Essay on Visiting Hours in ICU: Limitations on Family Care and Life-Critical Decisions

Introduction

Most hospitals in the United States and across the globe have a policy in visiting hours of patients in the ICU. This policy often limits the patients' family as well as other visitors from taking care of the patient, making them feel left out in their patient's care. Not to mention the intensive care unit always involves making some of the life-critical decisions that should be made by the family but sometimes when the family members cannot be reached the staff in the ICU makes these decisions. Most patients and visiting families are not comfortable with the Intensive Care Unit visiting policy. Therefore, reviewing this policy is essential in the healthcare sector.

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Some of these decisions made by the doctors may sometimes turn out not to be the patient's wish hence bringing negative impacts on the patient's recovery. Even though most healthcare providers believe that limitation of the visiting hours facilitates a faster patient recovery, sometimes it may, on the contrary, worsen the situation and slow the recovery. Presently no visitor is permitted for an overnight stay in the patient's room and daytime visiting hours limited to eight to ten minutes.

Methods

A questionnaire used is designed for handling the people's attitudes toward visitations in the intensive care unit and distributed them to a sample of intensive care nurses, recovered patients, family members of the patients, and doctors. The questionnaire sought to know their attitude towards various aspects of visiting patients in the ICU and the consequences. Interviews with a total of four families having patients in intensive care revealed that most of them felt so restricted by the visitation policy. Some of them complained that some critical decisions were made concerning their patients without consulting them. Also, a survey carried out by Spreen and Schuurmans in 2011 showed that an open visiting policy could bring a positive impact on the patients' recovery and as well help the family to cope with the condition.

Giving participants questionnaires was accompanied, informing the participants of the problem statement associated with the study. The participants signed consent forms. According to the research by Rosa et al. (2018), the safety of flexible visitation in ICU has not been stipulated hence proving there are no notifications provided concerning family members being allowed into ICU. The randomized crossover trial that involved family members ICU patients and ICU professionals showed that the safety measures align with restrictive family visitation in ICU. Restriction of visitation prevents delirium among ICU patients and aspects that are argued to enhance wellness and quick recovery.

My current healthcare restricts visitation according to daytime and nighttime visits. The argument in support of the restriction is based on prevention of delirium among ICU patients as well as the assurance of patient safety precautions from health conditions that can be caused by uncontrolled visitation in the ICU rooms. The staff in the ICU department and emergency rooms supported the need to uplift limitations so long as directives are structured out with regards to the number of hours that the visitors should spend with the patient in the ICU department. Most patients argue that they feel left out whenever their people are restricted from visiting them usually. Some of the issues that the patient race in the interviews is the fact that the nurse makes some decisions without consulting them whenever their family members are not present.

Analysis

Family presence is very crucial for patients in ICU; however, many hospitals have put strict rules to regulate ICU visits. In as much as doctors and caregivers argue that limited access is essential to control infections and to give patients enough time to rest, family time with ICU patients is very crucial.

A respondent, probably one of the recovered patients mentioned that a decision regarding blood transfusion was made without their consent and any family members view it about their values and spiritual perspective concerning blood transfusion. In that manner, most patients outlined that their stay in ICU without members of the family being present is a threat to their health and religious or cultural values concerning nursing care and medication. The aspect is also communicated by Clowes Candadai et al. (2019) research on rapid clinical sequencing in ICU patients and the impacts of post-transfusion when a patient is in critical need of blood transfusion. It is an aspect that is involving lack of consent from either the patient or their close family members with regards to transfusion of blood or blood plasma to save a situation that might arise when significant members of their family are not present.

The most common restriction is that there is limited time for ICU patients to spend with their families. Family participation helps to improve outcome by reducing psychological stress. Most hospitals allow visits either in the afternoon or late morning. In contrast, many people in America work for so many hours and may not be available to visit their loved ones during the prescribed time. Economically disadvantaged families tend to suffer more from the restrictions keeping them away from their loved ones. Less economic families do not afford caregivers and have to work long hours, making it hard for them to visit their patients in ICU (McKenna,2019). Racial disparities also exist in health systems in the US, and the racial bias makes it harder for people of different races to access the same services in terms of ICU visits.

