Nurses' Perceptions of Open Visiting Policy in the Adult Intensive Care Unit: An Integrative Review

Abstract

The Intensive care unit (ICU) can undoubtedly be overwhelming and stressful at times. Open visitation has many demonstrated benefits for the patient and the family but can also have disadvantages. Nurses, who are a central element in the care of the critical patient, can be greatly affected by visitation. This integrative review explored nurses' perceptions of open visitation as well as visitation policies of ICUs across the nation. Beneficial effects of open visitation include enhanced teaching, improved communication, reduced anxiety, and physiologic benefits. Barriers of open visitation include hindrance in the delivery of care, physiological concerns, creating additional workload, and privacy. A literature search was completed utilizing CINHAL, PubMed, and Medline databases. The PRISMA flowchart was used to depict the articles that were included or excluded, with 11 articles ultimately used. The framework utilized for the integrative review was the AACN’s Synergy Model for Patient Care, which guides quality nursing practice with a focus on the critical care arena. Utilizing Polit and Beck’s Tenth Edition Guide to an Overall Critique of Quantitative Research Report and Guide to an Overall Critique of Qualitative Research Report, the articles were critiqued. A cross study data table was used to examine similarities and differences across the articles. Overall, the integrative review supported open visitation as being beneficial for patients and families as well as being aligned with family/patient preferences. Nurses had mixed feelings regarding optimal visitation times and schedules; while they appreciated the benefits of family presence, they did have some apprehension about unrestricted visitation. Recommendations for practice include movement towards a patient and family centered care environment and overall support for open visitation.