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ABSTRACT: Purpose
Hospital policies forbidding or limiting families from visiting relatives on the intensive care unit (ICU) has affected patients, families, healthcare professionals, and patient- and family-centered care (PFCC). We sought to refine evidence-informed consensus statements to guide the creation of ICU visitation policies during the current COVID-19 pandemic and future pandemics and to identify barriers and facilitators to their implementation and sustained uptake in Canadian ICUs.Methods
We created consensus statements from 36 evidence-informed experiences (i.e., impacts on patients, families, healthcare professionals, and PFCC) and 63 evidence-informed strategies (i.e., ways to improve restricted visitation) identified during a modified Delphi process (described elsewhere). Over two half-day virtual meetings on 7 and 8 April 2021, 45 stakeholders (patients, families, researchers, clinicians, decision-makers) discussed and refined these consensus statements. Through qualitative descriptive content analysis, we evaluated the following points for 99 consensus statements: 1) their importance for improving restricted visitation policies; 2) suggested modifications to make them more applicable; and 3) facilitators and barriers to implementing these statements when creating ICU visitation policies.Results
Through discussion, participants identified three areas for improvement: 1) clarity, 2) accessibility, and 3) feasibility. Stakeholders identified several implementation facilitators (clear, flexible, succinct, and prioritized statements available in multiple modes), barriers (perceived lack of flexibility, lack of partnership between government and hospital, change fatigue), and ways to measure and monitor their use (e.g., family satisfaction, qualitative interviews).Conclusions
Existing guidance on policies that disallowed or restricted visitation in intensive care units were confusing, hard to operationalize, and often lacked supporting evidence. Prioritized, succinct, and clear consensus statements allowing for local adaptability are necessary to guide the creation of ICU visitation policies and to optimize PFCC.
SUBMITTER: Fiest KM
PROVIDER: S-EPMC8970637 | biostudies-literature | 2022 Jul
REPOSITORIES: biostudies-literature
Fiest Kirsten M KM Krewulak Karla D KD Hernández Laura C LC Jaworska Natalia N Makuk Kira K Schalm Emma E Bagshaw Sean M SM Bernet Xavier X Burns Karen E A KEA Couillard Philippe P Doig Christopher J CJ Fowler Robert R Kho Michelle E ME Kupsch Shelly S Lauzier François F Niven Daniel J DJ Oggy Taryn T Rewa Oleksa G OG Rochwerg Bram B Spence Sean S West Andrew A Stelfox Henry T HT Parsons Leigh Jeanna J
Canadian journal of anaesthesia = Journal canadien d'anesthesie 20220401 7
<h4>Purpose</h4>Hospital policies forbidding or limiting families from visiting relatives on the intensive care unit (ICU) has affected patients, families, healthcare professionals, and patient- and family-centered care (PFCC). We sought to refine evidence-informed consensus statements to guide the creation of ICU visitation policies during the current COVID-19 pandemic and future pandemics and to identify barriers and facilitators to their implementation and sustained uptake in Canadian ICUs.<h ...[more]