A multi‐centre study on patients dying from COVID‐19: communication between clinicians, patients and their families

Abstract

Background COVID−19 has led to challenges in providing effective and timely communication in healthcare. Services have been required to adapt and evolve as successful communication remains core to high quality patient‐centred care. Aim This study aims to describe the communication between admitted patients, their families and clinicians (medical, nursing, allied health) during end‐of‐life care. Methods This retrospective review included all patients (n = 230) who died directly due to COVID‐19 at five Melbourne hospitals between 1 January and 31 December 2020. Contacts and modality used (face to face, video, telephone) during the 8 days prior to death were recorded. Results Patients were predominantly elderly (median age 86 years) and from residential aged care facilities (62% ( n = 141)). Communication frequency increased the closer the patient was to death, where on day of death, contact between clinicians and patients was 93% ( n = 213) clinicians and families 97% (n = 222) and between patients and families 50% ( n = 115). Most contact between patients and families was facilitated by a clinician (91.3% ( n = 105) day of death) with the most commonly used mode being video call ( n = 30 day of death). Conclusion This study is one of the first and largest Australian reports on how communication occurs at the end of life for patients dying of COVID‐19. Contact rates were relatively low between patients and families, compared to other cohorts dying from non COVID‐19 related causes. The impact of this difference on bereavement outcomes requires surveillance and attention. This article is protected by copyright. All rights reserved.

‘I am afraid the news is not good’ – Breaking bad news in the time of COVID: Experiences from a field hospital

“…27 For HCWs, providing a link between patients and family increased their already heavy workload. 22 Harris et al described the workload for HCWs during COVID-19 as relentless and never-ending, and similar to our participants they faced limited opportunities to de-stress outside of work because of lockdown restrictions and social isolation. 28 This lack of 'breathing space' may lead to HCWs' struggling with breaking bad news, compounding the psychological impact of working on the COVID-19 frontline and result in HCWs' emotionally disengaging and/or feeling overwhelmed by feelings of guilt, sadness and anger.…”

“…20,21 COVID-19 saw health facilities worldwide dealing with patients' suddenly facing an unpredictable illness, isolated in hospital and unable to see their family even when facing death. 22 The condition of patients could deteriorate and they could die suddenly without prolonged illness or warning, complicating discussions about prognosis, timelines and preparation for death. 23 It is reasonable to ask whether refusing to allow families to visit very ill patients was a rational or reasonable response by hospitals, given that PPE was available, and HCWs themselves were spending many hours in COVID facilities.…”

Bereavement in the Time of COVID-19: Learning from Experiences of those Bereaved as a Result of Deaths in an Acute Hospital Setting in 2020

“…The importance of observing faith practices associated with death has been highlighted, with Muslim interviewees describing disenfranchised grief when death rituals and practices were disrupted by health protection measures ( Gabay & Tarabeih, 2022 ). The important role in communication that clinicians take on when visiting is restricted has been highlighted in a study which found that clinicians communicated more frequently with both patients and relatives the closer the patient was to death and often used video technology for these interactions ( Everitt et al, 2022 ). Lower levels of psychological distress have been found in people who were able to visit at the time of death and attend funerals ( Chen, 2022 ).…”

Relationship of Nurse-Patient Ratios in the Quality of Care in the Intensive Care Unit: Systematic Review and Meta-Analysis

“…Results were analyzed and compared using SPSS, APP Inventor, and mining models to determine application effects. (Chen, 2022) 4.4 Distribution of scientific production by area of knowledge In second place, Nursing with 125 articles and Social Sciences in third place with 14. The above can be explained thanks to the contribution and study of different branches, the article with the greatest impact was registered by the area of Medicine entitled "Effect of greater interprofessional familiarity on team performance, communication and psychological safety in medical teams of hospitalized patients: a randomized clinical trial" whose scope of study has as objective To determine the effectiveness of increasing familiarity between resident physicians and nurses on team performance, psychological safety and communication.…”