In the ICU of Hospital de Barcelona we have been 26 years working with an open regime of visits during the hours of the day (10:30 AM to 22 PM) and perhaps it´s time to step forward and allow the entry of the family by night.
For us it is not a worthwhile, we have not had to adapt to a change. When the hospital opened already settled this visitation schedule. It is the advantage of brand new hospital.
All professionals came from different centers. For someone it was his/her first ICU and from the first moment teamwork is enhanced, with the participation of nurses in the daily clinical session and their involvement in decision-making. In the first years of life, we implemented the sedoanalgesia Protocol, and since then nurses have full autonomy in the management of sedation, whereas they spend more hours beside the patient.
The physical structure of our unit has contributed to the open regime. We have individual and spacious rooms and a number of beds which let us control minimally access visits (13 beds with two entrance doors).
We work with the patient’s family. From the family we get information continuously, not only in what affects the patient´s disease, but also other personal and emotional aspects of the person who no doubt is valuable information to provide about managed care and quality.
On the other hand, family is witness of everything that happens to the patient hour-to-hour, minute-to-minute and this information greatly facilitates the understanding of the process. So when daily physicians give information, few things surprise them, because they know if the patient has fever, if he/she has bronchial secretions, if we must aspire the secretions too often, if the patient is able to cough or he/she is very asleep or perhaps restless… Many signs and symptoms that can be identified and which allows them to better understand the clinical evolution.
In addition, the fact that the family sees how, how often and how you take care of their loved one, on the one hand gives safety and confidence to the family and on the other hand, gives value to the care we provide as Intensive Care professionals.
Our next goal is to keep open the ICU by night. This is going to cost more because now it means that a change in our routine and at the end and we are after the same as other humans and for sure we will have resistances.
We are confident that both our patients and families and us, we will benefit from this decision.
We encourage you to open the doors of your ICU.
Working with the presence of the family is not only possible but beneficial to all, including professionals.
We don’t have nothing to hide and much that show our professionalism, dedication and good work.