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An environmental scan of visitation policies in Canadian intensive care units during the first wave of the COVID-19 pandemic.
Fiest, Kirsten M; Krewulak, Karla D; Hiploylee, Carmen; Bagshaw, Sean M; Burns, Karen E A; Cook, Deborah J; Fowler, Robert A; Kredentser, Maia S; Niven, Daniel J; Olafson, Kendiss; Parhar, Ken Kuljit S; Patten, Scott B; Fox-Robichaud, Alison E; Rewa, Oleksa G; Rochwerg, Bram; Spence, Krista L; Straus, Sharon E; Spence, Sean; West, Andrew; Stelfox, Henry T; Parsons Leigh, Jeanna.
  • Fiest KM; Department of Critical Care Medicine, Alberta Health Services & University of Calgary, Ground Floor, McCaig Tower, 3134 Hospital Drive NW, Calgary, AB, T2N 5A1, Canada. kmfiest@ucalgary.ca.
  • Krewulak KD; Department of Community Health Sciences & O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada. kmfiest@ucalgary.ca.
  • Hiploylee C; Department of Psychiatry & Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. kmfiest@ucalgary.ca.
  • Bagshaw SM; Department of Critical Care Medicine, Alberta Health Services & University of Calgary, Ground Floor, McCaig Tower, 3134 Hospital Drive NW, Calgary, AB, T2N 5A1, Canada.
  • Burns KEA; Department of Critical Care Medicine, Alberta Health Services & University of Calgary, Ground Floor, McCaig Tower, 3134 Hospital Drive NW, Calgary, AB, T2N 5A1, Canada.
  • Cook DJ; Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, AB, Canada.
  • Fowler RA; Critical Care Strategic Clinical Network, Alberta Health Services, Edmonton, AB, Canada.
  • Kredentser MS; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
  • Niven DJ; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.
  • Olafson K; Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, ON, Canada.
  • Parhar KKS; Department of Medicine, McMaster University, Hamilton, ON, Canada.
  • Patten SB; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.
  • Fox-Robichaud AE; Department of Critical Care Medicine and Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
  • Rewa OG; Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada.
  • Rochwerg B; Department of Critical Care Medicine, Alberta Health Services & University of Calgary, Ground Floor, McCaig Tower, 3134 Hospital Drive NW, Calgary, AB, T2N 5A1, Canada.
  • Spence KL; Department of Community Health Sciences & O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.
  • Straus SE; Department of Internal Medicine, University of Manitoba, Winnipeg, Canada.
  • Spence S; Department of Critical Care Medicine, Alberta Health Services & University of Calgary, Ground Floor, McCaig Tower, 3134 Hospital Drive NW, Calgary, AB, T2N 5A1, Canada.
  • West A; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
  • Stelfox HT; Department of Medicine, McMaster University, Hamilton, ON, Canada.
  • Parsons Leigh J; Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, AB, Canada.
Can J Anaesth ; 68(10): 1474-1484, 2021 10.
Article in English | MEDLINE | ID: covidwho-1392019
ABSTRACT

PURPOSE:

In response to the rapid spread of SARS-CoV-2, hospitals in Canada enacted temporary visitor restrictions to limit the spread of COVID-19 and preserve personal protective equipment supplies. This study describes the extent, variation, and fluctuation of Canadian adult intensive care unit (ICU) visitation policies before and during the first wave of the COVID-19 pandemic.

METHODS:

We conducted an environmental scan of Canadian hospital visitation policies throughout the first wave of the pandemic. We conducted a two-phased study analyzing both quantitative and qualitative data.

RESULTS:

We collected 257 documents with reference to visitation policies (preCOVID, 101 [39%]; midCOVID, 71 [28%]; and lateCOVID, 85 [33%]). Of these 257 documents, 38 (15%) were ICU-specific and 70 (27%) referenced the ICU. Most policies during the midCOVID/lateCOVID pandemic period allowed no visitors with specific exceptions (e.g., end-of-life). Framework analysis revealed five overarching themes 1) reasons for restricted visitation policies; 2) visitation policies and expectations; 3) exceptions to visitation policy; 4) patient and family-centred care; and 5) communication and transparency.

CONCLUSIONS:

During the first wave of the COVID-19 pandemic, most Canadian hospitals had public-facing visitor restriction policies with specific exception categories, most commonly for patients at end-of-life, patients requiring assistance, or COVID-19 positive patients (varying from not allowed to case-by-case). Further studies are needed to understand the consistency with which visitation policies were operationalized and how they may have impacted patient- and family-centred care.
RéSUMé OBJECTIF En réponse à la propagation rapide du SRAS-CoV-2, les hôpitaux du Canada ont adopté des restrictions temporaires pour les visites afin de limiter la propagation de la COVID-19 et de préserver les stocks d'équipements de protection individuelle. Cette étude décrit l'ampleur, les variations et fluctuations des politiques canadiennes concernant les visites aux unités de soins intensifs (USI) pour adultes avant et pendant la première vague de la pandémie de COVID-19. MéTHODE Nous avons réalisé une étude de milieu des politiques hospitalières canadiennes concernant les visites tout au long de la première vague de la pandémie. Nous avons mené une étude en deux phases analysant des données quantitatives et qualitatives. RéSULTATS Nous avons recueilli 257 documents faisant référence aux politiques de visites (pré-COVID, 101 [39 %]; mid-COVID, 71 [28 %]; et COVID-tardif, 85 [33 %]). Sur ces 257 documents, 38 (15 %) étaient spécifiques aux USI et 70 (27 %) faisaient référence aux USI. La plupart des politiques au cours de la période pandémique mid-COVID/COVID-tardif ne permettaient aucune visite sauf exception spécifique (p. ex., fin de vie). L'analyse du cadre a révélé cinq thèmes généraux 1) les raisons des restrictions des politiques de visites; 2) les politiques et attentes en matière de visites; 3) les exceptions aux politiques de visites; 4) les soins aux patients et centrés sur la famille; et 5) la communication et la transparence.

CONCLUSION:

Au cours de la première vague de la pandémie de COVID-19, la plupart des hôpitaux canadiens avaient des politiques de restriction des visites s'appliquant au public avec des catégories d'exception spécifiques, le plus souvent pour les patients en fin de vie, les patients nécessitant de l'aide ou les patients COVID-positifs (variant d'une interdiction au cas par cas). D'autres études sont nécessaires pour comprendre l'uniformité avec laquelle les politiques de visites ont été mises en œuvre et comment elles ont pu avoir une incidence sur les soins centrés sur le patient et la famille.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / COVID-19 Type of study: Observational study / Qualitative research Topics: Long Covid / Variants Limits: Adult / Humans Country/Region as subject: North America Language: English Journal: Can J Anaesth Journal subject: Anesthesiology Year: 2021 Document Type: Article Affiliation country: S12630-021-02049-4

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / COVID-19 Type of study: Observational study / Qualitative research Topics: Long Covid / Variants Limits: Adult / Humans Country/Region as subject: North America Language: English Journal: Can J Anaesth Journal subject: Anesthesiology Year: 2021 Document Type: Article Affiliation country: S12630-021-02049-4