The relationship between secondary traumatic stress and burnout in critical care nurses: The mediating effect of resilience

PurposeTo examine the mediating factor on the association of secondary traumatic stress and burnout among critical care nurses.DesignA correlational study.MethodsData were collected from a convenience sampling of 147 nurses from two general hospitals who had six or more months of experience working in an intensive care unit. The collected data were analyzed through t-test, ANOVA, Scheffé test, Mann-Whitney test, Kruskal-Wallis test, Bonferroni correction, and Pearson’s correlation coefficient using SPSS 25.0. The mediating effect of resilience was analyzed through the three-stage mediation effect test procedure using hierarchical regression analysis and the Sobel test.ResultsSecondary traumatic stress had a statistically significant positive correlation with burnout (r = 0.45, p <.001), and a statistically significant negative correlation between burnout and resilience (r = −0.54, p <.001) was observed. Secondary traumatic stress was found to have a statistically significant effect on resilience, which was the mediating variable (β = −0.17, p =.042). Additionally, secondary traumatic stress had a statistically significant effect on burnout (β = 0.45, p <.001). The significance of the mediating effect of resilience on the relationship between secondary traumatic stress and burnout was investigated using the Sobel test, and the mediating effect of resilience was found to be statistically significant (Z = 1.98, p =.048).ConclusionResilience was found to have a partial mediating effect in the relationship between critical care nurses’ secondary traumatic stress and burnout. The study thus provides basic data on the importance of resilience in preventing burnout from secondary traumatic stress.     

Mediating and/or moderating roles of psychological empowerment

PurposeThe purpose of this study was to explore the mediating and/or moderating effects of psychological empowerment in the relationship between structural empowerment and burnout among nurses in China.BackgroundBurnout is prevalent among nurses. Previous studies have found that empowering organizational structures contribute to reduce nurses’ burnout. However, little is known about the mediating or moderating role of psychological empowerment in the relationship between structural empowerment and burnout among nurses in China.MethodsA cross-sectional design was conducted. A total of 244 nurses participated in this study. The data were collected in March 2013. Multiple regressions were used to test the hypothesized models.ResultsPsychological empowerment was found to be a significant mediator of the relationship between structural empowerment and burnout (standardized β = − 0.553, Sobel test: z = 7.79, p < 0.001). The moderating effect of psychological empowerment in that relationship was not verified.ConclusionBoth structural and psychological empowerment negatively correlated with burnout. The psychological empowerment had a mediating effect on burnout.Implications for nursing managementIt is important for nurse managers to develop strategies to ensure that empowering structures are in place and to facilitate nurses’ perception of psychological empowerment.     

Evaluation of compassion fatigue and compassion satisfaction among emergency nurses in Jordan: A cross-sectional study

BackgroundNurses working in emergency departments are overworked and exposed to frequent stressors over time, leading to compassion fatigue, burnout, and secondary traumatic stress.AimsThis study aimed to assess the levels of compassion fatigue and compassion satisfaction, and examine the relationship of these two variables with specific demographic, health-related, and work-related factors among emergency nurses in Jordan.MethodsThis is a cross-sectional study. The Professional Quality of Life Scale Version 5 was used to collect data.ResultsA convenience sampling method was used to recruit 203 registered nurses from emergency departments in Jordan. The mean compassion fatigue and satisfaction scores were moderate. There was a significant but negligible correlation between compassion satisfaction and educational levels (r = 0.15, p < 0.05) and between secondary traumatic stress and comorbid diseases (r = −0.16, p < 0.05).ConclusionsAlthough the levels of compassion fatigue and satisfaction were moderate, both may negatively affect nurses’ care and patient outcomes. Conversely, compassion satisfaction should be improved in order to overcome the negative effects of compassion fatigue.     

