Investigation And Research On The Influence Factors Of ICU Visiting Policy In Grade Level A Hospital In Sichuan Province

Objectives:1.To investigating the situation of ICU visiting management system in the Grade Level A hospital in Sichuan Province.2.To research on the influence factors of ICU visiting management system.3.To provide reference for improving the ICU visiting management system.Methods:1.A self-designed questionnaire based on literature review and learn from the foreign questionnaires was used.Taking ICU(Comprehensive ICU and Specialized ICU)of the Grade Level A hospital in Sichuan Province as the respondents.Bring into 60 hospitals as respondents which is registered by Health Commission of Sichuan Province.Recruit practice nurses as the investigator from a medical college.A Internet questionnaire was send to the nurses who were responsible for the ICU in the 60 hospitals.SPSS24.0 statistical software was used for statistical processing of the data.Descriptive statistics,chi square test and other statistical methods were used.2.Combined with the quantitative survey results of the first stage,develop a semi-structured interview outline,using group interview,A interview was conducted with 8 head nurses with an average of over 9 years'experience in ICU management in a Grade Level A hospital.Results:1.72 questionnaires were distributed to 60 hospitals,44 of them participated in this survey.Result the collecting rate was 100%,the valid was 97.2%.44.hospitals include 70 ICUs,which 41 of them were Comprehensive ICUs and 29 were Specialized ICUs,generally 70 ICUs adopt a restricted visiting policy,most of them restricting visit time,visit gaps and number of visitors.1)Characteristics of the hospital:Among 44 hospitals,70%are District General hospital,and 25.7%are University Affiliated hospitals,4.3%are Specialized hospitals.Among the 70 ICUs,58.6%are Comprehensive ICUs and 41.4%are Specialized ICUs.2)Characteristics of visiting policy in ICUs:Includes three management types which is restricted policy,flexible policy and open policy.51.4%were restricted visiting policy,42.9%were flexible visiting policy and 5.7%were opening visiting policy.There was no significant difference in the visit restrict of ICU in different hospital types and areas(P>0.05);The visit characteristics with different types of ICU and different number of nurses were different(P<0.05),More opening visiting management in Specialized ICU/the nursesless than 30,the visiting time is longer than 4h/d and no limited in visiting gaps which is the features among those ICUs.No significant difference was found in the characteristics with restricted visiting policy and flexible visiting policy(P>0.05).3)Other characteristics of visiting policy in ICU:The wearing of gowns(more than 80%)and mask(more than 70%)was required.In addition to providing the easy chair,there was no more other convenient facilities in the rest area.Only 52.9%of the ICUs will schedule a routine meeting,and 35.7%of them carried out a satisfaction questionnaire.2.The qualitative research refining to there primary themes(traditional beliefs of ICU guards?seekingmanagement efficiency and limitation because of the objective conditions),Ten secondary themes(protect patients and their families,protect medical staff,traditional cultural,the families lack of capability in communication,the familieslack of medical knowledge,the familieshas a poor compliance,a shortage of ICU environmental and equipment,system requirements,lack of human resources,lack of capability with nursing)and four tertiary themes(reduce the risk of infection,to avoid disturbing the patients,to avoid increasing the psychological burden of family members,reduce the medical disputes).Conclusion:1.The restricted visiting policy is widespread in the Grade Level A hospital in Sichuan Province,which is lower opening than Europe countries,it as a obstacle which is hampering the ICU get better.2.The ICUs adopte a restricted visiting policy is related tothe traditional beliefs of ICU guards?ICU guards seeking better efficiency to management?a shortage of ICU environmental and equipmentand ICU lack of human resources.3.The ICU guards should pay attention to the limitation of restricted visiting policy,Trying to increased the visit times?Cancel unnecessary visit restrictions,pay attention to visit experience of family members,strengthen daily communication with family members,enhance daily training,and increase human resources;Explore the best visiting policy for the local reality.