Impact of COVID-19 visitor restrictions on healthcare providers in Canadian intensive care units: a national cross-sectional survey

O'Brien, Jennifer M; Bae, Faith A; Kawchuk, Joann; Reimche, Eileen; Abramyk, Candace; Kitts, Caitlyn; Mohamad, Sana; Patterson, Christine; Valiani, Sabira

doi:10.1007/s12630-021-02139-3

Cited by 6 publications

(3 citation statements)

References 5 publications

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“…The healthcare team experienced signi cant stress and uncertainty, referred to as working in a pressure cooker, due to the COVID-19 pandemic. This is consistent with previous research that has shown that the unprecedented nature of the pandemic led to challenging working conditions, limited resources, lack of information, and concerns about infecting loved ones (32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44). The collective global impact of COVID-19 on healthcare systems is likely a contributing factor to these stressors (45)(46)(47)(48).…”

Section: Altruistic Behaviorssupporting

confidence: 88%

Healthcare Team Resilience During COVID-19: A Qualitative Study

Ambrose

Catchpole

Evans

et al. 2023

Preprint

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BACKGROUND Resilience has been identified as the ability to maintain the safety and the performance of healthcare systems and is aligned with the principles of anticipation, monitoring, adaptation, and learning. In early 2020, the COVID-19 pandemic challenged the resilience of US healthcare systems due to the lack of equipment, supply interruptions, and a shortage of personnel. The purpose of this qualitative research was to describe resilience in the healthcare team during the COVID-19 pandemic with the healthcare team situated as a singular cognizant entity defined by its collective identity, purpose, competence, and actions. METHODS We developed a descriptive model which considered the healthcare team as a unified cognizant entity. This model combined elements from the Patient Systems Engineering Initiative for Patient Safety (SEIPS) and the Advanced Team Decision Making (ADTM) models. Using a qualitative descriptive design and guided by our adapted model, we conducted individual interviews with healthcare team members across the United States. Data were analyzed using thematic analysis and extracted codes were organized within the adapted model framework. To ensure the rigor of our study, we utilized the input of an expert in qualitative researcher and maintained an audit trail throughout the analysis process. Additionally, we explored factors participants’ described that may have either hindered or enhanced the resilience potentials within the healthcare team. RESULTS Five themes were identified from the interviews with acute care professionals across the US (N = 22): working in a pressure cooker, consistent with working in a high stress environment; healthcare team cohesion, applying past lessons to present challenges, congruent with transferring past skills to current situations; knowledge gaps, and altruistic behaviors, aligned with sense of duty and personal responsibility to the team. Participants’ described how their ability to adapt to their environment was negatively impacted by uncertainty, inconsistent communication of information, and emotions of anxiety, fear, frustration, and stress. Cohesion with co-workers, transferability of skills, and altruistic behavior enhanced healthcare team performance. CONCLUSION Working within the extreme unprecedented circumstances of COVID-19 affected the ability of the healthcare team to anticipate and adapt to the rapidly changing environment. Both team cohesion and altruistic behavior promoted resilience. The adapted model was useful to describe the healthcare team as a singular cognizant entity. Our research contributes to a growing understanding of the importance of resilience in healthcare and provides a bridge between individual and organizational resilience.

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Section: Altruistic Behaviorssupporting

confidence: 88%

Healthcare Team Resilience During COVID-19: A Qualitative Study

Ambrose

Catchpole

Evans

et al. 2023

Preprint

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“…Patient and family participants were recruited through the Saskatchewan Centre for Patient-Oriented Research, posters in Saskatchewan ICUs, and inviting participants from a prior related study. 42 , 43…”

Section: Methodsmentioning

confidence: 99%

Comprendre les moments de communication équitables et affirmatifs et les jalons relationnels pendant la trajectoire aux soins intensifs : résultats de la première étape d’un projet de réflexion conceptuelle

