Hospital visiting policies – impacts on patients, families and staff: A review of the literature to inform decision making

Abstract

Some healthcare organizations recommend adopting open visiting policies. These organisations are working towards the end goal of promoting the idea that patients and families can be true partners in care. An essential step in this culture shift involves openness to family presence and their engagement in the patient’s care. Among other things, their recommendations are based on data from studies that assessed the impacts of different types of visiting policies on patients, families and healthcare staff. In order to inform and guide an organizational reflection on possible changes to our hospital center’s visiting policies, our team undertook a systematic review that focussed on the advantages and disadvantages of open/flexible visiting policies, as perceived by patients, families and staff. Review articles and original articles were assessed and synthesized following a rigorous review process. Results of the reviewed studies suggest that flexible visiting policies lead to greater patient satisfaction with care and to positive impacts for both patients and families, and that these stakeholders have clear preferences for open/flexible policies. Nevertheless, policies including some guidelines to safeguard rest and sleep periods were deemed necessary by patients, rather than an unqualified open policy. Results also suggested that flexible visiting hours were not associated with an increased risk in hospital-acquired infections or septic complications in intensive care units (ICUs), where the majority of the reviewed studies were carried out. Authors recommended taking the specific context of care units into account when implementing new visiting policies, as needs may be different according to different health issues. Staff preferences over a model or the other were somewhat mixed. Some staff see the presence of families and visitors as an obstacle to the provision of care and a reason to fear increased workloads. In order to overcome this resistance, the importance of adequately preparing staff and supporting them throughout the policy change to ensure its success is highlighted.