Conditions and strategies to meet the challenges imposed by the COVID-19-related visiting restrictions in the ICU: a Scandinavian cross-sectional study

Irene Jensen, Hanne; Åkerman, Eva; Lind, Ranveig; Birgit Alfheim, Hanne; Frivold, Gro; Fridh, Isabell; Sophie Ågård, Anne

OBJECTIVES: To examine conditions and strategies to meet the challenges imposed by the coronavirus disease 2019 (COVID-19)-related visiting restrictions in Scandinavian intensive care units (ICUs). Research Methodology/Design A cross-sectional survey Setting Adult ICUs in Denmark, Norway and Sweden. Main Outcome Measures Likert scale responses and free-text comments within six areas: ICU capacity and staffing, visiting policies and access to the ICU, information and conferences with relatives, written information, children as relatives and follow-up initiatives. RESULTS: The overall response rate was 53% (74/140 participating ICUs). All ICUs had planned for capacity extensions; the majority ranging between 11 and 30 extra beds. From March–June 2020, ICUs had a mean maximum of 9.4 COVID-19 patients simultaneously. Allowing restricted visiting was more common in Denmark (52%) and Norway (61%) than in Sweden where ICU visiting was mostly denied except for dying patients (68%), due to a particular increased number of COVID-19 patients. The restrictions forced nurses to compromise on their usual standards of family care. Numerous models for maintaining contact between relatives and patients were described. CONCLUSION: Visitation restrictions compromised the quality of family care and entailed dilemmas for healthcare professionals but also spurred initiatives to developing new ways of providing family care.