Forms of Nursing Inquiry: Quality improvement (QI), Research, and Evidence-Based Practice (EBP)

The unit I previously worked in was changing from scheduled to open visitation; each week the staff held meetings on the proposed change. Staff who were scheduled as off came into the meetings as this was an important quality improvement project; there was no evidenced based practice outside mentor but the facility mentioned here in this journal article did have an outside evidence based practice nurse from a local university; some staff were embracing open visitation while others were not causing unit conflict; to compound matters the facility was changing corporate ownership.

Staff had concerns re job security and other staff resigned in the middle of the project; stakeholders were approached such as physicians and unit secretaries re how would they feel regarding open visitation for a family member and all bought in; the EBP expert provided research and nurses attended a journal club every 2 weeks; nurses were briefed in journal club on the best evidence for open visitation; unit secretaries kept track of the proposed and evolving change noting if open visitation was not conducted, the reason for it was documented; at shift change open visitation was not conducted due to patient confidentiality but family or significant others were allowed to remain in patient rooms with the door closed;

What facilitated the change was the biweekly journal club meetings which also became a support group due to the stressful corporate ownership change; managers met with all nurse privately and bolstered and supported each nurses role in the change; staff who came in on their days off were reimbursed by the CEO; this was similar to the policy change at the previous unit I worked on. Staff were reimbursed for tome spent in meetings on their days off.

 

The ICU unit brochure was completely redesigned reflecting the open visitation; evidence was indicating that open visitation improves communication; it enhances self satisfaction, facilitates better patient understanding, and it advances the patient-family-significant other centered care.

 

This particular unit reviewed the evidence as did my previous unit, but without an EBP specialist. An open visitation policy was succefuly initiated and it took about 10 months; staff conflict was resolved when all bought in on the evidence, and quality improvements documented by stakeholders such as unit secretaries.

 

Use of the evidence based practice initiative greatly assisted the ICU unit of 10 beds to initiate and carry forward the new adult open visitation policy in the ICU. 

L. Kean & K.A.Miller (2020). Implementation of open visitation in an a adult intensive care unit; An evidence-based practice quality improvement project. CriticalCare Nurse, 40(2) pp 1-5.

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