Is your health system allowing visitors again after a recent COVID-19 pandemic lockdown?
It’s the perfect time to re-evaluate your visitor policies. As doors are reopened to patients’ families across the nation, administrators face a difficult task: striking the best balance between patient support and patient safety. Now, more than ever, it’s paramount to review the policies that govern visitation at your healthcare facilities to ensure they follow the latest public health guidance and adhere to leading industry practices.
The Value of Visitors
We know that visits from family improve patient outcomes. According to Karlene Kerfoot, PhD, RN, FAAN, Chief Nursing Officer at symplr, “Highly restrictive visitor policies that prohibit or limit visitors such as often seen in ICUs can be very detrimental to the development of the family as the care partner and the well-being of the patient.”
Treating family and other individuals designated by patients as “partners in care” has a tangible impact on continuity of care, readmission rates, patients’ emotional wellbeing, safety, and the management of both chronic and acute illnesses. This stance is supported by an abundance of empirical evidence, as well as multiple studies and health publications. As a result, The Joint Commission now recommends patients bring a trusted individual along with them to the hospital to support their care and safety.
How can we balance the essential support patients need with contingencies, such as COVID-19?
COVID-19 Related Contingencies to Consider While Revamping Visitor Policies
COVID-19 has made it necessary for all healthcare facilities to re-evaluate infection control policies, including those regarding visitors. Combined with the serious consequences of infection and significant risk of mortality, ease of transmission makes COVID-19 positive visitors a distinct threat to patients and staff. For the same reasons, patients’ COVID-19 status is of equal concern to their families.
Unfortunately, ensuring that every person roaming the halls of hospitals, ambulatory and other health facilities is COVID-19 negative is all but impossible. People can be contagious for multiple days before they carry enough viral load to register as positive on a COVID-19 test. Checking nonpatients’ temperatures before they enter the building is an option many institutions are implementing to reduce the spread of illness. Yet, it’s important to note that not all people who contract COVID-19 will experience a fever. COVID-19 can also be spread before any symptoms appear.
While hospital and healthcare facility staff are trained ongoingly to follow proper infection control procedure, this is not the case for most visitors and patients. “The best practice solution we have now is masking, temperature checks, querying about symptoms, history of any positive contacts and frequent handwashing. We have seen healthcare organizations and other businesses require the use of masks which have been proven to be an effective deterrent,” Kerfoot said. Enforcing masking policies in accordance with public health guidance and encouraging frequent handwashing and hand sanitizing can help reduce the risk of contracting COVID-19 for patients, visitors, and staff. In the event that someone arrives to visit a patient without a mask, one should be provided along with infection control reminders. Hand sanitizer should also be made readily available throughout the facility.
The COVID-19 pandemic remains at the forefront of our minds, but it’s not the only safety concern worth considering while reviewing your visitor policy.
Patients’ Needs and Preferences
Individual patients will have different requirements and preferences based on their clinical situation and emotional needs. For example, patients in an acute care rehab center may not have any scheduled rehabilitation after 6 PM but will require quiet hours in the evening to rest.
And although many facilities are currently limiting visitors to one at a time, laboring mothers may choose to have both their partner and a doula present for their child’s birth, if possible. Organizations need a flexible plan to address the possibility of minors visiting parents, grandparents, and older siblings as the incidence of COVID-19 changes in specific localities.
In any setting, in-person visitation is ill-advised for patients who are at high risk from any form of highly infectious disease.
Alternatives to In-Person Visitation at Hospitals, Nursing Homes, and Other Health Facilities
When in-person visitation temporarily becomes unsafe or unsustainable, every effort should be made to help patients keep in touch with their support system. How can patients still receive the social support they need when having in-person visitors is not safe?
- Video chat, such as Facetime or Google Duo
- Cell phone calls
- Virtual conference calls, using technology such as Zoom, WebEx, or a number of other options
- Visiting from the other side of a ground-floor window
Patient and Visitor Safety
Crime and violence in the surrounding community also warrant additional measures from healthcare staff. In some areas, perhaps security guards are accountable for visitor check-in. Through security’s visitor screening, bad actors can be identified and prohibited from entering. If there is an imminent threat, such as an active shooter or bomb threat, it’s critical to know where visitors are and include them in your plan for protecting everyone in the facility.
An often-overlooked concern is the possibility that visitors may become abusive or violent toward patients, staff, and other visitors. Ensure your staff are well-trained on what to do should such a situation arise, and ensure your system allows you to document individuals who should be prohibited from visiting in the present and the future.
There is no one-size-fits-all approach to fit every healthcare setting. However, communication and consideration between administration, staff, patients, and caregivers can go a long way when it comes to developing the best visitor policy for your organization.
Start defining your visitor policy using our free template.