Louise Rose1, Lisa Yu2, Joseph Casey2, Amelia Cook3, Victoria Metaxa4, Natalie Pattison5, Anne Marie Rafferty3, Pam Ramsay6, Sian Saha7, Andreas Xyrichis3, Joel Meyer8. 1. King's College London, 4616, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, London, United Kingdom of Great Britain and Northern Ireland; louise.rose@kcl.ac.uk. 2. King's Health Partners, 150504, London, London, United Kingdom of Great Britain and Northern Ireland. 3. King's College London, 4616, London, London, United Kingdom of Great Britain and Northern Ireland. 4. King's College Hospital, London, United Kingdom of Great Britain and Northern Ireland. 5. University of Hertfordshire, 3769, Hatfield, Hertfordshire, United Kingdom of Great Britain and Northern Ireland. 6. University of Dundee, 3042, Dundee, Dundee, United Kingdom of Great Britain and Northern Ireland. 7. King's College Hospital NHS Foundation Trust, 8948, Anaesthetics, Critical Care, Emergency Medicine and Trauma (ACET) Research Team, London, United Kingdom of Great Britain and Northern Ireland. 8. Guy's & St Thomas' NHS Foundation Trust, London, United Kingdom of Great Britain and Northern Ireland.
Abstract
RATIONALE: Restriction or prohibition of family visiting to intensive care units (ICU) during the COVID-19 pandemic poses substantial barriers to communication, and family- and patient-centred care. OBJECTIVES: Our objective was to understand how communication between families, patients and the ICU team was enabled during the pandemic. Secondary objectives were to understand strategies used to facilitate virtual visiting and associated benefits and barriers. METHODS: Multi-centre, cross-sectional, self-administered electronic survey sent (June 2020) to all 217 UK hospitals with at least one ICU. RESULTS: Survey response rate was 54%; 117/217 hospitals (182 ICUs). All hospitals imposed visiting restrictions with visits not permitted under any circumstance in 16% of hospitals (28 ICUs); 63% (112 ICUs) permitted family presence at end of life. Responsibility for communicating with families shifted with decreased bedside nurse involvement. A dedicated ICU family liaison team was established in 50% (106 ICUs) of hospitals. All but three hospitals instituted virtual visiting, although there was substantial heterogeneity in the videoconferencing platform used. Unconscious or sedated ICU patients were deemed ineligible for virtual visits in 23% of ICUs. Patients at end of life were deemed ineligible for virtual visits in 7% of ICUs. Commonly reported benefits of virtual visiting were reducing patient psychological distress (78%), improving staff morale (68%) and reorientation of delirious patients (47%). Common barriers to virtual visiting related to insufficient staff time, rapid implementation of videoconferencing technology, and challenges associated with family member ability to use videoconferencing technology or have access to a device. CONCLUSIONS: Virtual visiting and dedicated communication teams were common COVID-19 innovations addressing restrictions to family ICU visiting, and resulting in valuable benefits in terms of patient recovery and staff morale. Enhancing access and developing a more consistent approach to family virtual ICU visiting could improve quality of care, both during and outside of pandemic conditions.
RATIONALE: Restriction or prohibition of family visiting to intensive care units (ICU) during the COVID-19 pandemic poses substantial barriers to communication, and family- and patient-centred care. OBJECTIVES: Our objective was to understand how communication between families, patients and the ICU team was enabled during the pandemic. Secondary objectives were to understand strategies used to facilitate virtual visiting and associated benefits and barriers. METHODS: Multi-centre, cross-sectional, self-administered electronic survey sent (June 2020) to all 217 UK hospitals with at least one ICU. RESULTS: Survey response rate was 54%; 117/217 hospitals (182 ICUs). All hospitals imposed visiting restrictions with visits not permitted under any circumstance in 16% of hospitals (28 ICUs); 63% (112 ICUs) permitted family presence at end of life. Responsibility for communicating with families shifted with decreased bedside nurse involvement. A dedicated ICU family liaison team was established in 50% (106 ICUs) of hospitals. All but three hospitals instituted virtual visiting, although there was substantial heterogeneity in the videoconferencing platform used. Unconscious or sedated ICU patients were deemed ineligible for virtual visits in 23% of ICUs. Patients at end of life were deemed ineligible for virtual visits in 7% of ICUs. Commonly reported benefits of virtual visiting were reducing patient psychological distress (78%), improving staff morale (68%) and reorientation of delirious patients (47%). Common barriers to virtual visiting related to insufficient staff time, rapid implementation of videoconferencing technology, and challenges associated with family member ability to use videoconferencing technology or have access to a device. CONCLUSIONS: Virtual visiting and dedicated communication teams were common COVID-19 innovations addressing restrictions to family ICU visiting, and resulting in valuable benefits in terms of patient recovery and staff morale. Enhancing access and developing a more consistent approach to family virtual ICU visiting could improve quality of care, both during and outside of pandemic conditions.
Authors: João João Mendes; José Artur Paiva; Filipe Gonzalez; Paulo Mergulhão; Filipe Froes; Roberto Roncon; João Gouveia Journal: Rev Bras Ter Intensiva Date: 2022-01-24
Authors: Ralph C Villar; Abdulqadir J Nashwan; Rejo G Mathew; Ahmed S Mohamed; Sathish Munirathinam; Ahmad A Abujaber; Mahmood M Al-Jabry; Mujahed Shraim Journal: Nurs Open Date: 2021-05-05
Authors: Karla D Krewulak; Natalia Jaworska; Krista L Spence; Sara J Mizen; Shelly Kupsch; Henry T Stelfox; Jeanna Parsons Leigh; Kirsten M Fiest Journal: Ann Am Thorac Soc Date: 2022-07
Authors: Kathleen A S Thomas; Bernadine F O'Brien; Agatha T Fryday; Ellen C Robinson; Marissa J L Hales; Sofia Karipidis; Aaron Chadwick; Kimberley J Fleming; Alan P Davey-Quinn Journal: J Intensive Care Med Date: 2021-07-22 Impact factor: 3.510