Intensive care unit visiting and family communication during the COVID-19 pandemic: A UK survey.
Intensive care unit visiting and family communication during the COVID-19 pandemic: A UK survey.
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DOI：
10.1177/17511437211007779
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发表时间：
2022-08
影响因子：
2.7
通讯作者：
Arora, Nitin
中科院分区：
文献类型：
--
作者：
Boulton, Adam J.;Jordan, Helen;Adams, Claire E.;Polgarova, Petra;Morris, Andrew Conway;Arora, Nitin
频繁探视和与患者家属沟通是ICU的正常做法，但新冠肺炎大流行对此提出了挑战，目前尚不清楚ICU是如何管理的。我们的目的是调查在新冠肺炎大流行期间，国民健康保险ICU是如何处理家庭沟通和探视的。在2020年4月16日至5月4日期间进行了一项电子快照调查，并向NHS ICU开放。研究对象包括134个有冠状病毒感染患者的ICU。所有报告都报告了比正常情况下更严格的探视限制，29(22%)不允许任何探访者，71(53%)只允许在患者生命末期(EOL)探视，30(22%)允许对脆弱的患者或EOL探视。几乎所有人(n = 130，97%)每天都在更新家庭，大多数人(n = 120，92%)开始更新。日常电话通常由医疗团队(n = 75，55%)或护理团队(n = 50，37%)进行。63人(47%)使用视频通话，39人(29%)建立了专门的家庭沟通团队。复苏和停产讨论最常通过电话进行(n = 129人，96%)，24人(18%)使用视频通话，15人(11%)报告讨论是当面进行的。临床医生表达了他们对这种情况的不满，并对患者、家属和工作人员的不利影响表示担忧。新冠肺炎已经导致整个NHS ICU在与家庭互动的方式上发生了重大变化。许多部队正在适应并朝着远程和技术辅助的通信方向发展。尽管有创新的解决办法，但挑战依然存在，地方和国家指导可能会发挥作用。
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. 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. 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. 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.
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