Critical care staff wellbeing: A new paradigm for understanding burnout

BackgroundThe wellbeing of paediatric intensive care unit (PICU) staff members influences their engagement with work and the quality of care they provide to patients. Baseline burnout measures in research provide inconclusive evidence of the determinants of burnout and how to target interventions to promote staff wellbeing.ObjectivesThe objectives of this study were to determine the prevalence of burnout using the Maslach Burnout Inventory (MBI) burnout-engagement workplace profiles in a sample of Australian PICU staff and investigate associations between demographic characteristics, meaningful work, satisfaction with life, and psychological distress on burnout.MethodsA cross-sectional survey was administered to a multidisciplinary sample of PICU staff (target n = 464) from three tertiary paediatric hospitals in Australia. The survey tool was comprised of the MBI, Work and Meaning Inventory, Satisfaction with Life Scale, Kessler Psychological Distress Scale, and demographic questions. Hierarchical multiple regressions examined the relationships between burnout and these variables of interest.ResultsA sample of 258 participants (56%) completed the survey. For most respondents, burnout was scored as a low to moderate risk, with over half the participants scoring low risk for emotional exhaustion (EE) (56%) and depersonalisation (DP) (54%). Personal accomplishment (PA) was more evenly distributed (range of burnout risk: low, 32%; moderate, 32%; high, 36%). MBI scores were classified using the burnout-engaged workplace profile system, identifying low levels of burnout (8% burnout, 3% disengaged, 21% overextended, 29% ineffective, and 39% engaged). Psychological distress significantly increased burnout risk across all three dimensions EE (β = 0.253, p < 0.001), DP (β = 0.145, p < 0.05), and PA (β = ?0.13, p < 0.05), and being aged between 41 and 55 years was protective of depersonalisation (β = ?0.214, p < 0.05).ConclusionUtilising MBI workplace profiles, this study has built upon the demand for a more comprehensive assessment of burnout. Research that helps improve our understanding of contributory factors to burnout and wellbeing will inform the development of effective interventions that promote wellbeing of staff.     

Caring Advanced Cancer Patients at Home During COVID-19 Outbreak: Burnout and Psychological Morbidity Among Palliative Care Professionals in Italy

ContextProviding palliative care (PC) at home for patients with advanced cancer has become essential during the COVID-19 emergency. Nevertheless, the home PC professionals (PCPs) faced a challenging situation because of increased number of discharged patients, reduced availability of health-care facilities, and physical/relational barriers between them and patients.ObjectivesThis study aimed to investigate the impact of COVID-19 pandemic on burnout and psychological morbidity among home PCPs in Italy.MethodsOne hundred and ninety-eight PC physicians and nurses working in home assistance in Italy were invited to participate. The results obtained by the investigation conducted during the COVID-19 emergency (COVID2020) were compared with data collected in 2016 in the same setting (BURNOUT2016). The questionnaires (socio-demographics, Maslach Burnout Inventory and General Health Questionnaire-12) were the same for both the surveys. The PCPs participating in COVID2020 survey (n = 145) were mostly the same (70%) who participated in the BURNOUT2016 study (n = 179).ResultsOne hundred and forty-five PCPs participated in the study (response rate 73.2%). During the COVID-19 emergency, home PCPs presented a lower burnout frequency (P < .001) and higher level of personal accomplishment than in 2016 (P = .047). Conversely, the risk for psychological morbidity was significantly higher during the pandemic (P < .001).ConclusionsIn the age of COVID-19, the awareness of being at the forefront of containing the pandemic along with the sense of responsibility toward their high-risk patients may arouse PCPs' psychological distress, but, on the other hand, this condition may improve their sense of professional satisfaction and personal accomplishment.     

