#VisualAbstract: Effect of Flexible Family Visitation on Delirium Among Patients in the Intensive Care Unit

1. In this randomized controlled trial, there was no difference in the incidence of delirium between flexible family visitation and standard, restricted family visitation.

2. Flexible visitation resulted in better measures of anxiety, depression, and satisfaction for family members.

Evidence Rating Level: 1 (Excellent)

Study Rundown: It is thought that flexible ICU visiting hours may contribute to delirium prevention and stress reduction among patients as well as improvement in family satisfaction. While some professional society guidelines have recommended flexible visitation policy for family members in ICUs, it is unclear if this would reduce delirium. In this cluster-crossover randomized clinical trial, flexible family visitation did not reduce the incidence of delirium compared to standard, restricted family visitation. However, flexible visitation resulted in better measures of anxiety, depression, and satisfaction for family members.

This study has several limitations. First, all the ICUs studied were from a single country, and flexible visitation may have different effects across distinct sociocultural contexts and cultures. In addition, cluster randomization was susceptible to recruitment bias. Lastly, the effect of the educational component of the flexible visitation model on family members cannot be isolated from flexible visiting hours.

Click to read the study in JAMA (Journal of the American Medical Association)