COGDELL MEMORIAL HOSPITAL
Standard Policy and Procedures ADM.LD.10.16
Title: Visitation Policy and Procedure
Approved By: Administration Board of Directors
Effective Date: April 2013
Statement of Purpose: Cogdell Memorial Hospital promotes and supports a patient and family centered approach to care. The purpose of this policy is to define and set expectations regarding persons visiting hospitalized patients and to recognize our commitment to provide visitation in accordance with our non-discrimination policy, which provides access without regard to race, color, sex, national origin, disability, age, religion, marital status, citizenship, gender identity, gender expression, sexual orientation, and/or other legally protected classification. It also provides a mechanism to issue identification to authorized individuals visiting a patient.
A. The diagnosis and treatment of illness and disease can result in a range of stressful circumstances for patients, their families, and significant others. Most patients and families require assistance and support, at different times and in different ways, from people important to them. This support may involve someone to assist in decisions about medical care, someone to provide companionship, or someone to provide care in the home after treatment. For some patients, their support may come from immediate family members. For other patients, their support may include other relatives, neighbors, friends, co-workers or clergy.
B. Clear explanations from staff members about what family members and visitors can do to help the patient, where they can be in the nursing unit and any limitations on their participation will be provided. Guidelines for the participation of persons spending time with the patient should be flexible in order to respond to the diverse and changing needs and preferences of each patient and the hospital. Time and treatment may alter patient wants, desires or needs. Wherever possible, we recognize and honor patients’ wishes regarding visitation. Patients may need help in modifying the visiting schedule or expectations about time spent with family members and visitors.
A. Family or Family Member: The terms “family” or “family member” in all policies at the Cogdell Memorial Hospital are understood and interpreted to include any person(s) who plays a significant role in an individual’s socio-emotional life. This may include a person(s) not legally related to the individual. Members of “family” may include spouses, domestic partners, and both different-sex and same-sex significant others. “Family” may include a minor patient’s parents, regardless of the gender of either parent. Solely for purposes of visitation policy, the concept of parenthood is to be liberally construed without limitations encompassing biological parents, legal parents, foster parents, same-sex parents, step-parents, and other persons operating in caretaker roles, consistent with applicable law.
B. Visitor: A “visitor” is defined as a guest of the patient. Family members are considered to be visitors as well. Visitors are encouraged to visit during the hospital visitation hours of 7:00 AM to 9:00 PM. Due to the critical nature of certain units (i.e., progressive care unit, recovery rooms, obstetrics, emergency department, etc.) visiting hours may be more restrictive.
A. In general, family members and visitors are welcome from 7:00 AM to 9:00 PM unless one or more of the following considerations are noted, or other special circumstances apply as described in this policy.
1. The patient or the patient’s designated representative, in conjunction with the registered nurse and healthcare team, may make visitation limitations. Family and visitors will not be denied access to the patient without a legitimate reason, as determined by the hospital. Special considerations that determine the amount of time family and visitors spend with the patient include:
a. Clinical and emotional needs of the patient. Having family or visitors present must not put the patient at risk or bring the patient harm. Examples include exhaustion, overstimulation, or marked increase in agitation.
b. Family member’s or visitor’s inability to meet hospital infection control policies.
c. The need to maintain a sterile environment during bedside procedures.
d. Limitations as requested by the patient or patient’s designated representative. e. Patient, family, visitor or employee safety issues.
f. Family members and visitors are asked to respect changes of shift from 6:30 AM to 7:30 AM. (for those visitors allowed in patient care areas prior to 9 a.m.) and from 6:30 PM to 7:30 PM by having minimal interruptions in entering and leaving the unit.
g. Visitors or family members with prohibitive legal documentation, such as applicable restraining orders, will not be allowed to visit.
h. To help patients recover and to not overly tire patients, visits should be brief, quiet and pleasant. The patient or patient’s designated representative, in conjunction with the registered nurse and healthcare team, may make additional limitations for family and visitors, especially in the progressive care unit.
2. Children should always be accompanied by an adult other than the patient. Information and access should be developmentally appropriate. There are also a variety of ways other than visiting those children younger than 12 can stay in touch with their loved ones. These include sending notes or letters, poems, artwork, tapes of talking, reading or singing, photos and by making phone calls. Children can only visit if they are able to comply with all isolation and/or infection control precautions.
* Note: There may be unique and extenuating circumstances (i.e., imminent death, impending surgery, etc.) that require compassionate exceptions to these guidelines. The registered nurse and the health care team, using professional judgment and in collaboration with the patient or the patient’s designated representative, will consider the unique family circumstances and patient needs when applying these guidelines. In these circumstances, to the greatest extent feasible, family will be allowed brief visits.
