Clinician perceptions of the impact of ICU family visiting restrictions during the COVID-19 pandemic: an international investigation

Abstract

Purpose To guarantee the safety of the public, clinicians and patients during the COVID-19 pandemic, hospital visits were severely restricted internationally. There are limited data on the precise impact of these visiting restrictions on Intensive Care Unit clinicians. Our objectives therefore were to explore the impact of family visitation restrictions on clinicians and care delivery and describe innovation alongside areas for potential improvement. Methods A qualitative approach using focus groups was employed. We recruited members of the multi-disciplinary team from Spain, France and the UK. Framework analysis was used to synthesize and interpret data. Results In total, 28 staff from multiple international sites contributed to data across six focus groups: 12 from the UK, 9 from France and 7 from Spain. In relation to the key aims, we derived four themes: the emergence of new technologies, relationships and rapport establishment, communication challenges and end-of-life care provision. Across each theme, the overarching concepts of clinician emotional exhaustion and emotional distress emerged alongside the negative impact on job satisfaction. Conclusion The impact of COVID-19 family visitation restrictions is far reaching. Future research should examine the wider impact of family presence in the ICU.

Frontline nurses' experiences of managing visitor restrictions during the COVID‐19 pandemic in a Danish university hospital – Lessons learned

“…McPeake et al. [24] also found some positive effects of family visiting restrictions on care provision more broadly. In addition, a study on orthopaedic patients reported that 24% of patients and 13% of relatives were satisfied with the non‐visit situation.…”

“…In a recent study from the field of postpartum care, both the mothers and nurses described how visitor restrictions reduced distraction from visitors, promoting family bonding and allowing more time for higher-quality nursing care [23]. McPeake et al [24] also found some positive effects of family visiting restrictions on care provision more broadly. In addition, a study on orthopaedic patients reported that 24% of patients and 13% of relatives were satisfied with the non-visit situation.…”

Determinants of information provided by anaesthesiologists to relatives of patients during surgical procedures

“…In ICU, the impact of family visitation restrictions was well studied and associated in a qualitative study with clinician emotional exhaustion and emotional distress alongside the negative impact on job satisfaction. 33 Another study 34 revealed that among family members of patients hospitalised in the ICU with acute respiratory distress syndrome, COVID-19, compared with other causes of acute respiratory distress syndrome, was significantly associated with increased risk of symptoms of post-traumatic stress disorder at 90 days after ICU discharge. All these points suggest that the restriction of family visitation during the COVID-19 pandemic might be associated with worse prognosis of the relative, and need to be evaluated in operating room setting.…”

Effect of a Standardized Family Participation Program in the ICU: A Multicenter Stepped-Wedge Cluster Randomized Controlled Trial*

“…However, based on similar studies that were previously described (18,19,21), our results seem robust. The COVID-19 pandemic has affected HCPs as well (26)(27)(28)(29) and may have influenced intervention delivery, warranting further research.…”