Are you or a loved one facing the prospect of being admitted to an intensive care unit (ICU)? If so, you may be concerned about being cut off from your family and loved ones during your stay because of the rigid visitation policies employed in most ICUs. A clinical trial explores the possibility of using a flexible visitation system for critically-ill ICU admitted patients.
In recent years there has been an increased understanding of the pathophysiology of critically ill patients and many advances have been made in this field, however, a visitation system is one area that needs to be solved on an urgent basis.
Although completely closed management can prevent and reduce the occurrence of nosocomial infection and is conducive to treating critically ill patients, it cannot meet the psychological needs of patients and their families and even increases the psychological burden of patients and their families.
A good visiting system can increase the sense of trust and identity between nurses and patients, play a positive role in settling disputes and contradictions, and significantly promote overall healthcare delivery. There have been some clinical studies on the efficacy of implementing flexible visitation systems in ICUs but their results need further validation.
Clinical TrialFortunately, a clinical trial published in the journal Science Progress has found that a flexible visitation system may help in achieving better clinical outcomes in ICU-admitted patients.
The trial involved 280 critically ill patients who were admitted to an ICU. Half of the patients were assigned to a flexible visitation group, while the other half received standard care. In the standard care group visits were allowed each day for a specified time while in the flexible visitation group, in addition to the daily visit time, an appointment system was adopted. When patients or their family members had special requirements, they were allowed to visit after the patient's evaluation by doctors and nurses in charge of the patient's care.
The primary outcome was whether delirium occurred, and the secondary outcomes were (1) whether a nosocomial infection occurred; (2) whether complaints occurred; (3) the satisfaction questionnaire; (4) ICU length of stay; and (5) length of hospital stay.
The results of the trial were striking. Patients in the flexible visitation group had a significantly lower incidence of delirium, a common complication of ICU stays. Delirium occurred in 5.7% of the patients in the intervention group compared to 17.1% of the patients in the control group. Five complaints were received during the trial, with one in the experimental group and the others in the control group. There were 28 cases of nosocomial infection in the experimental group and 29 cases in the control group; therefore, the incidence of nosocomial infection was 20% versus 20.7%. The satisfaction of patients in the experimental group and the control group was 98.6% and 92.1%. Additionally, the flexible visitation group also had a reduced length of ICU stay.
These results indicate that a flexible visitation system may be beneficial for reducing delirium and improving the overall clinical outcomes in ICU-admitted patients.
The trial has important implications for ICU practice. Traditionally, ICU patients have been restricted to limited visiting hours, with the rationale being that too much stimulation from visitors could be harmful. However, this study suggests that a flexible visitation policy may be beneficial for patients.
ConclusionThis clinical trial provides compelling evidence in favor of a flexible visitation policy for critically ill patients in the ICU. While implementing such a policy may require some adjustments in hospital practice, the potential benefits for patients are substantial. If you or a loved one are facing an ICU stay, it may be worth discussing the possibility of a flexible visitation policy with your healthcare provider.
Sage Journals, Mar-27-23