After hearing heartbreaking stories from health care workers, patients and families, a University of Calgary doctor is researching how to improve COVID-19-related ICU visitor restrictions across the country.
“Back when COVID(-19) started nearly a year ago I was speaking to colleagues who were working in the intensive care unit,” epidemiologist Dr. Kirsten Fiest said. “They kept talking about the distress they were feeling about having important clinical conversations over the phone.
“I thought, if this is causing the clinicians distress, it’s likely causing the patients and families quite a bit of distress too.”
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As part of Fiest and her team’s four phased program, they looked at visitation policies at hospitals across Canada. They’ve also conducted dozens of interviews speaking with healthcare providers, patients and their families.
“The ICU is quite different than the hospital,” Fiest explained. “The sickest patients from the healthcare system are in the ICU. They rely on their family members to provide support and to be partners in care with the healthcare team.”
“When that’s removed it definitely leads to distress and changes the way care is provided.”
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Throughout the pandemic visitor restrictions have fluctuated at Alberta hospitals.
According to its website Alberta Health Services has revisited visitation guidelines since April and adjusted them to reflect the current COVID-19 transmission in our province.
Currently ICU patients in Alberta can have up to two designated visitors but that’s not always been the case.
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“There was an older patient who had dementia and they didn’t understand why no one was coming to visit them and why they were alone,” Fiest said. “The family had to continually tell them and experience that distress of not being able to be there.”
Fiest added that over the last 10 to 15 years, ICUs have switched to a more holistic approach embracing family involvement.
“Having families there improves the outcomes for the patient and for the family members.”
Fiest already has a few recommendations which are expected to be shared with health officials across Canada as well as with the World Health Organization in April.
The recommendations include clarifying fluctuating visitation policies at hospitals as well providing access to technology and training on how to use it.
“An older person in the ICU may not know how to FaceTime with a loved one, they may not have a phone at all or a phone that’s capable of that,” Fiest said. “So potentially providing technology so patients can connect with family members is very important.”
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The research also includes studying literature from around the world to see what’s essential to include in policies going forward and partnering with healthcare workers, patients and families to get their feedback.
“The policies that were put in place were absolutely necessary but now that we have so much more information, I’m hopeful people will be open to adapting them.”