Visiting and Communication Policy in Intensive Care Units during COVID-19 Pandemic: A Cross-sectional Survey from South Asia and the Middle East

Arora, Nitin; Nasa, Prashant; Kantor, Sandeep; Sodhi, Kanwalpreet; Chanchalani, Gunjan; Bahrani, Maher J Al; Tayar, Ashraf Al; Jaiswal, Vinod; Lopa, Ahsina Jahan; Mansour, Bassam; Mudalige, Anushka D; Nadeem, Rashid; Shrestha, Gentle S; Ahmed, Taha; Türkoğlu, Melda; Weeratunga, Dameera

doi:10.5005/jp-journals-10071-24091

Cited by 12 publications

(6 citation statements)

References 27 publications

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“… 30 Chanchalani et al, studied the visiting and communication policy in ICUs during the pandemic across South Asia and Middle East. 31 In this survey health care practitioners (HCP), mostly ICU consultants found the altered communication process during COVID-19, a challenge and highly dissatisfying. The process of consent taking too was found by the families to be less clear than in- person's procedure and wanting in terms of medico–legal repercussions by the HCP.…”

Section: Discussionmentioning

confidence: 94%

Assessment of Family Satisfaction with Remote Communication for Critically Ill COVID-19 Patients: An Observational Cohort Study

Pichamuthu,

Chacko,

Nair

et al. 2023

Indian Journal of Critical Care Medicine

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A bstract Background During the pandemic, traditional family meetings were replaced by remote telecommunications. We assessed the families’ satisfaction with these communications using a survey-based questionnaire. Methods The study involved 20-minute telephonic surveys conducted with the family member who was updated during the hospitalization of the patient. A thematic-based questionnaire with responses on a scale of 5 ranging from very dissatisfied to very satisfied was used. The responses were dichotomized into bad and good reports for analysis. Results A total of 196 patients were eligible. Only 154 patients’ family representatives consented to the study. The frequency and content of the telephonic updates were satisfactory. The bad report was assigned to 5% of families only. Among features assessing empathy of communication providers, the satisfaction rate was much higher with 3% of families alone providing a bad report. The response was significantly biased against the final outcome of the patient with poor review often provided by relatives of patients who had succumbed to the illness. The dissatisfaction rate was much higher, above 12% for the trust of communication and ICU visitation. However, the final outcome of the patient did not affect the trust in the information conveyed by the physician. Interpretation This study highlights several drawbacks in the communication strategy during the second surge of c oronavirus disease-2019 (COVID-19). The final outcome of the patient was the key decisive factor for the response to most of the questionnaire. Sustained faith in communication by the physician despite the final outcome of the patient, re-emphasizes the need for emotional connection and training for breaking bad news. How to cite this article Varghese MP, Selwyn T, Nair S, Samuel S, Chacko B, Pichamuthu K. Assessment of Family Satisfaction with Remote Communication for Critically Ill COVID-19 Patients: An Observational Cohort Study. Indian J Crit Care Med 2023;27(8):537–544.

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Section: Discussionmentioning

confidence: 94%

Assessment of Family Satisfaction with Remote Communication for Critically Ill COVID-19 Patients: An Observational Cohort Study

Pichamuthu,

Chacko,

Nair

et al. 2023

Indian Journal of Critical Care Medicine

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“…It is the opposite of the "placebo effect." A cross-sectional survey done in South Asia and the Middle East on visiting and communication policies showed that 35.4% of hospitals allowed family visits of terminally ill patients as part of reaching end-of-life care (EOL) decisions [ 24 ]. In our study, a much smaller proportion of family visits was allowed for terminally ill patients.…”

Section: Discussionmentioning

confidence: 99%

Understanding the Challenges of Intensive Care Staff in Communicating With Patients and Patients’ Families During the COVID-19 Crisis: A Qualitative Exploration

