Open-Door ICU Model and Humanized Care: A Systematic Review

Area of Science:

• Critical Care Medicine
• Patient Experience
• Healthcare Management

Background:

• Traditional closed-door intensive care units (ICUs) can negatively impact patients through limited visitation and depersonalization.
• Altered circadian rhythms and psychological distress are common in high-technology ICU environments.
• A growing trend emphasizes social and psychological support, leading to the adoption of open-door ICU models.

Purpose of the Study:

• To evaluate the impact of humanized care, including social and psychological support, on patient outcomes within open-door ICUs.
• To explore how the open-door ICU concept facilitates improved patient well-being.
• To assess the effectiveness of humanized care strategies in critical care settings.

Main Methods:

• A systematic review adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines.
• Comprehensive literature search across six databases (LILACS, SciELO, PubMed, Scopus, ScienceDirect, Dialnet) using MeSH and DeCS terms.
• Analysis of 50 selected studies published between 2018-2025 using qualitative coding techniques (open, axial, selective).

Main Results:

• Three emergent categories: Patient and Family Perceptions of ICU Care, flexible visitation and technological mediation, and humanization-centered care.
• Humanized care elements correlated with improved emotional well-being and reduced patient anxiety.
• Enhanced communication and increased trust between families and healthcare professionals were observed.

Conclusions:

• Humanized care practices are crucial for improving patient outcomes in open-door ICUs.
• Flexible visitation, emotional/spiritual support, respectful communication, and family involvement are key components of compassionate, patient-centered care.
• Recommendations include developing institutional policies that actively support humanization for both patients and their families.