Perceptions of a 24-hour visiting policy in the intensive care unit
Perceptions of a 24-hour visiting policy in the intensive care unit
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DOI：
10.1097/01.ccm.0000295310.29099.f8
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发表时间：
2008-01-01
影响因子：
8.8
通讯作者：
Carlet, Jean
中科院分区：
文献类型：
--
作者：
Garrouste-Orgeas, Maite;Philippart, Francois;Carlet, Jean
目的：调查重症监护病房(ICU)工作人员对无限制探视的认知，测量探视次数，并确定家属焦虑和抑郁症状的患病率。观察性、前瞻性、单中心队列。内外科ICU在一家拥有460张床位的三级护理医院。299名连续住院3天的患者在前5天的ICU中进行了研究。干预措施；无。测量和主要结果。收集患者(n=209)、家属(n=149)和ICU工作人员(n=43)的特征。ICU工作人员报告了他们对不受限制探视的看法，家人填写了医院焦虑和抑郁量表。计算每日严重程度评分(简化急性生理学评分11分和Logistic器官衰竭评分)和工作量评分(相当于护理人力的地雷评分)。最大中位就诊时间为每名患者每天120分钟，出现在第4天和第5天。病情严重程度、工作量和就诊时间之间没有相关性。对于115名患者，护士和医生的调查问卷都是可用的；尽管注意到了几个差异，但护士和医生都不认为开放探视扰乱了患者的护理，但医生对延迟组织护理的中位数评分为“从未”，护士的评分中值为“偶尔”。护士比医生更能感觉到护理的无序性(p=.008)。与护士相比，医生报告了更多的家庭信任(p=.0023)，更多的家庭压力(p=.047)，以及在检查病人时更多的不安(p=.02)。医院焦虑抑郁量表显示有焦虑症状73例(49%)，抑郁症状44例(29.5%)。24小时探视政策得到了家庭的好评。它只在ICU工作人员中引起中度不适，因为可能会中断护理，特别是对护士。
Objective: To examine perceptions by intensive care unit (ICU) workers of unrestricted visitation, to measure visiting times, and to determine prevalence of symptoms of anxiety and depression in family members.Design. Observational, prospective, single-center cohort.Setting. Medical-surgical ICU in a 460-bed tertiary-care hospital.Patients. Two hundred nine consecutive patients hospitalized >3 days were studied over the first 5 ICU days. Interventions; None.Measurements and Main Results. Characteristics of patients (n = 209), families (n = 149), and ICU workers (n = 43) were collected. ICU workers reported their perceptions of unrestricted visitation, and family members completed the Hospital Anxiety and Depression Scale. Daily severity scores (Simplified Acute Physiology Score 11 and Logistic Organ Failure) and a workload score (Mine Equivalents of Nursing Manpower) were computed. Maximum median visit length was 120 mins per patient per day and occurred on days 4 and 5. No correlations were found among severity of illness, workload, and visit length. For 115 patients, both nurse and physician questionnaires were available; although several differences were noted, neither nurses nor physicians perceived open visitation as disrupting patient care, The median rating for delay in organizing care was "never" for physicians and "occasionally" for nurses. Nurses perceived more disorganization of care than physicians (p = .008). Compared with nurses, the physicians reported greater family trust (p = .0023), more family stress (p = .047), and greater unease when examining the patient (p = .02). The Hospital Anxiety and Depression Scale indicated symptoms of anxiety in 73 (49%) family members and depression in 44 (29.5%).Conclusions. The 24-hr visitation policy was perceived favorably by families. It induced only moderate discomfort among ICU workers, due to the potential for care interruption, in particular for nurses.