Improvement of quality of life and postural balance of institutionalized elderly people undergoing to a treadmill walking training

IntroductionInstitutionalized older adults have fewer opportunities to participate in daily living activities and tasks in an independent manner, with greater deleterious effects on the physiological losses inherent to aging and with increased gait and balance impairment compared to community-dwelling older adults. The use of a treadmill for rehabilitation, with or without partial weight support, has been studied in different groups, but not on institutionalized older adults.ObjectivesTo assess the effects of a treadmill walking program on the postural balance and quality of life of institutionalized older adults.MethodsThirty-seven institutionalized older adults: intervention group (n = 23, 75.7 ± 7.8 years) and control group (n = 14, 78.9 ± 10.2 years). A total of 10 weeks of treadmill walking, twice a week (intervention group) vs. no training (control group). Postural balance was assessed by the Tinetti test, 6-min walk test (6MWT), and 10-m walk test and Quality of life with the WHOQOL-Bref questionnaire.ResultsSignificant improvement was observed in balance parameters (6MWT distance: p < 0.001; gait speed 6MWT: p < 0.001; gait speed 10MWT: p < 0.001; Tinetti scale: p = 0.001), and in the physical (p = 0.01), psychological (p = 0.002), self-assessed quality of life (p = 0.01) and overall quality of life domains (p = 0.002).ConclusionsTreadmill walking program had positive effects on the postural balance and quality of life of institutionalized older adults.     

Burnout and job satisfaction of intensive care personnel and the relationship with personality and religious traits: An observational,multicenter, cross-sectional study

ObjectivesTo investigate if burnout in the Intensive Care Unit (ICU) is influenced by aspects of personality, religiosity and job satisfaction.Research methodologyCross-sectional study, designed to assess burnout in the ICU and to investigate possible determinants. Three different questionnaires were used: the Malach Burnout Inventory, the Eysenck Personality Questionnaire and the Spiritual/Religious Attitudes Questionnaire. Predicting factors for high burnout were identified by multivariate logistic regression analysis.Setting/ParticipantsThis national study was addressed to physicians and nurses working full-time in 18 Greek ICU departments from June to December 2015.ResultsThe participation rate was 67.9% (n = 149) and 65% (n = 320) for ICU physicians and nurses, respectively). High job satisfaction was recorded in both doctors (80.8%) and nurses (63.4%). Burnout was observed in 32.8% of the study participants, higher in nurses compared to doctors (p < 0.001). Multivariate analysis revealed that neuroticism was a positive and extraversion a negative predictor of exhaustion (OR 5.1, 95%CI 2.7–9.7, p < 0.001 and OR 0.49, 95%CI 0.28–0.87, p = 0.014, respectively). Moreover, three other factors were identified: Job satisfaction (OR 0.26, 95%CI 0.14–0.48, p < 0.001), satisfaction with current End-of-Life care (OR 0.41, 95%CI 0.23–0.76, p = 0.005) and isolation feelings after decisions to forego life sustaining treatments (OR 3.48, 95%CI 1.25–9.65, p = 0.017).ConclusionsPersonality traits, job satisfaction and the way End-of-Life care is practiced influence burnout in the ICU.     

Interrelationships among workload,illness severity,and function on return to work following acute respiratory distress syndrome

