Family visitation in PACU.

H ISTORICALLY, PACUs have been closed units. A patient’s family anxiously waited in the patient’s room while the patient recovered in the PACU. Rapid advances in anesthesia management, faster recovery from the effects of anesthetics, the increasing use of regional anesthesia, a growing body of nursing research in support of family visitation, and an educated public that desires to be included in patient care should cause us to reevaluate the needs of the patients and families when striving to achieve quality patient care. Several research studies conducted over the last 15 years show that family visitation in PACU is a benefit to both the patient and family. A study completed in 1987 by Vogelsang showed that family visitation in the PACU decreased patient anxiety scores when compared with no visitation. A study by Noonan et al in 1991 showed that 89% of patients reported family visitation in the PACU to be beneficial, and 96% of the families believed that visitation was beneficial. In 1992, a study by Cormier et al reported that family members ranked the visit second in importance out of 10 items, whereas PACU nurses ranked this need as seventh. More recently, a study by Tuller et al piloted an open-visitation policy and simultaneously evaluated the patient’s, the visitor’s, and the nurse’s responses to the practice. From the patient’s perspective, only 64% of the patients remembered the PACU visit; yet 76% of the patients said the visit was helpful to them, and 85% thought it was helpful to their visitors. Ninety-four percent of visitors cited positive benefits. Although 15% described some aspect of the visit that was disturbing to them, it did not alter their positive perceptions of being able to visit their loved ones as soon after surgery as possible. The nurses indicated that there was more than one benefit to the patient in 71% of the cases. Nurses described a better state for the patient, as well as benefits for the visitor, in 35% of the cases. Nurses indicated that the visitors were helpful in some aspect of patient’s care in 7% of the cases. The length of time that the visitor remained in the PACU varied from less than 15 minutes to 60 minutes. At the medical center where the study was conducted, the nurses permanently adopted the new visitation policy based on the research findings. Despite the evidence that supports family visitation in the PACU, visitation remains a controversial issue for nurses working in the postanesthesia setting. It is interesting to consider the factors that cause some nurses to continue to resist supporting this evidence. A look at the ASPAN Web site (www.aspan.org) and a review of questions that come to the Clinical Practice Committee show that this is still a hot topic with perianesthesia nurses. Practices vary widely, from no visitors or visitors for ICU patients, overnights, and patients who are waiting for beds to units that have well-established visitation programs. In most cases, I believe that the nurses would buy into a visitor program if adequate support systems were in place to effectively manage the program. Many units are in the process of developing family-visitation programs and are looking for support and guidance on how to develop programs. In most cases and certainly in my own experience, nurses are initially uncomfortable with family visitation for various reasons. It is a change in practice, and it is sometimes difficult to work out the logistics of a successful program. Although