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What’s New in the Patient Safety World

August 2022

Visitors – Good or Bad?



Restrictions on visiting patients may be due to legitimate reasons (eg. a COVID-19 outbreak or other contagious disease outbreak). But often we end up restricting visitors for reasons that are inappropriate or even selfish. We often just don’t want to be interrupted by questions from visitors. We’ve even seen physicians who round early in the morning to avoid having to speak with relatives or other patient visitors!


But visitors can also be helpful. They can assist the hospital staff with things like feeding patients. We often recommend that relatives or close friends sit in the room with patients who have delirium. And they can often serve to ensure that a patient understands instructions when the patient might be otherwise distracted or cognitively impaired.


So, are visitors good or bad? Researchers at the Pennsylvania Patient Safety Authority actually looked at this. Sanchez et al. culled information from patient safety reports from 92 hospitals in Pennsylvania (Sanchez 2022). Not surprisingly, they found visitor behavior might have good or bad influence on patient risks.


They found evidence of helpful visitor behavior. For example, visitors often helped reposition patients, helped them ambulate, helped them gain balance, and even escorted patients within the hospital in some cases. They identified instances where visitor behaviors prevented events such as falls, administration of incorrect medication, or allergic reactions from occurring.


But some other behaviors might be good or bad. For example, they might give a patient something potentially harmful or they might take such an item away from a patient. Or they might alert staff to a potential safety situation or they might distract staff from other responsibilities.


And some behaviors may always be detrimental, such as powering on or off devices or equipment, disconnecting equipment, or changing placement of equipment. The equipment or devices most frequently manipulated by visitors were bed or chair alarms and intravenous (IV) catheters.


Some specific detrimental actions they found included:


Of course, the classic detrimental action by a visitor is manipulating a PCA (patient-controlled analgesia) pump (see our many columns on PCA safety listed below).


Sanchez et al. suggest some potential safety strategies targeting visitor behaviors:


They note that development and display of warning and instructional signs require minimal effort and could be designed to impact numerous behaviors and event types. The article has a nice table with design recommendations for effective signage.


Overall, this is an excellent contribution to a topic we don’t pay enough attention to.



Other Patient Safety Tips of the Week pertaining PCA safety:







Sanchez CE, Taylor MA, Jones R. Visitor Behaviors Can Influence the Risk of Patient Harm: An Analysis of Patient Safety Reports From 92 Hospitals. Patient Safety 2022; 4(2): 70-79






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