Vaz¹,

D'Silva²,

Krishna³

et al. 2023

Cureus

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Background Coronavirus disease 2019 (COVID-19) isolation protocols in India restricted family members of COVID-19 patients from visiting them in hospitals and in intensive care units, especially during the peak of the pandemic. This along with the elaborate personal protective equipment (PPE) created challenges for intensivists and nurses in COVID ICUs in effectively communicating with patients and patients’ families, especially in shared decision-making processes. Methods This article is the outcome of a qualitative study using in-depth one-on-one interviews with 10 intensivists and four intensive care nurses in two teaching hospitals in Bengaluru, South India. Each participant, purposively selected till data saturation was reached, had spent extensive periods of time in a COVID ICU during both COVID-19 waves in 2020 and 2021. A framework of descriptive phenomenology led to the design of the study in which varied experiences and insights of participants were captured using an interview guide to understand their lived reality. The interviews were conducted online or in person between July 2021 and October 2021 and were audio recorded and transcribed verbatim. Coding of transcripts using the NVivo 12 (Burlington, MA: QSR International Pty Ltd) software helped with the thematic analysis. This was guided by interpretive phenomenological methods that derived meaning from participants’ life experiences. Results Four themes involving challenges in effective communication in the COVID ICU emerged as follows: physical barriers, emotional and mental stressors, infrastructural challenges, and ethical and moral dilemmas. Sub-themes included personal protective equipment as a barrier, reduced energy levels, and isolation of family from patients under the domain of physical challenges; fears of the unknown, handling death of patients in isolation, and the frustrations of families were challenges under the emotional and mental domain. Infrastructural/systemic challenges included poor connectivity and insufficient mobile phones, and the absence of rules to handle interruptions. Privacy breaches, taking consent over the phone, end-of-life discussions, and medico-legal risks emerged as the subthemes under the domain of ethical and moral challenges. A mobile phone communication policy specifying usage times and operating methods, a mandatory communication and counseling training module for intensivists and intensive care nurses, and a set of protocols for highly restrictive, intensive care units in pandemic situations were recommendations and lessons learned. Conclusions The lack of face-to-face interactions was a serious barrier to communication between ICU staff and patients and their caregivers. It had a bearing on trust levels and had emotional and ethical consequences for healthcare teams to handle. Opportunities for self-care, venting of anxiety and distress, and opportunities to celebrate and reward special efforts and cooperation between con...

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“…Regarding hospital visitors, it should be mentioned that ICU departments are more sensitive to the screening of patients for Covid-19 at the entrance of the department and have better protocols to limit the direct visits of patients in the ICU departments or have virtual visits instead of face-to-face visits. 27 , 28 Jamaati et al proposed a model for managing the COVID-19 crisis at Masih Daneshvari Hospital in Tehran as one of the major centers for the admission and treatment of COVID-19 patients. This model considers items such as increasing staff awareness about COVID19, changing the use of different parts of the hospital, including changing the ICU of tuberculosis patients to the ICU of COVID-19 patients, canceling all elective surgeries in the hospital, increasing patients’ triage units from 1 to 3 cases, and allocating maximum possible beds to COVID-19 patients.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Response Rates of Hospitals in the Prevention and Control of COVID-19 in Hamadan Province of Iran

Seifrabiei

Keramat

Sedighi

et al. 2023

Health�Serv�Insights

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The COVID-19 pandemic has challenged the capacity of health systems in various countries. This study was designed to evaluate the response rates of hospitals in the prevention and control of COVID-19 in Hamadan province, Iran. In this cross-sectional study, all 20 hospitals in Hamadan province were monitored in February 2020. The instrument used in this study was the WHO checklist, entitled “Infection prevention and control health-care facility response for COVID-19.” In each hospital, the hospital infection control officials completed the checklists under the supervision of the hospital managers and were then provided to the project manager. Data analyzed by SPSS 22 software. There were 3482 hospital beds (the average beds of each hospital was 174) in the studied hospitals. Of 15 055 patients admitted to all hospitals, 2196 (14.6%) individuals were COVID-19 patients. The total average score obtained from the checklist was 62.25. Among 7 domains studied, the lowest scores belonged to 2 domains of “infrastructure and equipment” and “patient screening and triage.” The scores of domains “IPC programs” and “visitors” were significantly higher in hospitals with ICU beds than other hospitals ( P-value = .03 in both domains). A comparison between university-teaching hospitals with other hospitals and those in Hamadan city with other cities revealed no significant differences in any of the domains. The mean response rate (62.25) of hospitals in terms of COVID-19 in Hamadan province indicates their relative readiness to prevent and control the COVID19 pandemic. The shortage of infrastructure and equipment and screening and triage problems of patients were the main challenges of hospitals in managing the COVID-19 pandemic in Hamadan province, Iran.

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Visiting and Communication Policy in Intensive Care Units during COVID-19 Pandemic: A Cross-sectional Survey from South Asia and the Middle East

Cited by 12 publications

References 27 publications

Assessment of Family Satisfaction with Remote Communication for Critically Ill COVID-19 Patients: An Observational Cohort Study

Assessment of Family Satisfaction with Remote Communication for Critically Ill COVID-19 Patients: An Observational Cohort Study

Understanding the Challenges of Intensive Care Staff in Communicating With Patients and Patients’ Families During the COVID-19 Crisis: A Qualitative Exploration

Evaluation of the Response Rates of Hospitals in the Prevention and Control of COVID-19 in Hamadan Province of Iran

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