Family presence and visitation in critical care : a rapid evidence assessment

Patients and families want to be in close proximity to one another during the phase of critical illness. This has historically been challenged by restrictive hospital visiting hours. Nurses have played the gatekeeper role and decided who could visit the patient, when, and for how long. A scholarly review of the existing literature was conducted to identify what patients, families and nurses believe about visiting and to determine and suggest best evidence for practice, policy, education and research. Using a Rapid Evidence Assessment (REA) methodology 18 studies were evaluated through the lens of Patient and Family Centred Care. The best evidence is presented as well as the recommendations for best practice, policy, education and future research to help promote family presence in the Intensive Care Unit. Families and patients had improved outcomes, physiological and psychological, when Intensive Care Unit policy supports the presence of the family at the bedside. Nurses felt that working with families was part of their expected practice but struggled with the increased workload. They also struggled with relinquishing control over visitation but when they did patients and families felt empowered. The key recommendations are to create flexible patient controlled visitation policies in the Intensive Care Unit, replicate studies to reinforce the findings from the studies presented, provide education for nurses about family nursing, and education for families and patients regarding the unit policies and events.Applied Science, Faculty ofNursing, School ofGraduat