care unit. Arch Pediatr Adolesc Med 150:1021–1026PubMed Meyer EC, Kennally KF, Zika-Beres E, Cashore WJ, Oh W (1996) Attitudes about sibling visitation in the neonatal intensive care unit. Arch Pediatr Adolesc Med 150:1021–1026PubMed
26.
Zurück zum Zitat Plowright C (2006) Just who actually benefits from restricted visiting hours is not clear. Nurs Times 102:12PubMed Plowright C (2006) Just who actually benefits from restricted visiting hours is not clear. Nurs Times 102:12PubMed
28.
Zurück zum Zitat Jones C, Skirrow P, Griffiths RD, Humphris G, Ingleby S, Eddleston J, Waldmann C, Gager M (2004) Post-traumatic stress disorder-related symptoms in relatives of patients following intensive care. Intensive Care Med 30:456–460PubMedCrossRef Jones C, Skirrow P, Griffiths RD, Humphris G, Ingleby S, Eddleston J, Waldmann C, Gager M (2004) Post-traumatic stress disorder-related symptoms in relatives of patients following intensive care. Intensive Care Med 30:456–460PubMedCrossRef
29.
Zurück zum Zitat Azoulay E, Pochard F, Kentish-Barnes N, Chevret S, Aboab J, Adrie C, Annane D, Bleichner G, Bollaert PE, Darmon M, Fassier T, Galliot R, Garrouste-Orgeas M, Goulenok C, Goldgran-Toledano D, Hayon J, Jourdain M, Kaidomar M, Laplace C, Larche J, Liotier J, Papazian L, Poisson C, Reignier J, Saidi F, Schlemmer B; FAMIREA Study Group (2005) Risk of post-traumatic stress symptoms in family members of intensive care unit patients. Am J Respir Crit Care Med 171:987–994PubMedCrossRef Azoulay E, Pochard F, Kentish-Barnes N, Chevret S, Aboab J, Adrie C, Annane D, Bleichner G, Bollaert PE, Darmon M, Fassier T, Galliot R, Garrouste-Orgeas M, Goulenok C, Goldgran-Toledano D, Hayon J, Jourdain M, Kaidomar M, Laplace C, Larche J, Liotier J, Papazian L, Poisson C, Reignier J, Saidi F, Schlemmer B; FAMIREA Study Group (2005) Risk of post-traumatic stress symptoms in family members of intensive care unit patients. Am J Respir Crit Care Med 171:987–994PubMedCrossRef
30.
Zurück zum Zitat Slota M, Shearn D, Potersnak K, Haas L (2003) Perspectives on family-centered, flexible visitation in the intensive care unit setting. Crit Care Med 31(Suppl 5):S362–S366PubMedCrossRef Slota M, Shearn D, Potersnak K, Haas L (2003) Perspectives on family-centered, flexible visitation in the intensive care unit setting. Crit Care Med 31(Suppl 5):S362–S366PubMedCrossRef
32.
Zurück zum Zitat Rogers S (2004) Why can't I visit? The ethics of visitation restrictions—lessons learned from SARS. Crit Care 8:300–302PubMedCrossRef Rogers S (2004) Why can't I visit? The ethics of visitation restrictions—lessons learned from SARS. Crit Care 8:300–302PubMedCrossRef
33.
Zurück zum Zitat Guzzanti E (1998) L'autorizzazione e l'accreditamento nelle realtà delle strutture ospedaliere e delle tecnologie sanitarie in Italia: considerazioni e proposte. Ricerca per i Servizi Sanitari 2:3–24 Guzzanti E (1998) L'autorizzazione e l'accreditamento nelle realtà delle strutture ospedaliere e delle tecnologie sanitarie in Italia: considerazioni e proposte. Ricerca per i Servizi Sanitari 2:3–24
34.
Zurück zum Zitat Guidelines/Practice Parameters Committee of the American College of Critical Care Medicine, Society of Critical Care Medicine (1995) Guidelines for intensive care unit design. Crit Care Med 23:582–588CrossRef Guidelines/Practice Parameters Committee of the American College of Critical Care Medicine, Society of Critical Care Medicine (1995) Guidelines for intensive care unit design. Crit Care Med 23:582–588CrossRef
35.
Zurück zum Zitat Ferdinande P (1997) Recommendations on minimal requirements for intensive care departments. Members of the Task Force of the European Society of Intensive Care Medicine. Intensive Care Med 23:226–232PubMedCrossRef Ferdinande P (1997) Recommendations on minimal requirements for intensive care departments. Members of the Task Force of the European Society of Intensive Care Medicine. Intensive Care Med 23:226–232PubMedCrossRef
36.
Zurück zum Zitat McClenathan BM, Torrington KG, Uyehara CFT (2002) Family member presence during cardiopulmonary resuscitation: a survey of US and international critical care professionals. Chest 122:2204–2211PubMedCrossRef McClenathan BM, Torrington KG, Uyehara CFT (2002) Family member presence during cardiopulmonary resuscitation: a survey of US and international critical care professionals. Chest 122:2204–2211PubMedCrossRef
37.
Zurück zum Zitat Edward AE, McGann KA (2002) Steps to reduce nosocomial infections in children. Infect Med 19:414–424 Edward AE, McGann KA (2002) Steps to reduce nosocomial infections in children. Infect Med 19:414–424
38.
Zurück zum Zitat Levine C, Zuckerman C (1999) The trouble with families: toward an ethic of accommodation. Ann Intern Med 130:148–152PubMed Levine C, Zuckerman C (1999) The trouble with families: toward an ethic of accommodation. Ann Intern Med 130:148–152PubMed
Metadaten
Titel
Visiting policies in Italian intensive care units: a nationwide survey
verfasst von
Alberto Giannini
Guido Miccinesi
Stefania Leoncino
Publikationsdatum
01.07.2008
Verlag
Springer-Verlag
Erschienen in
Intensive Care Medicine / Ausgabe 7/2008
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-008-1037-4

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