Australian College of Critical Care Nurses and Australasian College for Infection Prevention and Control position statement on facilitating next-of-kin presence for patients dying from coronavirus disease 2019 (COVID-19) in the intensive care unit

Abstract

The coronavirus disease 2019 (COVID-19) pandemic is challenging healthcare systems worldwide, none more so than critical and intensive care settings. Significant attention has been paid to the capacity of Australian intensive care unit (ICUs) to respond to a COVID-19 surge, particularly in relation to beds, ventilators, staffing, personal protective equipment, and unparalleled increase in deaths in ICUs associated with COVID-19 seen internationally. While death is not uncommon in critical care, the international experience demonstrates that restrictions to family presence at the end of life result in significant distress for families and clinicians. As a result, the Australian College of Critical Care Nurses and the Australasian College for Infection Prevention and Control supported the development of a position statement to provide critical care nurses with specific guidance and recommendations for practice for this emerging priority area. Where possible, position statements are founded on high-quality evidence. However, the short time period since the first recognition of a cluster of pneumonia-like cases in China in January, 2020, meant that an integrative approach was required to expedite timely development of this position statement in preparation for a COVID-19 surge in Australia. This position statement is intended to provide practical guidance to critical care nurses in facilitating next-of-kin presence for patients dying from COVID-19 in the ICU.

Family‐centered care during a pandemic: The hidden impact of restricting family visits

“…In response, a suite of public health measures, such as restricting the free movement of people and limiting crowd sizes in the community, was implemented in an attempt to control the pandemic and minimize the risk of outbreaks (Parodi & Liu, 2020). In hospitals, infection prevention and control (IPC) measures have resulted in widespread use of personal protective equipment, isolation of patients with suspected or confirmed COVID‐19, monitoring of staff and visitors for symptoms of COVID‐19, and significant restrictions to visitors wanting to visit hospitalized patients (Bloomer & Bouchoucha, 2020; WHO, 2020b). A recent media report also describes how even when a patient was dying, visitors were banned (Hafner, 2020).…”

Palliative Care Principles and Anesthesiology Clinical Practice: Current Perspectives

“…69 Limitations in family access to ICUs are still common even though some institutions are allowing visits to some extent, especially when dealing with end-of-life situations. 70 , 71 This aspect appears to be burdensome for all the people participating to ICU care: patients may experience depression and anxiety; relatives do not have the chance to physically interact with their loved ones and personally observe and assist in treatment and caring process. The effect of these limitations may increase the development of anxiety, post-traumatic stress and complicated grief for families ( Figure 3 ).…”

Prevention, Control and Safety of Health Care Providers during COVID-19: A Review Study

“…The same results were also reported in Melissa et al study of infection control in healthcare providers. They concluded that by providing infection prevention and control measures for emergency care workers, they can take care of the patients as best as they can although the implementation of these guidelines require a uni ed approach [16]…”