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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care
Minerva Anestesiologica 2015 December;81(12):1338-45
Potential predictors of visiting hours policies in the intensive care setting
Speroni C. 1, Gobbi D. 1, Gemperli A. 3, Merlani P. 2, 4, Pagnamenta A. 1
1 Intensive Care Unit, Department of Intensive Care Medicine of the Ente Ospedaliero Cantonale (EOC), Regional Hospital Mendrisio, Mendrisio, Switzerland;
2 Intensive Care Unit, Regional Hospital Lugano, Lugano, Switzerland;
3 Department of Health Sciences and Health Policy, Lucerne University, Switzerland, and Swiss Paraplegic Research, Nottwil, Switzerland;
4 Department of Anesthesiology, Pharmacology and Intensive Care, University of Geneva, Geneva, Switzerland
BACKGROUND: Restrictions on visiting hours in the intensive care unit (ICU) are usually adopted worldwide. Current knowledge shows that these limitations are not necessary. In order to identify potential variables that are associated with restricted visiting times we carried out an observational study on visiting policy.
METHODS: We conducted a questionnaire-based nationwide survey among all certified adult Swiss ICUs. An electronic questionnaire was sent by e-mail between May and June 2012 to all chief nurses. Length of permitted visiting time was taken as main endpoint to assess the association with different potential predictor variables using simple and multiple linear regression analysis.
RESULTS: Response rate was 73 of 75 ICUs (97%). Only two ICUs (3%) have an unrestricted visiting policy. Median daily visiting time was 8 hours (range: 1.5 to 24 hours; interquartile range: 6-10 hours). Simple and multiple linear regression analysis demonstrated a significant effect in visiting hours between Italian- and French-speaking parts of Switzerland with 4.0 hours longer visiting hours in the former (P=0.039) without identifying other predictors.
CONCLUSION: Swiss ICUs have less restrictive visiting policies compared to other Western countries; nevertheless very few Swiss ICUs have unrestricted visitations. Neither medical type of ICU, nor ICU infrastructure was determining the visiting policy in Swiss intensive care setting. Cultural factors, as captured by the linguistic areas are the only identified predictors of visiting hours. Since the current policy is not justified by clinical outcomes but based only on cultural settings, it needs to be definitively reconsidered and unrestricted visiting policies must become the rule rather than the exception.