BackgroundInability to return to work (RTW) is common after acute respiratory distress syndrome (ARDS).ObjectivesThe aim of this study is to examine interrelationships among pre-ARDS workload, illness severity, and post-ARDS cognitive, psychological, interpersonal, and physical function with RTW at 6 and 12 months after ARDS.MethodsWe conducted a secondary analysis using the US multicentre ARDS Network Long-Term Outcomes Study. The US Occupational Information Network was used to determine pre-ARDS workload. The Mini-Mental State Examination and SF-36 were used to measure four domains of post-ARDS function. Analyses used structural equation modeling and mediation analyses.ResultsAmong 329 previously employed ARDS survivors, 6- and 12-month RTW rates were 52% and 56%, respectively. Illness severity (standardised coefficients range: ?0.51 to ?0.54, p < 0.001) had a negative effect on RTW at 6 months, whereas function at 6 months (psychological [0.42, p < 0.001], interpersonal [0.40, p < 0.001], and physical [0.43, p < 0.001]) had a positive effect. Working at 6 months (0.79 to 0.72, P < 0.001) had a positive effect on RTW at 12 months, whereas illness severity (?0.32 to ?0.33, p = 0.001) and post-ARDS function (psychological [6 months: 0.44, p < 0.001; 12 months: 0.33, p = 0.002], interpersonal [0.44, p < 0.001; 0.22, p = 0.03], and physical abilities [0.47, p < 0.001; 0.33, p = 0.007]) only had an indirect effect on RTW at 12 months mediated through work at 6 months.ConclusionsRTW at 12 months was associated with patients' illness severity; post-ARDS cognitive, psychological, interpersonal, and physical function; and working at 6 months. Among these factors, working at 6 months and function may be modifiable mediators of 12-month post-ARDS RTW. Improving ARDS survivors' RTW may include optimisation of workload after RTW, along with interventions across the healthcare spectrum to improve patients’ physical, psychological, and interpersonal function.     

Gender and occupational role differences in work-related post-traumatic stress symptoms,burnout and global functioning in emergency healthcare workers

ObjectivesTo explore gender and occupational role impact on work-related Post-Traumatic Stress Symptoms, Post-Traumatic Stress Disorder, burnout and global functioning in a sample of emergency healthcare workers.DesignA cross-sectional study.Participants/setting126 healthcare workers of the Emergency Department, including Intensive Care Unit, Emergency Room and Emergency Medicine, of a major University Hospital in central Italy were recruited.Main outcome measuresParticipants were assessed by means of the: Trauma and Loss Spectrum-Self Report (TALS-SR) to explore Post-Traumatic Stress Spectrum Symptoms, Professional Quality of Life (ProQOL) Scale to assess Compassion Satisfaction, Burnout and Compassion Fatigue and Work and Social Adjustment Scale (WSAS) to measure global functioning.ResultsThe present findings showed females were more prone to develop Post-Traumatic Stress Symptoms, particularly re-experiencing (p = .010) and hyperarousal (p = .026) symptoms and medical doctors reporting higher Burnout (p < .001) and lower Compassion Satisfaction (p = .009) mean scores than nurses. Higher levels of functioning impairment emerged amongst medical doctors rather than nurses, in both social (p = .029) and private (p = .020) leisure activities. Linear correlations highlighted relationships between the TALS-SR, ProQOL and WSAS scores. Finally, medical doctor status was significantly associated with lower Compassion Satisfaction (p = .029) and higher Burnout (p = .015).ConclusionOur results highlight high post-traumatic stress symptoms and burnout levels in emergency healthcare workers with a relevant impact of female gender and occupational role, supporting the need for preventive strategies, also in light of the current COVID-19 pandemic.     

Personal determinants of nurses' burnout in end of life care

PurposeOur aim is to identify socio-demographic, professional exposure to dying, training degree and personal factors relevant to burnout dimensions in nurses coping with death issues.MethodA sample of 360 nurses (response rate 70.6%) from internal medicine, oncology, haematology and palliative care departments of five health institutions answered to a socio-demographic and professional questionnaire, Maslach Burnout Inventory, Death Attitude Profile Scale, Purpose in Life Test and Adult Attachment Scale.ResultsNo significant differences were found between medical departments in burnout scores except when comparing those with palliative care department which showed significant lesser levels of emotional exhaustion (t = 2.71; p < .008) and depersonalization (t = 3.07; p < .003) and higher levels of personal accomplishment (t = −2.24; p < .027).By multiple regression analysis exhaustion and depersonalization are negative, sequentially determined respectively by purpose in life, dependent attachment, fear of death attitude and by purpose in life, dependent attachment, years of professional experience and personal accomplishment by positive purpose on life and secure attachment.ConclusionWe conclude for the protective value of factors such as meaning and purpose in life, secure attachment and attitude towards death, through the various burnout dimensions that shows the need to develop under and postgraduate training strategies in these specific areas.     

