Bedside caregivers: Research shows opening visitation access improves patient satisfaction

All too often, restrictive visitation policies take that away from hospitalized patients. From narrow visiting hours to "immediate family member" limitations, many believe the absence of visitors affects the quality of care those patients receive. Now, retrospective research from a team of Baylor nurses proves it.

Published in the Journal of Nursing Administration in July/August 2014, "The Impact of Opening Visitation Access on Patient and Family Experience" explored the patient effects at 12 Baylor hospitals after each shifted to open visitation access in September 2010. Terri Nuss, MS, MBA, and vice president of patient experience at Baylor, led the study, along with a nursing administration team.

"Providing the patient access to those who support him/her is part of creating safe passage and healing environments," Nuss said. "We knew we could change the policies and practices, but it was important for us to have evidence that our patients perceived this invitation for their loved ones and that loved ones felt welcomed."

Through that research, the team sought to answer two important questions: How does opening visitation impact patients? And how does communication impact the success of that open visitation?

Put simply, the team concluded that open visitation improves patient care substantially, but only if the visitation policies are communicated clearly. They determined this by measuring the 12 hospitals on five factors: 1) the presence of open visitation signage; 2) the adoption/availability of the new visitation policy; 3) the documentation of the patient's primary support person; 4) the ability of that primary support person to visit the patient 24/7; and 5) the disclosure of rights and responsibilities to patients and their families.

The third and fourth factors were especially important, because in July 2011, Baylor Health Care System adopted a policy that allows patients to designate a "primary support person." That person could visit the patient 24/7, with patient permission. During overnight visits, the policy urges hospital staff to provide blankets, sheets, pillows and other comfort measures to the primary support person.

Eighteen months after visitation policies changed, each of the five factors improved, with more than 82 percent of hospitals successfully adopting and communicating ideal open access visitation. In the next two years, that number improved to nearly 94 percent of units offering ideal access.

Most significantly, patient satisfaction surveys reflected a more satisfied, comfortable patient population. Respondents felt that their nurses kept them informed (from 88.2 percent to 89.1 percent) and treated them with courtesy/respect (from 85.9 percent to 88.4 percent) and also that the hospital tended to the accommodations and comfort of visitors (from 86.8 percent to 88.9 percent).

The results indicate a growing need to allow expanded, around-the-clock visitation during a patient's stay. Such visits could significantly improve inpatient care, elevate moods, reduce anxiety, and help acute and long-term patients adjust to the unfamiliarity of hospitalization.

"Family and pediatric medicine [practitioners] and caregivers have long understood the importance of the patient and loved ones' partnership in care," Nuss said. "As this understanding spreads to acute and long-term care environments, we find that all patients need support and confidence, and it is our job to reduce their suffering and fear wherever and whenever possible."