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

Stephana J Moss; Karla D Krewulak; Henry T Stelfox; Sofia B Ahmed; Melanie C Anglin; Sean M Bagshaw; Karen E A Burns; Deborah J Cook; Christopher J Doig; Alison Fox-Robichaud; Robert Fowler; Laura Hernández; Michelle E Kho; Maia Kredentser; Kira Makuk; Srinivas Murthy; Daniel J Niven; Kendiss Olafson; Ken Kuljit S Parhar; Scott B Patten; Oleksa G Rewa; Bram Rochwerg; Bonnie Sept; Andrea Soo; Krista Spence; Sean Spence; Sharon Straus; Andrew West; Jeanna Parsons Leigh; Kirsten M Fiest

doi:10.1186/s13054-021-03763-7

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

Crit Care. 2021 Sep 25;25(1):347. doi: 10.1186/s13054-021-03763-7.

Authors

Stephana J Moss¹, Karla D Krewulak¹, Henry T Stelfox¹, Sofia B Ahmed², Melanie C Anglin¹, Sean M Bagshaw³, Karen E A Burns⁴, Deborah J Cook⁵, Christopher J Doig¹, Alison Fox-Robichaud⁵, Robert Fowler⁶, Laura Hernández¹, Michelle E Kho⁷, Maia Kredentser⁸, Kira Makuk¹, Srinivas Murthy⁹, Daniel J Niven¹, Kendiss Olafson¹⁰, Ken Kuljit S Parhar¹, Scott B Patten¹¹, Oleksa G Rewa¹², Bram Rochwerg⁵, Bonnie Sept¹, Andrea Soo¹³, Krista Spence¹, Sean Spence¹⁴, Sharon Straus⁶, Andrew West¹⁵, Jeanna Parsons Leigh¹⁶, Kirsten M Fiest¹⁷

Affiliations

¹ Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
² Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
³ Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, Canada.
⁴ Interdepartmental Division of Critical Care, University of Toronto, Toronto, ON, Canada.
⁵ Department of Medicine, McMaster University, Hamilton, ON, Canada.
⁶ Department of Medicine, University of Toronto, Toronto, ON, Canada.
⁷ School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.
⁸ Department of Clinical Health Psychology, University of Manitoba, Manitoba, Canada.
⁹ Department of Pediatrics, University of British Columbia, British Columbia, Canada.
¹⁰ Department of Medicine, University of Manitoba, Manitoba, Canada.
¹¹ Department of Psychiatry, Cumming School of Medicine, Cuthbertson and Fischer Chair in Pediatric Mental Health, University of Calgary, Calgary, AB, Canada.
¹² Department of Critical Care Medicine, University of Alberta, Edmonton, AB, Canada.
¹³ Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, AB, Canada.
¹⁴ Chinook Regional Hospital, Lethbridge County, Alberta, Canada.
¹⁵ Canadian Society of Respiratory Therapists, Saint John, NB, Canada.
¹⁶ School of Health Administration, Faculty of Health, Dalhousie University, Halifax, NS, Canada.
¹⁷ Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. [email protected].

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.

Keywords: Acute care; COVID-19; Family presence; Hospital Policy; Visitors.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

COVID-19 / prevention & control*
COVID-19 / psychology
COVID-19 / transmission
Communication
Critical Care*
Family* / psychology
Health Personnel / psychology
Health Policy*
Humans
Inpatients* / psychology
Mental Health Services
Pandemics
Physical Distancing*
Psychological Distress
SARS-CoV-2
Telephone
Visitors to Patients* / psychology

Grants and funding

447521/CIHR/Canada