3. Entry Process:
a. Family and visitors should always wash hands each time they enter and leave the patient room or unit.
b. Family and visitors should follow all isolation and/or infection control pre-cautions as instructed by nursing staff.
c. Family and visitors are asked not to come to the hospital if they are feeling ill or have signs of, or have recently been exposed to, communicable illnesses or infections. Hospital personnel reserve the right to ask family and visitors to leave if they show signs of illness.
d. To maintain the privacy of other patients, family and visitors should only enter the room of the patient that they are there to spend time with.
e. To maintain patient privacy and minimize disturbances to other patients and families, congregating outside in the hallways is prohibited.
f. To facilitate the rest and recovery of all patients, family members and visitors should be mindful and sensitive to the needs of other patients and families by keeping noise and disturbances to a minimum.
g. At all times, family and visitors should act in compliance with all applicable rules/regulations and hospital policies and procedures.
h. At all times, family and visitors must not interfere with normal hospital operations.
4. Family and Visitor Behavior:
a. Family and visitors are expected to abide by conduct supportive of the hospital environment. Family or visitors may be asked to leave the premises if they become disruptive or interfere with the general comfort and care of the patients, visitors, or staff. A Code Black will be called and/or law enforcement will be will be notified to handle disruptive issues as needed.
b. Family or visitors may not consume alcohol or illegal drugs while on the hospital campus.
c. Family or visitors who wish to smoke while visiting may only do so at approved smoking areas outside the buildings.
5. Special Considerations:
a. In special situations, an adult family member may spend the night with the patient and contributes to the well being of the patient. The family member must be able to safely stay alone and take care of their own needs.
b. Children may not remain overnight in a patient room.
c. Patients in police custody and/or correctional services custody will not be permitted to have visitors.
6. Progressive Care Units:
a. Family and visitors must wash hands and wear personal protective equipment when visiting in the PCU as determined by the current unit practice.
b. To maintain patient confidentiality and infection control, family and visitors at the patient’s bedside should be limited to two (2) at a time.
c. Children visiting in the PCU shall be at the discretion and mutual agreement of the healthcare team, patient and family.
d. Family and visitors are requested to wait in the waiting rooms and not in the hallways.
7. Emergency Services:
a. In general, there are no pre-set visiting hours in these areas. However, family and visitors will not be denied visitation without a legitimate reason (e.g., medical reasons, unit activity, or safety/privacy concerns) as determined by the physician and/or unit charge nurse.
b. The length and frequency of visits will be at the discretion of the Nurse Manager/Charge Nurse taking into account the patient’s condition.
c. Every effort will be made to keep the family or appropriate legal decision maker involved in the patient’s care.
d. Every effort will be made to communicate patient information and condition or location updates as appropriate as quickly as possible. The information will be provided to family or appropriate legal decision maker via the physician, nurse and/or social worker.
8. Peri-anesthesia Services:
a. Visitors are not routinely allowed in the recovery area. There are exceptions and include the following:
(1) Children 18 years of age and younger are permitted to have parents/guardians stay with them.
(2) Mentally/emotionally challenged patients or patients with special needs may have family at their bedside.
(3) To maintain patient confidentiality and infection control, family at the patient’s bedside should be limited to two (2) at a time.
(4) Family is requested to remain by the patient’s bedside while visiting.
(5) Children visiting in the acute recovery area shall be at the discretion of the healthcare team, patient and family. Children under the age of 12 years should be accompanied by an adult.
(6) Family may stay with the patient until transferred or discharged
9. Guidelines for Patient Education:
a. The registered nurse should review the family presence and visitor guidelines with the patient on or shortly after admission so the patient may make choices about family presence and visitor access. If the patient is unable to participate in these discussions and decisions, the patient’s designated representative should be involved
b. The nurse should communicate that the patient, or patient’s designated representative may make changes to their visitation choices at any time.
c. The nurse should discuss the balance between providing support to the patient and allowing the patient sufficient rest and privacy.
d. To the extent possible, the nurse should provide clear expectations about what family members and visitors can do to assist in supporting the patient’s care, where they can be on the unit, and any limitations on their participation. e. When appropriate, the nurse may also discuss the risk of caregiver fatigue with family and visitors.
f. The healthcare team should be flexible in order to respond to the needs and preferences of each patient.
g. In the event that a dispute arises between families or visitors regarding access to or information about patients, the Nurse Manager/Charge Nurse/House Supervisor (or AOC if during nights, weekends or holidays) is to be contacted to assist with resolution.