Cardiorespiratory and metabolic demand of the 6-minute pegboard and ring test in healthy young adults

ObjectiveTo determine the cardiorespiratory and metabolic demand of the Six-Minute Pegboard and Ring Test (6PBRT) in healthy young adults and its association with maximal arm cycle ergometer test (arm CET).MethodsVolunteers were randomized to performed the 6PBRT test or arm CET. The second test was performed after 48 h. Oxygen consumption (VO₂), heart rate (HR), dyspnea and upper limb fatigue were assessed during the tests. Demographic data, body composition, level of physical activity, arm strength and endurance were also evaluated.ResultsDuring 6PBRT, VO₂ values increased from 5.8 to 11.1 mL kg⁻¹.min⁻¹ (p < 0.001). VO_2peak, HR _Mean and HR_max at 6PBRT were 47.2% and close to 65% respectively of those achieved during the arm CET. There was a positive correlation between the score on 6PBRT and VO_2mean and VO_2peak achieved at arm CET (r = 0.268; p = 0.003 and r = 0.247; p = 0.046 respectively). No correlation was found between the HR_mean, HR_peak, level of physical activity or strength with 6PBRT (p > 0.05). Handgrip endurance had a positive correlation with score on 6PBRT (r = 0.237; p = 0.054). Body Mass Index, body fat and fat mass were negatively correlated with the score on 6PBRT (r = 0.301; p = 0.014, 0.329; p = 0.007 and r = 0.427; p = 0.001).ConclusionsThe 6PBRT test showed a moderate cardiorespiratory and metabolic demand in healthy individuals in comparison of arm CET. BMI, body fat and fat mass correlated with the score on 6PBRT.     

Are intensive care units good places for nursing students’ learning compared to other settings? Findings from an Italian national study

ObjectiveTo explore students’ perceived quality of the intensive care unit learning environment during their rotations; to compare these perceptions with that reported by students attending other settings and to assess correlations between the perceptions regarding the quality of the environment and the competences learned.Research methodologyA secondary analysis of data collected by a national cross-sectional study carried out in Italy. A total of 9607 nursing students participated; they ranked the intensive care units’ quality, as assessed by the Clinical Learning Quality Evaluation Index; the perceived competences learned were also ranked with a Likert scale; from 0 = None to 3 = Very much.ResultsA total of 323 (3.5%) participants attended their rotation in an intensive care unit. They perceived the quality of the environment to be significantly higher (n = 2.11 out of 3) than those rotating in non-intensive care unit wards (n = 1.91; p < 0.001). The competences learned by intensive care unit students were significantly higher than that reported by students attending non-intensive care unit wards (n = 2.31 out of 3 vs 2.06 out of 3; p < 0.001).ConclusionIntensive care units are highly appreciated by students, both in terms of their quality learning environment and their capacity to promote learning compared to other settings. Therefore, intensive care units should be considered as a place for clinical rotation to promote positive attitudes regarding critical care patients.     

An evaluation of the use of an iPad for hospital orientation in a regional hospital

ProblemPatient orientation is a crucial point of information exchange, designed to support and enhance patient safety, comfort, and understanding during their hospital stay. Currently, most hospital patients receive face-to-face orientation with a nurse. The quality and content of orientation information can be affected by the nurse’s emotional state, job satisfaction, knowledge, and authenticity for the information conveyed, which can have a positive or negative impact on the patient.AimFocusing on key hospital policies and protocols, in a regional New South Wales hospital and compared to routine ward orientation, the objective was to assess the efficacy of digital video orientation.MethodsA two-group design was conducted utilising quantitative and qualitative approaches and drew on self-report, focusing on overall Understanding and Emotional Comfort. Participants (n = 35) were selected and randomly allocated into a digital orientation or face-to-face orientation group.FindingsEmotional Comfort scores for both groups were found to be similar (p < 0.05 level, t(33) = 0.27, p = 0.09), while the digital orientation group was found to have significantly higher understanding of key hospital policy (t(33) = −3.98, p < 0.001). Additionally, there was a negative correlation (r = −0.45, p = 0.006) between age and self-reported understanding, revealing that the lower age groups had scored higher.DiscussionThis research has demonstrated that key concepts can be effectively communicated using a digital format.ConclusionIt is recommended that this method of orientation be implemented and its efficacy continues to be evaluated.     

