Family presence has always been a hot topic in the healthcare community. I can remember when family presence in an ICU meant visiting for 15 minutes three times per day. At least that was the policy in the local hospital where my grandparents were patients when I was a kid. We’d wait and wait for the clock to strike that magic moment and then take turns, two at a time, to visit. I’m not sure that communication with the staff even occurred during those minutes, or if it did, it may have been just a quick word or two.
It just so happens that later on, as a nurse in the medical intensive care unit (MICU) at a large teaching hospital, our unit transitioned from set visiting hours to open visiting hours from 11 am to 8 pm. It was then up to the discretion of the staff if family could come in earlier or stay later, even all night. Interdisciplinary rounds, led by the attending physician, took place each morning outside of each patient’s room. If family members were present, sometimes the attending updated them at that time and teaching of interns and residents occurred in front of the patient and family. More often, however, he or she told the family that they’d get an update when rounds were completed.
Much has been written about family presence, especially with regard to visitation and emergency care and resuscitation efforts, however little has been studied about including family members in medical or interdisciplinary rounds. In Family Presence on Rounds
, the author performed a systematic review of 17 studies on this topic. The PICO question
guiding this study was “In critical and noncritical pediatric and adult patients, does family presence on rounds compared with non-inclusion of family members lead to positive outcomes and increased satisfaction?”
While it is clear that further research is warranted on this topic, the author does a nice job of organizing results from the review based on family members’ outcomes, both positive and negative, and health care staff outcomes, both positive and negative. She even takes it one step further, by dividing the health care staff outcomes among nurses (although only 5 of the 17 studies addressed nurses’ perceptions) and medical staff. Positive outcomes outnumbered the negative outcomes for all groups, but interestingly, the nurses did not perceive any
negative outcomes to family presence on rounds.
What is the policy where you practice? What’s been your experience with family presence during interdisciplinary rounds?
Cypress, B.S. (2012). Family Presence on Rounds: A Systematic Review of the Literature. Dimensions of Critical Care Nursing, 31(1).