Suleman¹,

O'Brien

McIlduff

et al. 2023

Can J Anesth/J Can Anesth

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Purpose Communication is vital to facilitate patient and family-centred care (PFCC) and to build trusting relationships between intensive care unit (ICU) health care providers, the patient, and their loved ones in the ICU. The focus of this investigation was to identify, define, and refine key moments of communication, connection, and relationship building in the ICU through a lens of Equity, Diversity, Decolonization, and Inclusion (EDDI) to encourage meaningful communication and development of trusting relationships. Methods We conducted 13 journey mapping interviews with ICU health care providers, patients, and their loved ones as the first stage in a design thinking project. We used directed content analysis to identify intersections where principles of EDDI directly or indirectly impacted communication, relationships, and trust throughout the ICU journey. To serve diverse patients and their loved ones, accessibility, inclusivity, and cultural safety were foundational pillars of the design thinking project. Results Thirteen ICU health care providers, patients, and their loved ones participated in journey mapping interviews. We defined and refined 16 communication moments and relationship milestones in the journey of a patient through the ICU (e.g., admission, crises, stabilization, discharge), and intersections where EDDI directly or indirectly impacted communication and connection during the ICU journey. Conclusion Our findings highlight that diverse intersectional identities impact communication moments and relationship milestones during an ICU journey. To fully embrace a paradigm of PFCC, consideration should be given to creating an affirming and safe space for patients and their loved ones in the ICU. Supplementary Information The online version contains supplementary material available at 10.1007/s12630-023-02456-9.

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“…The experience of restrictions in adult critical care during the COVID-19 pandemic has been explored. 20 Within the PICU, one qualitative study found that care provision during the COVID-19 pandemic added stress for clinicians, though it did not focus on the influence of the family presence restrictions. 21 To inform future policy and practice, the impact of these policies in a PICU context must be explored to assess the proportionality of the response.…”

mentioning

confidence: 99%

A survey of pediatric intensive care unit clinician experience with restricted family presence during COVID-19

Foster,

Lee,

Seabrook

et al. 2023

Can J Anesth/J Can Anesth

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Purpose Limiting family presence runs counter to the family-centred values of Canadian pediatric intensive care units (PICUs). This study explores how implementing and enforcing COVID-19-related restricted family presence (RFP) policies impacted PICU clinicians nationally. Methods We conducted a cross-sectional, online, self-administered survey of Canadian PICU clinicians to assess experience and opinions of restrictions, moral distress (Moral Distress Thermometer, range 0–10), and mental health impacts (Impact of Event Scale [IES], range 0–75 and attributable stress [five-point Likert scale]). For analysis, we used descriptive statistics, multivariate regression modelling, and a general inductive approach for free text. Results Representing 17/19 Canadian PICUs, 368 of 388 respondents (94%) experienced RFP policies and were predominantly female (333/368, 91%), English speaking (338/368, 92%), and nurses (240/368, 65%). The mean (standard deviation [SD]) reported moral distress score was 4.5 (2.4) and was associated with perceived differential impact on families. The mean (SD) total IES score was 29.7 (10.5), suggesting moderate traumatic stress with 56% (176/317) reporting increased/significantly increased stress from restrictions related to separating families, denying access, and concern for family impacts. Incongruence between RFP policies/practices and PICU values was perceived by 66% of respondents (217/330). Most respondents (235/330, 71%) felt their opinions were not valued when implementing policies. Though respondents perceived that restrictions were implemented for the benefit of clinicians (252/332, 76%) and to protect families (236/315, 75%), 57% (188/332) disagreed that their RFP experience was mainly positive. Conclusion Pediatric intensive care unit-based RFP rules, largely designed and implemented without bedside clinician input, caused increased psychological burden for clinicians, characterized as moderate moral distress and trauma triggered by perceived impacts on families. Supplementary Information The online version contains supplementary material available at 10.1007/s12630-023-02547-7.

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Impact of COVID-19 visitor restrictions on healthcare providers in Canadian intensive care units: a national cross-sectional survey

Cited by 6 publications

References 5 publications

Healthcare Team Resilience During COVID-19: A Qualitative Study

Healthcare Team Resilience During COVID-19: A Qualitative Study

Comprendre les moments de communication équitables et affirmatifs et les jalons relationnels pendant la trajectoire aux soins intensifs : résultats de la première étape d’un projet de réflexion conceptuelle

A survey of pediatric intensive care unit clinician experience with restricted family presence during COVID-19

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