Proposed Solution

The solution for the issue of limited visitation policies is a review of these policies to enable non-limiting family visitations. There should be an open visiting hour policy for patients in ICU putting in place mechanisms to control the spread of infectious disease, abusive family members, and to ensure the patients get enough sleep. A recommendation of a 24- hour free visitation unless for cases where the patient needs special care. Nurses should be trained continuously to identify the best strategy to determine the best time for visiting patients in the ICU to ensure safety concerns by the medical providers (Vinatier et al., 2016). The nurses should also be made aware of the benefits visiting families have on the patients and the nurses as well informed of how the patient's geographical space and privacy contribute to the patient's wellbeing.

Research showed that the involvement of the patient's family and friends in his care helps them gain experience in taking care of the patient, makes it easier to manage certain illnesses hence limiting patient readmissions, and this also saves on the costs. Studies have also proven that when a patient is separated from the people, he loves at his most vulnerable times, they risk having emotional problems (Liu et al., 2013). It would also be beneficial if the expert's stakeholders regarding patient family care come up with specific guidelines to change the existing visiting policies. Sources in the implementation would include the department of health and human services.

Justification of the Proposed Solution

Responses from nurse leaders and other clinical officers outline the relevance of maintaining cleanliness as an aspect that can prevent any further infections to the patients in ICU. Perhaps, a total of two responses communicated about an infection that can be attributed by either the seasonal flu or a pandemic flu-like covid-19 being transferred to a patient in ICU due to improper management of their cleanliness before assessing or visiting the patients in the ICU department. It was also mentioned that some viral infections had been reported to affect siblings who attend patients in ICU without proper leadership that should restrict their duration of stay in the ICU department (Horikoshi et al., 2018).

Recommendations

The visiting policy for ICU patients' needs to be liberalized to improve both the wellbeing of the patients and their relatives. A strict ICU visit policy causes families of patients to suffer from Post-Traumatic Stress Symptoms. Researchers and physicians recommend an open visiting system so as also to give families a chance to take care of their loved ones in ICU and the patients an opportunity to feel loved by their families (McKenna, 2019).

Proposed Solution and Cost-Benefit Analysis

Extension of visiting hours should be guided by an active leader in the emergency department to ensure that the number of individuals around the ICU are controlled. Cost-effective measures align with the fact that it can be costly to start controlling issues of infections either to the patient in ICU or the visitor who stays for a longer time than the universally stipulated time (McKenna, 2019). A need for specialized care should also be controlled by the outcome of the visits as well as the cost of managing the appointments through considering increasing the number of nursing care overseers.

Roles

I performed the role of a scientist in a way by designing and conducting the research study on the problem of visiting policies in the ICU, coming with research questions, collecting the raw data and analyzing it to help come up with the findings of the problem of research. As a detective, I was able to use my clinical interest with the science of nursing to determine the possible impacts of changes to an open visitation policy and take action for the prevention and control of such results. Finally, I took the role of a manager by understanding the presence and absence of family visitations that could affect the patients in intensive care and staff by reducing their stress and anxiety. Also, I considered how both the ICU team and family could take part in providing the patient with a healing environment.

Timeline

Steps Duration

Brainstorming ideas concerning the extension of visitation time and duration Three days

Writing down the thoughts and linking with EBP in care Five days

Meeting staff committee to device the new policiesFour Days

Identification of positive and negative implicationsFour days

Carrying out a test for the identified extension of duration and visiting hoursOne week

Recommendations for improvementsThree days

Managers approvalTwo weeks

Implementation Three months

Stakeholders

Nursing practitioners with experience of over ten years will be vital for the brainstorming, identification of future challenges, and recommendations for the implementation. RN nurses in the emergency department who offer support during visitation hours will be valuable for the brainstorming and choice of a better measure to improve the practice.

Stakeholders Engagement

The most relevant individuals who outlined their views were the RN and intensive care practitioners. Their contribution concerning the topic was associated with the safety of the visitors as well as the patients in the ICU. The aspect was associated with the fact that a patient's condition can guarantee the ICU to be restricted. Such scenarios were outlined to be exempted in case a need arises. The most appropriate way to interact with the stakeholders is to make them get prepared with tips concerning the adjustments. Communication will be aired earlier to enable them to make use of EBP. The communication regarding the policy will be on the nursing care centre billboard, notice board and at the waiting bay's notice board.

Success with Working with Key Stakeholders

It will be essential to keep in touch with emergency room nurses during the piloting of the implementations. The aspect will enable them to communicate the pros and cons of the implemented issue of the facility. They will also share their challenges with the new implementation. The element will enable them to receive proper suppo...