Hospital Policies During COVID-19: An Analysis of Visitor Restrictions
Hospital Policies During COVID-19: An Analysis of Visitor Restrictions
复制标题
DOI：
10.1097/phh.0000000000001320
复制
发表时间：
2022-01-01
影响因子：
3.3
通讯作者：
Joyner, Benny L., Jr.
中科院分区：
文献类型：
--
作者：
Jaswaney, Rohit;Davis, Arlene;Joyner, Benny L., Jr.
目标：为应对COVID-19疫情，医院已制定访客限制政策，以减少感染传播。我们审查了医院访客限制政策的一致性，并提出建议，以强调政策制定和实施中的公平和透明的限制、例外和上诉。设计：收集和分析疫情前3个月面向公众的游客限制政策。背景：代表美国所有4个主要地区23个州的综合急症护理医院。参与者：一个队列的70家最大的医院的总床位容量。测量值：访客限制政策的特征，包括一般访客限制声明、政策随时间的变化/更新、政策例外情况以及针对COVID-19阳性患者的限制。结果：在70家接受审查的医院中，有65家制定了面向公众的访客限制政策。在这65份保单中，有49份保单有一般性的“禁止探视”声明，而16份保单允许至少有一名探视者陪同所有患者。在65家医院中，有63家医院的访客限制政策有例外。设置特定的例外情况包括儿科、产科/妇科、急诊科、行为健康、住院康复、外科和门诊。适用于各种环境的治疗包括临终患者和残疾患者。结论：在这次审查中，医院之间的访客限制政策差异显着。这些差异带来了挑战，因为它们的公平适用可能会有问题，可能会出现与分配有关的道德问题。为医院修订或制定此类政策提供了五项建议，包括提供透明，可访问，面向公众的政策可以最大限度地减少伦理困境。此外，医院将受益于在制定访客政策时相互沟通，以确保统一性，并在患者和家属浏览医院访视时提供支持。
Objective: In response to the COVID-19 pandemic, hospitals have developed visitor restriction policies in order to mitigate spread of infection. We reviewed hospital visitor restriction policies for consistency and to develop recommendations to highlight fair and transparent restrictions, exceptions, and appeals in policy development and implementation. Design: Collection and analysis of public-facing visitor restriction policies during the first 3 months of the pandemic. Setting: General acute care hospitals representing 23 states across all 4 major regions of the United States. Participants: A cohort of the 70 largest hospitals by total bed capacity. Measurements: Characteristics of visitor restriction policies including general visitor restriction statement, changes/updates to policies over time, exceptions to policies, and restrictions specific to COVID-19-positive patients. Results: Sixty-five of the 70 hospitals reviewed had public-facing visitor restriction policies. Forty-nine of these 65 policies had general "no-visitor" statements, whereas 16 allowed at least 1 visitor to accompany all patients. Sixty-three of 65 hospitals included exceptions to their visitor restriction policies. Setting-specific exceptions included pediatrics, obstetrics/gynecology, emergency department, behavioral health, inpatient rehabilitation, surgery, and outpatient clinics. Exceptions that applied across settings included patients at end of life and patients with disabilities. Conclusion: Visitor restriction policies varied significantly among hospitals in this review. These variances create challenges in that their fair application may be problematic and ethical issues related to allocation may arise. Five recommendations are offered for hospitals revising or creating such policies, including that offering transparent, accessible, public-facing policies can minimize ethical dilemmas. In addition, hospitals would benefit from communicating with each other in the development of visitor policies to ensure uniformity and support patients and family members as they navigate hospital visitation.