Implementation and sustainment strategies for open visitation in the intensive care unit: A multicentre qualitative study()

OBJECTIVE: Open visitation in adult intensive care units has been associated with improved family and patient outcomes. However, worldwide adoption of this practice has been slow and reasons for this are unclear. This study documents barriers and strategies for implementing and sustaining open visitation in adult intensive care units in the United States experienced by nursing leadership. RESEARCH DESIGN: Qualitative approach using grounded theory. PARTICIPANTS: Nurse leaders in adult intensive care units with open visitation. SETTING: Magnet® or Pathway to Excellence® designated hospitals in the United States. METHODS: Semi structured interviews were conducted with 19 nurse leaders from 15 geographically dispersed hospitals. Interviews were recorded, transcribed and imported into Atlas.ti qualitative software for analysis. Grounded theory constant comparison analysis was used for coding and category development. FINDINGS: The analysis revealed three barriers; nursing attitudes and clinical and nonclinical barriers. Strategies to overcome these barriers were empathy, evidence-based practice, models of care, shared governance, nurse discretion, security and family spaces. CONCLUSION: Intensive care nursing leadership experienced distinct barriers and strategies during pre-implementation, implementation and sustainment of open visitation. Other nursing leaders interested in open visitation can use these findings as they plan this transition in their intensive care units.