ABSTRACT
Purpose: To explore and describe the impact of COVID-19 restrictive visitation policies on healthcare providers (HCPs) and to identify ongoing challenges and pragmatic solutions that could inform recommendations for patient- and family-centred care (PFCC) in the ICU during pandemic conditions. Methods: We conducted a qualitative descriptive study within a constructivist paradigm. We used two sources of data collected simultaneously: semi-structured interviews conducted remotely via video or phone and written comments gathered through open-ended response boxes in a questionnaire to explore the perspectives of HCPs working in Canadian ICUs during visitor restrictions resulting from the first wave of COVID-19. Between June-September 2020, eligible participants were invited through email or Twitter by their professional societies: The Canadian Critical Care Society, the Canadian Association of Critical Care Nurses, and the Canadian Society of Respiratory Therapists. Interview transcripts were analyzed inductively to create a thematic framework, and written comments were analyzed using deductive content analysis to support a richer description. Findings: Healthcare providers’ descriptions of COVID-19 visitor restrictions in ICU revealed five main themes: 1) Impacting Healthcare Providers, 2) Communicating and Connecting, 3) Perceiving the Impact on Families and Patients, 4) Proposing Solutions with Caveats, and 5) Considering End-of-Life. Discussion: If restrictive visitation policies are justified in the interest of infection prevention and control, healthcare leadership must consider the impact on HCPs, and strategies for mitigating the associated harms, and identify important considerations for PFCC in the context of COVID-19 visitor restrictions. Specifically, there is a need for enhanced communication with patients and families, and between administrators, management, and the healthcare team.