Open visiting policies in intensive care units : an update

Abstract

In times pasts, family members were not welcome in intensive care units (ICUs). Over the last two decades, major improvements have been made towards “patients centred care and family centred care”. However, many ICUs still have restrictions in their visitation policy, and although scientific societies support the need for families ‘presence in the ICU, only a minority of ICUs apply “unrestricted” or “open” visitation policies.

Yet, the positive impact of unrestricted presence in the ICU on family members makes no doubt, particularly by maintaining the connection with the patient and building a trustful relationship the ICU team. Unrestricted presence is associated with a high level of satisfaction among family members and less symptoms of anxiety and depression. Patients also benefit from the presence of their relatives who participate in humanizing the hostile environment of the ICU. Furthermore, although many ICU staff have a negative perception if open visitations, many of them believe that it helps build a closed relationship with the family members and finally only few of those who work in ICUs with an open policy would wish to move back to a restricted policy. Finally, the COVID-19 pandemic has demonstrated the negative effect of visits restrictions.