Restricted visitation policies in acute care settings during the COVID-19 pandemic: a scoping review

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.

Changes in home visit utilization during the COVID-19 pandemic: a multicenter cross-sectional web-based survey

“…Another notable finding of this study was that most directors of home visit facilities thought that restricted visitation of inpatient facilities led to an increase in home visit utilization. A previous review reported that if visitation restrictions had a negative impact on mental health outcome of patients and their families, the patient and family preferred to stay at or go back to their home [ 22 ]. This would affect decisions about health care utilization not only by the patient and their family, but also by health care professionals.…”

Comparative end-of-life communication and support in hospitalised decedents before and during the COVID-19 pandemic: a retrospective regional cohort study in Ottawa, Canada

“…Collectively, our findings have implications for patients and their families, and both the healthcare team and administrative policy. 15 25 For patients, in whom ‘the fear of dying alone is nearly universal’, 26 reduced end-of-life contact with family and reduced interprofessional team input may compound their existing distress. Furthermore, patients with end-of-life delirium may be deprived of family reorientation efforts and the presence of a familiar face as a source of comfort.…”

Infection control strategies for patients and accompanying persons during the COVID-19 pandemic in German hospitals: a cross-sectional study in March–April 2021

“…While visitor regulation can have a positive effect on the prevention of viral respiratory infections [ 50 , 51 ], reviews show that they can also have negative consequences for the mental and physical health of patients, the wellbeing of family members and the workload of care providers [ 52 , 53 ].…”