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Restricted visitation policies in acute care settings during the COVID-19 pandemic: a scoping review.
Moss, Stephana J; Krewulak, Karla D; Stelfox, Henry T; Ahmed, Sofia B; Anglin, Melanie C; Bagshaw, Sean M; Burns, Karen E A; Cook, Deborah J; Doig, Christopher J; Fox-Robichaud, Alison; Fowler, Robert; Hernández, Laura; Kho, Michelle E; Kredentser, Maia; Makuk, Kira; Murthy, Srinivas; Niven, Daniel J; Olafson, Kendiss; Parhar, Ken Kuljit S; Patten, Scott B; Rewa, Oleksa G; Rochwerg, Bram; Sept, Bonnie; Soo, Andrea; Spence, Krista; Spence, Sean; Straus, Sharon; West, Andrew; Parsons Leigh, Jeanna; Fiest, Kirsten M.
  • Moss SJ; Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
  • Krewulak KD; Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
  • Stelfox HT; Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
  • Ahmed SB; Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
  • Anglin MC; Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
  • Bagshaw SM; Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, Canada.
  • Burns KEA; Interdepartmental Division of Critical Care, University of Toronto, Toronto, ON, Canada.
  • Cook DJ; Department of Medicine, McMaster University, Hamilton, ON, Canada.
  • Doig CJ; Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
  • Fox-Robichaud A; Department of Medicine, McMaster University, Hamilton, ON, Canada.
  • Fowler R; Department of Medicine, University of Toronto, Toronto, ON, Canada.
  • Hernández L; Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
  • Kho ME; School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.
  • Kredentser M; Department of Clinical Health Psychology, University of Manitoba, Manitoba, Canada.
  • Makuk K; Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
  • Murthy S; Department of Pediatrics, University of British Columbia, British Columbia, Canada.
  • Niven DJ; Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
  • Olafson K; Department of Medicine, University of Manitoba, Manitoba, Canada.
  • Parhar KKS; Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
  • Patten SB; Department of Psychiatry, Cumming School of Medicine, Cuthbertson and Fischer Chair in Pediatric Mental Health, University of Calgary, Calgary, AB, Canada.
  • Rewa OG; Department of Critical Care Medicine, University of Alberta, Edmonton, AB, Canada.
  • Rochwerg B; Department of Medicine, McMaster University, Hamilton, ON, Canada.
  • Sept B; Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
  • Soo A; Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, AB, Canada.
  • Spence K; Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
  • Spence S; Chinook Regional Hospital, Lethbridge County, Alberta, Canada.
  • Straus S; Department of Medicine, University of Toronto, Toronto, ON, Canada.
  • West A; Canadian Society of Respiratory Therapists, Saint John, NB, Canada.
  • Parsons Leigh J; School of Health Administration, Faculty of Health, Dalhousie University, Halifax, NS, Canada.
  • Fiest KM; Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. kmfiest@ucalgary.ca.
Crit Care ; 25(1): 347, 2021 09 25.
Article in English | MEDLINE | ID: covidwho-1438304
ABSTRACT

BACKGROUND:

Restricted visitation policies in acute care settings because of the COVID-19 pandemic have negative consequences. The objective of this scoping review is to identify impacts of restricted visitation policies in acute care settings, and describe perspectives and mitigation approaches among patients, families, and healthcare professionals.

METHODS:

We searched Medline, Embase, PsycINFO, Healthstar, CINAHL, Cochrane Central Register of Controlled Trials on January 01/2021, unrestricted, for published primary research records reporting any study design. We included secondary (e.g., reviews) and non-research records (e.g., commentaries), and performed manual searches in web-based resources. We excluded records that did not report primary data. Two reviewers independently abstracted data in duplicate.

RESULTS:

Of 7810 citations, we included 155 records. Sixty-six records (43%) were primary research; 29 (44%) case reports or case series, and 26 (39%) cohort studies; 21 (14%) were literature reviews and 8 (5%) were expert recommendations; 54 (35%) were commentary, editorial, or opinion pieces. Restricted visitation policies impacted coping and daily function (n = 31, 20%) and mental health outcomes (n = 29, 19%) of patients, families, and healthcare professionals. Participants described a need for coping and support (n = 107, 69%), connection and communication (n = 107, 69%), and awareness of state of well-being (n = 101, 65%). Eighty-seven approaches to mitigate impact of restricted visitation were identified, targeting families (n = 61, 70%), patients (n = 51, 59%), and healthcare professionals (n = 40, 46%).

CONCLUSIONS:

Patients, families, and healthcare professionals were impacted by restricted visitation polices in acute care settings during COVID-19. The consequences of this approach on patients and families are understudied and warrant evaluation of approaches to mitigate their impact. Future pandemic policy development should include the perspectives of patients, families, and healthcare professionals. TRIAL REGISTRATION The review was registered on PROSPERO (CRD42020221662) and a protocol peer-reviewed prior to data extraction.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Visitors to Patients / Family / Critical Care / Physical Distancing / COVID-19 / Health Policy / Inpatients Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Qualitative research / Randomized controlled trials / Reviews Limits: Humans Language: English Journal: Crit Care Year: 2021 Document Type: Article Affiliation country: S13054-021-03763-7

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Visitors to Patients / Family / Critical Care / Physical Distancing / COVID-19 / Health Policy / Inpatients Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Qualitative research / Randomized controlled trials / Reviews Limits: Humans Language: English Journal: Crit Care Year: 2021 Document Type: Article Affiliation country: S13054-021-03763-7