Intensive care unit visiting and family communication during the COVID-19 pandemic: A UK survey

Abstract

Background Frequent visiting and communication with patients’ families are embedded within normal ICU practice, however the COVID-19 pandemic has challenged this, and it is unclear how ICUs are managing. We aimed to investigate how NHS ICUs are approaching family communications and visiting during the COVID-19 pandemic. Methods An electronic snapshot survey was delivered between 16th April and 4th May 2020 and was open to NHS ICUs. Replies from 134 individual ICUs with COVID patients were included. Results All reported that visiting was more restricted than normal with 29 (22%) not allowing any visitors, 71 (53%) allowing visitors at the end of a patient’s life (EOL) only, and 30 (22%) allowing visitors for vulnerable patients or EOL. Nearly all (n = 130, 97%) were updating families daily, with most initiating the update (n = 120, 92%). Daily telephone calls were routinely made by the medical (n = 75, 55%) or nursing team (n = 50, 37%). Video calling was used by 63 (47%), and 39 (29%) ICUs had developed a dedicated family communication team. Resuscitation and EOL discussions were most frequently via telephone (n = 129, 96%), with 24 (18%) having used video calling, and 15 (11%) reporting discussions had occurred in person. Clinicians expressed their dissatisfaction with the situation and raised concerns about the detrimental effect on patients, families, and staff. Conclusions COVID-19 has resulted in significant changes across NHS ICUs in how they interact with families. Many units are adapting and moving toward distant and technology-assisted communication. Despite innovative solutions, challenges remain and there may be a role for local and national guidance.

Critical care nurses’ experiences of working during the first phase of the COVID-19 pandemic – Applying the Person-centred Practice Framework

“…This resulted in difficulties to obtain knowledge about who the patient was as a person. Part of CCNs’ work is to form relationships so the patient feels safe and the relatives comfortable knowing that their loved one is in the care of skilled, caring CCNs ( Boulton et al, 2021 , McCormack and McCance, 2016 ). Similar to the findings of Maaskant et al (2021) , the CCNs reported that they missed the presence of the patients’ relatives and that this made it difficult to relate to the patient as a person ( Boulton et al, 2021 ).…”

Humanizing critical care

“…The lack of family visitation during the pandemic, including during end-of-life care, has compounded the issue, making it increasingly difficult to be able to relate to the patient as an individual. [8][9][10] Our interactions with patients' families allow us to see into them as a person, to learn their likes, dislikes, and get an overall picture of the person in the bed. Most importantly, they allow us to establish relationships, and with that comes trust.…”

Angehörigenbetreuung auf Intensivstationen

“…Boulton et al. (2021) berichtet, dass in dieser Zeit rund 22 % der ICU keine Besuche gestatteten und rund 53 % nur am Ende des Lebens [ 5 ]. Viele bereits implementierte Maßnahmen in der Angehörigenbetreuung wurden unterbrochen oder adaptiert.…”