Effects of Kangaroo Care on body temperature of premature infants and maternal satisfaction at Maharaj Nakhon Si Thammarat hospital,Thailand

ObjectiveThis quasi-experimental study aimed to examine the effects of Kangaroo Care (KC) on infant temperature and maternal satisfaction.MethodsPurposive sampling was used to select mothers and premature infants into either the KC group (n = 32) or the control group (n = 32). The researchers applied KC to mothers and infants 1 h a day for three consecutive days. The control group received no intervention except for usual care. The infants' temperature was measured before, immediately after KC, and 30 and 60 min. Mothers’ satisfaction in both groups was collected after the experiment on day 3.ResultsThe overall average infant temperature in the KC group on days 1 through 3 was significantly different (p < 0.001), with a change in the average temperature between the four-time points. The average temperature measured at three-time points after KC was significantly higher than those of the control group on days 1–3 (p < 0.01). The mean maternal satisfaction score in the KC group was significantly higher than that of the control group (p < 0.001).     

The Implementation of a Cultural Change Toolkit to Reduce Nursing Burnout and Mitigate Nurse Turnover in the Emergency Department

ProblemNursing burnout and high levels of nursing turnover contribute to negative work environments, diminished patient care, and increased health care costs. There is a gap in literature regarding cost-effective, easily implemented interventions to address burnout and turnover. The purpose of this project was to determine if the implementation of evidence-based interventions would improve the perception of the practice environment, decrease the levels of nursing burnout, and decrease the voluntary nurse turnover rate in the emergency department.MethodsThe Cultural Change Toolkit was developed based on current recommendations in literature and implemented within an emergency department in southeast Texas. The toolkit included specific interventions related to meaningful recognition, shared decision making, and increased leadership involvement and support. Nursing burnout and anticipated turnover were measured using the Anticipated Turnover Scale and the Oldenburg Burnout Inventory both before and after implementation of the project. Participants (n = 30) included nursing staff employed in the emergency department.ResultsThere was a reduction in both the anticipated turnover (mean anticipated turnover score, preimplementattion = 3.133, postimplementation = 2.989) and burnout scores among nursing staff (mean burnout score, preimplementation = 4.808, postimplementation = 4.463). The reduction in overall burnout scores were statistically significant following a paired t-test analysis (P = 0.004). There were no resignations among nursing staff throughout the project period.DiscussionNursing burnout and turnover are frequently discussed topics. The results support the use of cost-effective interventions outlined in the Cultural Change Toolkit to address nursing turnover and burnout.     

Person-centred care among intensive care unit nurses: A cross-sectional study

ObjectivePractising person-centred care is crucial for nurses in the intensive care unit, as patients have high physical and psychological care needs. We aimed to identify the predictors of person-centred care among nurses working in intensive care settings.MethodsIn this cross-sectional study, 188 intensive care unit nurses at four tertiary hospitals in two cities of South Korea were included. They completed self-reported questionnaires on emotional intelligence, compassion satisfaction, secondary traumatic stress, burnout, and person-centred care. Emotional intelligence was measured using the Korean version of the Wong and Law’s emotional intelligence scale. Compassion satisfaction, secondary traumatic stress, and burnout were measured by the Professional Quality of Life questionnaire (version 5). Person-centred care was measured using the person-centred critical care nursing scale.ResultsMultiple regression identified compassion satisfaction (β = 0.49, p <.001) as the most powerful predictor of person-centred care, followed by emotional intelligence (β = 0.21, p =.004) and intensive care unit career length (β = 0.17, p =.021). These three variables accounted for 31.0 % of the variance in person-centred care.ConclusionsThis study highlights the importance of career length, emotional intelligence, and compassion satisfaction in the promotion of person-centred care among intensive care unit nurses. Nursing management should contemplate specific measures to reduce turnover among experienced intensive care unit nurses and to enhance the factors that promote person-centred care, such as compassion satisfaction and emotional intelligence.     

