Parental presence and visiting policies in Italian pediatric intensive care units: a national survey

Abstract

Objective: To investigate parental presence and visiting policies in Italian pediatric intensive care units (PICUs).

Design: : Descriptive survey.

Setting: All 34 Italian PICUs.

Patients: Patients were not involved in this work.

Interventions: None.

Measurements and main results: A questionnaire was sent to the unit heads. Response rate was 100%. Median daily visiting time for parents was 300 mins; for other visitors, it was 120 mins. Twelve percent of PICUs had unrestricted policies; 59% did not allow the constant presence of a parent, even during the day. Visits from other relatives and from nonfamily were not permitted in 35% and 88% of units, respectively. Policies were not modified for a dying patient in 6% of PICUs. Children's visits were not allowed in 76% of units. Cardiac surgical PICUs were more likely to have restrictive visiting hours. Parents were permitted to be present at the bedside during ordinary nursing procedures, invasive procedures or cardiopulmonary resuscitation in 62%, 3%, and 9% of PICUs, respectively. No waiting room was provided in 32% of PICUs. Gowning procedures were compulsory for visitors in 94% of units. In 48% of PICUs, a formal process of revising visiting policies was ongoing. On patient admission, 77% of PICUs provided the family with informative material on the unit. Phone information on the patient was given frequently (often/always, 70% of PICUs).

Conclusions: In Italian PICUs, there is a marked tendency to apply restrictive visiting policies, not to allow parents 24-hr access at bedside, and to limit the presence of parents during procedures and cardiopulmonary resuscitation. A revision of current policies has begun, signaling a readiness for change.