Hi all, my beloved rogue. 
Today I want to introduce you Jose Manuel Velasco, for my  he has been one of the revelations of the Congress. As I told you, I was impressed by his presentation in the session of Humanization organised by SEEIUC, so I contacted him and… This is the first fruit of this new friendship. Today the blog gives him the word.

There are many voices that in different areas and networks have expressed that the recent Pan American and Iberian Congress of Critical Medicine and Intensive Therapy, held between 15 and 18 June in Madrid, has resulted in a major boost to humanization of assistance to the critical patient refers.

I have no doubt, in matters related to the humanization of care, this blog has been a forced meeting point. And no doubt also, his promoter contagious enthusiasm and energy that all people who have encountered with him recently. Enthusiasm that has managed to combine a “team” that will give much to talk about in this regard. 

We also must be outstanding to other initiatives underway at the moment as the study that is being conducted by the Hospital Universitario Central de Asturias fellow to know the Organization of visits in Spain at the moment. As well as a survey that will be published shortly in REMI that will deepen a bit more in that organization and professionals in the same position. 

Referring to the table of humanization held Wednesday 18 at the Congress, referred to in this entry, I join the views expressed in some of the same comments. The Organization of a round table and its adaptation to a specific timetable is the opportunity to offer a candy that  we don´t have enough time to completely undo. But sweeten us the mouth and allows us to enjoy it then. This required limit in time forces to outline contents that cannot be removed them all the juice – at the time – but at the same time allows us to hear different voices. And it is, most of the time, in those voices involved in the late discussion from which we could draw the best conclusions.

In an exceptional climate, we had opportunity to hear several interventions. On one hand they shows that a more flexible visits conception is possible with satisfaction for everyone involved and on the other hand, they claimed “clues” to advance in openness of our units. 

The time limit that we pointed out previously forced us to outline some answers but we now have the opportunity to delve into some of the ideas shown. And so I linked some of the most relevant documents (available full text on the web) that were cited in the table. With respect to the chosen “tracks”, we agreed that there was no universal recipe but we advocate the importance of starting to generate the debate that is conducive to a necessary intervention to the absurdity of the restriction that currently we impose on the units. Henneman dares to propose a series of steps that can be summarized in the following:

 * Check recommendations based on research about the visits.

 * Clarify the values, attitudes and beliefs regarding the incorporation of the members of the family to certain care.

 * Discuss with colleagues, other members of the team, patient and family who have experienced critical care experience to reach the consensus of what will be the guidelines of visits for your unit.

 * Adapt the signals and the environmental conditions of the units. 

* Receive institutional aid to make timely changes recommended. 

* Be patient. 

And that can be found in the following document.

A working group of the Institute for Patient – and Family-Centered Care aims to eradicate the word visits from a conception necessary considering the family as something more than visitors (“She is not a visitor: she is my wife.”) We made reference to a document generated by them in which also it makes clear, perhaps a bit diluted in relation to the role that could play the family in the prevention of problems related to the safety of the patient.

There are several guides or set of recommendations among which we highlight: 

* The best practices guide of the RNAO revised in 2006, generic in terms of care and support to families, but with interesting proposals can be adapted completely to our entorno.

* Another guide from the Association of British nurses in critical care (BACCN). Nurs Crit Care 2012, 17:213-218 

* American Nurses of critics: American Association of Critical Care Nurses (2011) Family presence: visitation in the adult ICU. 

* And the American College of Critical Care MedicineTask Force 2004-2005, of the Society of Critical Care Medicine (2007) 
Clinical practice guidelines for support of the family in the patientcentered intensive care unit: American College of Critical Care Medicine Task Force 2004–2005. Crit Care Med 35:605-622 

And although the slides out of context to say little, there I leave the presentation that served as support for one of the papers. 

We continue with questions…