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Canadian Journal of Anesthesia/Journal canadien d'anesthésie

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Open Access 17-08-2022 | Care | Reports of Original Investigations

Impact of restricted visitation policies during COVID-19 on critically ill adults, their families, critical care clinicians, and decision-makers: a qualitative interview study

Authors: Kirsten M. Fiest, PhD, Karla D. Krewulak, PhD, Natalia Jaworska, MD, Krista L. Spence, RN, MN, Sara J. Mizen, MA, Sean M. Bagshaw, MD, MSc, Karen E. A. Burns, MD, Deborah J. Cook, MD, Robert A. Fowler, MD, Kendiss Olafson, MD, Scott B. Patten, MD, PhD, Oleksa G. Rewa, MD, MSc, Bram Rochwerg, MD, Sean Spence, MD, Andrew West, EdD, Henry T. Stelfox, MD, PhD, Jeanna Parsons Leigh, PhD, for the Canadian Critical Care Trials Group

Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Issue 10/2022

Abstract

Purpose

During the first wave of the COVID-19 pandemic, restricted visitation policies were enacted at acute care facilities to reduce the spread of COVID-19 and conserve personal protective equipment. In this study, we aimed to describe the impact of restricted visitation policies on critically ill patients, families, critical care clinicians, and decision-makers; highlight the challenges faced in translating these policies into practice; and delineate strategies to mitigate their effects.

Method

A qualitative description design was used. We conducted semistructured interviews with critically ill adult patients and their family members, critical care clinicians, and decision-makers (i.e., policy makers or enforcers) affected by restricted visitation policies. We transcribed semistructured interviews verbatim and analyzed the transcripts using inductive thematic analysis.

Results

Three patients, eight family members, 30 clinicians (13 physicians, 17 nurses from 23 Canadian intensive care units [ICUs]), and three decision-makers participated in interviews. Thematic analysis was used to identify five themes: 1) acceptance of restricted visitation (e.g., accepting with concerns); 2) impact of restricted visitation (e.g., ethical challenges, moral distress, patients dying alone, intensified workload); 3) trust in the healthcare system during the pandemic (e.g., mistrust of clinical team); 4) modes of communication (e.g., communication using virtual platforms); and 5) impact of policy implementation on clinical practice (e.g., frequent changes and inconsistent implementation).

Conclusions

Restricted visitation policies across ICUs during the COVID-19 pandemic negatively affected critically ill patients and their families, critical care clinicians, and decision-makers.

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Title: Impact of restricted visitation policies during COVID-19 on critically ill adults, their families, critical care clinicians, and decision-makers: a qualitative interview study
Authors: Kirsten M. Fiest, PhD
Karla D. Krewulak, PhD
Natalia Jaworska, MD
Krista L. Spence, RN, MN
Sara J. Mizen, MA
Sean M. Bagshaw, MD, MSc
Karen E. A. Burns, MD
Deborah J. Cook, MD
Robert A. Fowler, MD
Kendiss Olafson, MD
Scott B. Patten, MD, PhD
Oleksa G. Rewa, MD, MSc
Bram Rochwerg, MD
Sean Spence, MD
Andrew West, EdD
Henry T. Stelfox, MD, PhD
Jeanna Parsons Leigh, PhD
for the Canadian Critical Care Trials Group
Publication date: 17-08-2022
Publisher: Springer International Publishing
Keywords: Care
COVID-19
Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Issue 10/2022
Print ISSN: 0832-610X
Electronic ISSN: 1496-8975
DOI: https://doi.org/10.1007/s12630-022-02301-5

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Impact of restricted visitation policies during COVID-19 on critically ill adults, their families, critical care clinicians, and decision-makers: a qualitative interview study

Abstract

Purpose

Method

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Method

Results

Conclusions

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