Providence St. Patrick Hospital Visitor Policy Update

Providence St. Patrick Hospital Visitor Policy

Visitors can have a positive impact on patients and family members. However, patient care is our primary directive. Visitor guidelines are based on the patient and family needs taking into consideration family culture and the patient/family response to illness.

Full and equal visitation for all visitors is available based on a patient's or his/her support person's designation consistent with the patient's preferences. Patients have the right to be informed of their visitation rights to include identifying any clinically necessary or reasonable restriction or limitation the ministry may need to place on such rights and the reasons for the clinical restriction or limitation.

Visitation rights may be limited at any time. Visitors are not restricted, limited, or denied visitation privileges based on age, race, color, creed, ethnicity, religion, national origin, marital status, sex, sexual orientation, gender identity or expression, disability or veteran or military status. Whenever possible, patients are notified of their visitation rights before care is provided.

Regular visiting hours range from 8 a.m. to 9 p.m., are flexible, and may vary based on patient care needs. Specific visiting guidelines are established for specialty areas, e.g., emergency, critical care, perioperative, pediatrics and psychiatry.

NOTE: Visitors that are considered "high risk" (e.g., sexual offender, history of domestic violence, person making threats against safety of patient, physician or staff, etc.) are assessed and an appropriate visitation plan developed that outlines requirements for visitations and/or restrictions, which may include no visitation/access to Providence St Patrick Hospital if indicated by the circumstances.

Visitor Restrictions

In the interest of patient safety, the Nurse may be in the best position to determine whether any restriction is clinically necessary and may document any restrictions on the care plan. Examples when visitation restrictions may be appropriate include, but are not limited to:

• Court order limiting/restraining contact;
• Behavior presenting a direct risk or threat to the patient, hospital staff, or others in the immediate environment;
• Behavior disruptive of the functioning of the patient care unit;
• Reasonable limitations on the number of visitors at any one time;
• Patient's risk of infection by the visitor;
• Visitor's risk of infection by the patient;
• Extraordinary protections because of a pandemic or infectious disease or outbreak;
• Substance abuse treatment protocols requiring restricted visitation;
• Patient's need for privacy or rest;
• Need for privacy or rest by another individual in a patient's shared room.
• For patients, family members, or friends demonstrating behaviors that cannot be managed safely within the ministry, Security may be called, as appropriate, to assist in dealing with the behaviors. As a result of this intervention, family or friends may be escorted out per security policy.

After-hours visitation

After-hours visitation is the period between 9 p.m. and 8 a.m. During these hours, access to patient care areas is limited. Visitors after hours enter through the Emergency entrance.

Patient in Transmission-Based Precautions

• End-of-life:
  • 4 visitors will be allowed to visit at one time. Remaining family members are asked to wait in the cafeteria or outside of the hospital until it is their turn.
  • There is no age requirement for end-of-life visitors, although minors will be counted as a visitor and must be accompanied by an adult. 
• Not end-of-life: 2 visitors will be allowed to visit at one time. Remaining family members are asked to wait in the cafeteria or outside of the hospital until it is their turn.
• Visitors will be required to wear appropriate PPE while in the patient’s room.

Visitors 17 & under (i.e., minor):

• In most cases, minors are discouraged to stay overnight even when other adults are present.
• An exception may be made if death is believed to be imminent.
• Minors can't stay overnight unless an adult other than the patient is present.
• If a female patient is admitted and wants a newborn to stay, there must be another responsible adult staying at all times to provide care for the child.

Minor patient visitor guidelines:

• A legal parent/guardian is authorized to identify visitors on behalf of a minor child;
• A person recognized as a "legal parent/guardian" in one state remains able to designate visitors on behalf of a minor child should they travel to another state that may not recognize the relationship;

Whether a non-biological or non-adoptive parent is recognized as such is governed by Montana State law. State law determines whether designation of visitors on behalf of a minor child is permissible.

Overnight Visitation Guidelines – Adult Patient Units:

Primary determination for overnight visitation should first be at the patient's request if the patient is capable of providing input into that request. Some of the common situations that warrant overnight visitation are as follows:

• Patient is terminal and end-of-life care is being provided;
• Patient is in unstable/critical condition*;
• Family has a desire to be involved in patient's care, e.g., assist with communication, provide safety needs, etc. or family is encouraged by staff to stay for patient safety;
• The night following a patient’s surgery*;
• Ethnic or family culture dictates not to leave family member alone.

In instances flagged with an *: Before a family member or designated support person spends the night in the patient's room, a discussion between the unit nursing staff and the family member or designated support person about overnight stays is encouraged.

Private Room Accommodations:

• The hospital will provide one cot in the room for a family member, if available;
• The Charge Nurse may allow others to stay quietly in the room at his/her discretion;
• The hospital will encourage others to stay in waiting/day room and visit frequently, if warranted;
• The hospital will use discretion in encouraging/discouraging the number needing to stay overnight.

Semi-Private Room Accommodations:

• If one bed is not occupied, the hospital will try to avoid admission in that room if an overnight visitor is being considered; 
• If both beds are occupied, overnight visitation for either patient is not allowed;
• The hospital may accommodate family members in the day/waiting room and allow frequent visitation;
• The hospital will consider placement in a private room if this need is ongoing such as for end-of-life care, patient confusion, and safety needs.

Visitor Guidelines in Treatment Areas, e.g, Emergency, Surgical/Outpatient Services, Cardiac Cath Lab, etc.:

• To avoid compromising the care and treatment of the patient and to reasonably prevent injury to a non-medical person(s) accompanying the patient, visitation in the above-referenced treatment areas may be restricted at the discretion of the Registered Nurse or Physician.
• Pediatric patients may be visited by their parents or primary caregiver in Phase I Recovery.
• Patients who are not routine post-op wakeups or patients being held for extended periods may be allowed visitors if conditions warrant.
• Designated visitors are allowed in the Phase II Recovery area. Registration is notified when the patient reaches this area to ease visitation.
• One visitor will be allowed per patient in the Cardiac Cath Lab & Observation Unit.