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Steve Breinholt, KSL TV

Do family members belong in the ICU? New Intermountain study findings mixed

By Wendy Leonard, KSL | Posted - May 26th, 2019 @ 10:23pm

SALT LAKE CITY — Waiting rooms are filled with people with questions.

But for the intensive care unit at Intermountain Medical Center, that seems to be a fading practice.

"It's been tradition to ask family members to leave during a procedure," said Dr. Sarah Beesley, a clinical researcher at Intermountain's Center for Humanizing Critical Care. She said that in recent years, and for many physicians, that culture has changed.

The idea, however, is still met with some concern from physicians and their staff, and notably so, Beesley said. But she wants them to feel at ease, because having family present can benefit almost everyone.

The Center for Humanizing Care surveyed 125 clinical care clinicians across 14 Intermountain Healthcare hospitals in Utah over a two-week period as part of a quality improvement project designed to understand and improve patient and family experience in the ICU.

Nearly 40 percent of clinicians are already allowing families to be present, and 90 percent of them say family presence during a procedure is a generally positive experience.

Instead of restricting visiting hours at the ICU, Intermountain allows visitors at any time at its Shock Trauma Intensive Care Unit, and family members don't necessarily have to leave when doctors are performing invasive or potentially traumatic procedures like an intubation, placing a central intravenous line, inserting a chest tube or resuscitating a patient.

"There's a lot of things happening in the ICU," Beesley said. "Sometimes it's the last moments of a patient's life and we're working hard to save their life. For the family to have the option, if they want, to be present, is invaluable, and we should not be taking that away from them."

Many times, though, the patient is not dying and family is at their bedside to provide support and encouragement. Interrupting that and creating inconvenience and anxiety for the family member, Beesley said, is unnecessary.

Of course, intensive care physicians and staff don't want visitors to be getting in the way of their lifesaving work.

Researchers found that 35 percent of clinicians surveyed did not like family present, because of concerns about sterility, distraction, trainee education or legal permissibility. The Center for Humanizing Critical Care plans to address these concerns in its next project.

Having family in the room, Beesley said, allows the family to better understand what is happening with the patient. Staff should only need to instruct them that "anything blue is sterile," Beesley said.

"Families want the best things for their family member who is a patient and they don't want to get in the way," she said, adding that only rarely is someone asked to leave for interference.

Sometimes it's the last moments of a patient's life and we're working hard to save their life. For the family to have the option, if they want, to be present, is invaluable, and we should not be taking that away from them.

–Sarah Beesley

Having someone there to hold the hand of a patient during a procedure can also be beneficial to the doctors, as it can be comforting to the patient, helping avoid restraints and/or medications to calm them.

"There's huge benefits to having the family there," Beesley said.

In addition to allowing family to calm their loved one, she said, having them there improves the communication between doctors and the patient and the family about their condition.

Research has shown that having family in the ICU with a patient can help them all deal with the depression and anxiety that often follows a stay in the ICU, called post-intensive care syndrome, even reducing the impact of it long-term.

It also allows family to spend more time together.

"Time in there is valuable," Beesley said.

She presented the findings from the study at the American Thoracic Society annual international conference in Dallas on Monday.

"I really value what my colleagues are doing in the ICU and don't want to be critical of that," Beesley said. "Medicine changes and we all want to get better. This is just one piece that I hope will help the patients and their families in the ICU and their recovery after."

Wendy Leonard

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