Beliefs That Dictate Evidence: Open Visitation in the ICU (Again)

The cart belongs behind the horse.

I recently blogged on idealogues who haven't any interest in the truth, rather their interest is in defending their beliefs.  For these true believers, evidence is sought selectively and strength of belief is not apportioned to strength of evidence.  Beliefs reign supreme, and evidence serves the beliefs.  The cart leads the horse.

And so let it be with open visitation in the ICU.  I'm interested in this because it is an issue of practical concern for me, and my interest was recently piqued because in nursing school, my wife was taught that open visitation is better for everyone and that ample evidence supported this contention.  Today, I came across a tweet about ICU visitation policies, a statement from the American Association of Critical Care Nurses.  So I decided to investigate a bit further the evidence upon which their policy proposals are predicated.

The very first statement in the "Supporting Evidence" section of this document is "In practice, 78% of ICU nurses in adult critical care units prefer unrestricted policies."  This statement is at odds with my personal experience working with ICU nurses for the better part of the past 20 years.  While they are patient and family advocates generally, they also recognize that the exigencies of the ICU environment require some limitation of visitation, and so does their own psychological well-being.  So I began by investigating references 7-13 which are proffered in support of this statement which for some (many?) lacks face validity.  Here are those seven references, a description, and a synopsis taken from the abstract of each: