FAMILY-CENTERED CARE VISITATION GUIDELINES

Generally, visiting hours in our multi-service cardiovascular ward are from 11 AM to 8 PM. However, we also practice flexible visitation hours on an individualized basis. Our goals in establishing the family-centered concept are to (1) coordinate with nursing staff to meet patient and family needs to create greater flexibility and (2) allow more access for the family to their loved one.

There may be times when visitors are asked to leave the room to maintain patient privacy/confidentiality during medical rounds and the delivery of nursing care. Many of our patients have roommates. Respect for all patients' privacy and comfort is necessary to maintain a healthy environment of care.

We have a patient lounge that is available for patient and family members. For overnight visits, the lounge may be used for visitor use if we are unable to accommodate a family member's request to sleep at his/her loved one's bedside. Visitors may rest at the bedside as long as it does not disturb the patient and the roommate (if applicable) and does not disrupt nursing care. Sleeping in the patient's bed or in an empty bed next to the patient is not appropriate. The family member may sleep in a chair next to the patient if it does not interrupt patient care, the patient, and/or the roommate.

Visitation by younger visitors (infants, toddlers, and school-aged children) is encouraged. However, the duration of visitation is dependent upon a positive environment for all patients and family. Children must be directly supervised by an adult other than the patient and/or staff. Children are not permitted to wander from the bedside or play with equipment. Children younger than 12 years may not be left unattended in the critical care lounge. Visits with patients who are immunocompromised will be considered with physician approval. All visitors must adhere to infection-control policies and practices, that is, hand washing, gown, glove, and mask. Use of the waiting lounge is highly encouraged for younger visitors (infants, toddlers, and children), especially if the patient's assigned room is semiprivate.

Visitors should not visit if they have any symptoms of infection or have recently been exposed to a communicable disease. For questions regarding suitability related to visitation, we may contact the physician for guidance or approval, as well as our Infection Control Department. A sign is posted outside the door if the patient is in isolation.

Following universal precaution guidelines will significantly decrease the transmission of infection. The nursing staff provides education and guidance related to proper infection-control procedure to each family member before and after the visit. Hand washing is the key component in reducing transmission of infection. There are several options available on our unit. They are washing one's hands using (1) the antimicrobial soap and water located in every bathroom, (2) the antimicrobial foam hand rinse located outside every patient's room, and (3) an alcohol-based hand rinse located inside every patient's room.

These guidelines have been implemented successfully in our critical care unit. They have helped us meet the goals of greater flexibility in visitation and more access to the patient to establish the family-centered concept.