Nowadays, many Intensive care units (ICU) remain restrictive visiting hours regimens. This decision is based on the following premises:

1. Difficulty to work with patients for the physician.

2. Interference in the work of nursing, the safety of the staff and workload.

3. The privacy of the patient, and adverse changes in the physiology.

4. Constant information demand to physicians.

5. Family and/or social violence to bad news.


The Group of Dr. Samuel Brown has recently published in American Journal of Critical Care (AJCC):  Satisfaction with elimination of all Visitation Restrictions in a mixed -profile Intensive Care Unit. 

In a mixed ICU, they did changes in visiting during two periods: a restrictive mode 3 hours per day of visit to unrestricted mode 24 hours a day.

They wanted to study the satisfaction of family members and secondly, to determine the influence of visits among nurses and families through surveys .

Their statistical analysis determined these results:

Family satisfaction

The waiting room, hours visit and interaction with the staff were evaluated. There were a significantly greater family satisfaction and the waiting room ambience in the model without restrictions.

NurseSatisfaction 

Family interference did not vary with the change. The satisfaction of visitors was higher with restrictions change. Nurses with 15 to 20 years of experience were more likely to perceive the families as an interference with clinical care. This difference may be due to training.

The authors conclude that elimination of even minimal restrictions on visitation hours improved family satisfaction and improved nurses’ perceptions of family satisfaction with the visitation policy. Nurses’ satisfaction did not change.

The limitations of this study should be taken into account: to be developed into one unit and with a very small sample. On the other hand studies evaluating these restructurings of the ICU are needed, also optimizing medical work, with less load and night shifts.

Perhaps all together lead us to have a more human ICU for everybody.

Dra. Gabriela Vidal
Intensive Care Physician.
Hospital Interzonal General José San Martín. La Plata, Argentina