Treatment of infant colic with craniosacral therapy. A randomized controlled trial

ObjectiveTo evaluate the number of craniosacral therapy sessions that can be helpful to obtain a resolution of the symptoms of infantile colic and to observe if there are any differences in the evolution obtained by the groups that received a different number of Craniosacral Therapy sessions at 24 days of treatment, compared with the control group which did not received any treatment.MethodsFifty-eight infants with colic were randomized into two groups of which 29 babies in the control group received no treatment and those in the experimental group received 1–3 sessions of craniosacral therapy (CST) until symptoms were resolved. Evaluations were performed until day 24 of the study. In this study crying hours served as primary outcome. The secondary outcome were the hours of sleep and the severity, measured by an Infantile Colic Severity Questionnaire (ICSQ).ResultsSignificant statistical differences were observed in favor of experimental group compared to the control group on day 24 in crying hours (mean difference = 2.94, at 95 %CI = 2.30–3.58; p < 0.001) primary outcome, and also in hours of sleep (mean difference = 2.80; at 95 %CI = − 3.85 to − 1.73; p < 0.001) and colic severity (mean difference = 17.24; at 95 %CI = 14.42–20.05; p < 0.001) secondary outcomes.Also, the differences between the groups ≤ 2 CST sessions (n = 19), 3 CST sessions (n = 10) and control (n = 25) were statistically significant on day 24 of the treatment for crying, sleep and colic severity outcomes (p < 0.001).ConclusionBabies with infantile colic may obtain a complete resolution of symptoms on day 24 by receiving 2 or 3 CST sessions compared to the control group, which did not receive any treatment.     

Staff perceptions of family access and visitation policies in Australian and New Zealand intensive care units: The WELCOME-ICU survey

BackgroundFamily-centred critical care recognises the impact of a loved one's critical illness on his relatives. Open visiting is a strategy to improve family satisfaction and psychological outcomes by permitting unrestricted or less restricted access to visit their family member in the intensive care unit (ICU). However, increased family presence may result in increased workload and a risk of burnout for ICU staff.ObjectivesThe objective of this study was to evaluate ICU staff perceptions regarding visiting hours and family access in Australian and New Zealand ICUs. Secondary outcomes included an evaluation of current visiting policies, witnessed events in ICUs, and barriers to implementing open visiting policies.DesignA web-based survey open to all healthcare workers in Australia and New Zealand ICUs was distributed through local, state-based, and national critical care networks. Open visiting was defined as ICUs open for visiting >14 h per day.Main resultsWe received 1255 valid responses. Most respondents were nurses (n = 930, 74.1%) with a median critical care experience of 10 y. Most worked in open visiting ICUs (n = 749, 59.7%). Reported visiting hours varied greatly with a median of 20 h per day (interquartile range: 10–24 h). Open visiting was perceived as beneficial for the relatives, but less so for patients and staff (relatives: n = 845, 67.3%, patients: n = 561, 44.7%, staff: n = 257, 20.5%, p < 0.0001). Respondents from closed visiting units and nurses identified more risks from open visiting than other professional groups. Generally, staff preferred not to change from their current practice.ConclusionWe report that staff perceived open visiting as beneficial for relatives, but also identified risks to themselves, including increased workload, a risk of burnout, and a risk of occupational violence. Reluctance to change highlights the importance of addressing staff perceptions when implementing an open visiting policy.