The impact of restrictions to visiting in paediatric intensive care during the COVID-19 pandemic.

BACKGROUND: Restrictions to hospital visiting were mandated during the COVID-19 pandemic, with variability in the degree of restriction imposed. At times, paediatric intensive care units (ICU) restricted visiting to one parent/carer. Views of parents/carers and ICU staff about changes in the visiting policy are not well understood. STUDY DESIGN: This is a Service evaluation involving questionnaire survey incorporating rating scales and free-text comments. Inner-city specialist children's hospital. Parents/carers of children on ICU between December 2020-March 2021 and staff who were working on ICU during May-June 2021. Parents and staff on ICU were invited to complete a questionnaire focusing on their experience of being or working on ICU. Quantitative data were analysed descriptively and free-text comments were thematically analysed. RESULTS: Completed questionnaires were received from 81/103 (79%) parents/carers and 217/550 (39%) staff. The majority of parents (n = 60;77%) and staff (n = 191;89%) understood the need for the one-parent visiting policy but acknowledged it was a source of considerable stress. More staff than parents agreed it was appropriate other relatives/friends visiting was not permitted (Z = 3.715;p < .001). There was no association between parents' satisfaction with their child's care and views about the visiting policy. However, staff were more likely to report an impact on their ability to deliver family centred care if they disagreed with the policy. CONCLUSION: The COVID-19 visiting policy had a clear impact on parents and staff. In the event of any future threat to open-access visiting to children in hospital, the potentially damaging effect on children, parents, and staff must be considered. RELEVANCE TO CLINICAL PRACTICE: Visiting policies need to take account of parents being partners in their child's care, rather than purely visitors to the unit where their child is being cared for. Visiting for two carers should always be facilitated, including during a crisis such as a pandemic.

Mullerianosis: a rare cause of acute renal colic.

A 50-year-old woman presented to the urology department with an acute history suggestive of left-sided renal colic. There were no other associated symptoms, but urine dipstick revealed non-visible haematuria. CT-KUB revealed a soft tissue mass at the left vesico-ureteric junction. Flexible cystoscopy demonstrated a mass intruding into the posterior bladder. A transurethral resection of the bladder 'tumour' was undertaken, and it was noted that the mass was not macroscopically consistent with transitional cell carcinoma. Histology demonstrated Müllerianosis, a rare lesion characterised by locally invasive growth of tissue originating from the Müllerian (paramesonephric) duct. The patient was seen by gynaecologist who initiated hormone treatment with an lutenising hormone--releasing hormone (LH-RH) analogue. Urological follow-up 3 months later highlighted ongoing pelvic pain but no further colicky loin pain. Repeat cystoscopy showed the mass had become smaller and the left ureter was laterally displaced. Further gynaecological input is planned if symptoms are ongoing.