Hospital Policies During COVID-19: An Analysis of Visitor Restrictions.
Journal
Journal of public health management and practice : JPHMP
ISSN: 1550-5022
Titre abrégé: J Public Health Manag Pract
Pays: United States
ID NLM: 9505213
Informations de publication
Date de publication:
Historique:
pubmed:
18
3
2021
medline:
25
11
2021
entrez:
17
3
2021
Statut:
ppublish
Résumé
In response to the COVID-19 pandemic, hospitals have developed visitor restriction policies in order to mitigate spread of infection. We reviewed hospital visitor restriction policies for consistency and to develop recommendations to highlight fair and transparent restrictions, exceptions, and appeals in policy development and implementation. Collection and analysis of public-facing visitor restriction policies during the first 3 months of the pandemic. General acute care hospitals representing 23 states across all 4 major regions of the United States. A cohort of the 70 largest hospitals by total bed capacity. Characteristics of visitor restriction policies including general visitor restriction statement, changes/updates to policies over time, exceptions to policies, and restrictions specific to COVID-19-positive patients. Sixty-five of the 70 hospitals reviewed had public-facing visitor restriction policies. Forty-nine of these 65 policies had general "no-visitor" statements, whereas 16 allowed at least 1 visitor to accompany all patients. Sixty-three of 65 hospitals included exceptions to their visitor restriction policies. Setting-specific exceptions included pediatrics, obstetrics/gynecology, emergency department, behavioral health, inpatient rehabilitation, surgery, and outpatient clinics. Exceptions that applied across settings included patients at end of life and patients with disabilities. Visitor restriction policies varied significantly among hospitals in this review. These variances create challenges in that their fair application may be problematic and ethical issues related to allocation may arise. Five recommendations are offered for hospitals revising or creating such policies, including that offering transparent, accessible, public-facing policies can minimize ethical dilemmas. In addition, hospitals would benefit from communicating with each other in the development of visitor policies to ensure uniformity and support patients and family members as they navigate hospital visitation.
Identifiants
pubmed: 33729198
doi: 10.1097/PHH.0000000000001320
pii: 00124784-900000000-99192
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
E299-E306Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors declare no conflicts of interest.
Références
Klompas M, Morris CA, Sinclair J, Pearson M, Shenoy ES. Universal masking in hospitals in the COVID-19 era. N Engl J Med. 2020;382(21):e63.
Ranney ML, Griffeth V, Jha AK. Critical supply shortages—the need for ventilators and personal protective equipment during the COVID-19 pandemic. N Engl J Med. 2020;382(18):e41.
Farrell NM, Hayes BD, Linden JA. Critical medication shortages further dwindling hospital resources during COVID-19. Am J Emerg Med. 2020;S0735-6757(20)30404-30406.
Diaz A, Rahmanian A, Pawlik TM. COVID-19: the road to recovery. Am J Surg. 2020;220(3):561–565.
Buchbinder N, Dumesnil C, Pinquier D, et al. Pandemic A/H1N1/2009 influenza in a paediatric haematology and oncology unit: successful management of a sudden outbreak. J Hosp Infect. 2011;79(2):155–160.
Mukhopadhyay A, Tambyah PA, Singh KS, Lim TK, Lee K-H. SARS in a hospital visitor and her intensivist. J Hosp Infect. 2004;56(3):249–250.
Sfeir MA, Simon MS, Banach D. Isolation precautions for visitors to healthcare settings. In: Bearman G, Munoz-Price S, Morgan D, Murthy R, eds. Infection Prevention. Cham, Switzerland: Springer; 2018:19–27.
Johnston CP, Qiu H, Ticehurst JR, et al. Outbreak management and implications of a nosocomial Norovirus outbreak. Clin Infect Dis. 2007;45(5):534–540.
Teixeira CA. The rationale of flexible ICU visiting hours for delirium prevention. Intensive Care Med. 2018;2:968–970.
Giannini A. The “open” ICU: not just a question of time. Minerva Anestesiol. 2010;76(2):89–90.
Steen M, Downe S, Bamford N, Edozien L. Not-patient and not-visitor: a metasynthesis fathers' encounters with pregnancy, birth and maternity care. Midwifery. 2012;28(4):362–371.
Public Health Law (PHL) 2803(i)(g) Patients' Rights 10NYCRR, Section 405.7 (2019).
Darby JA, Falco C. Infection control and the need for family-/child-centered care. In: McNeil J, Campbell J, Crews J, eds. Healthcare-Associated Infections in Children. Cham, Switzerland: Springer; 2019:57–79.
Special Bulletin COVID-19 #83: Title II Americans with Disabilities Act (ADA) and Section 504 Rehabilitation Act (RA) Protections during the COVID-19 Pandemic (May 6, 2020).
Matheny Antommaria AH, Gibb TS, McGuire AL, et al. Ventilator triage policies during the COVID-19 pandemic at US hospitals associated with members of the Association of Bioethics Program Directors. Ann Intern Med. 2020;173(3):188–194.
NC Rural Health Research Program US Hospital List. The Cecil G Sheps Center for Health Services Research Web site. https://www.shepscenter.unc.edu/programs-projects/rural-health/data. Published 2020. Accessed August 31, 2020.
Healthcare facilities: managing operations during the COVID-19 pandemic. https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-hcf.html. Published June 28, 2020. Accessed August 31, 2020.
Samanta A, Samanta J. Advance directives, best interests and clinical judgement: shifting sands at the end of life. Clin Med (Lond). 2006;6(3):274–278.
Dias E. The last anointing. The New York Times. https://www.nytimes.com/interactive/2020/06/06/us/coronavirus-priests-last-rites.html. Published June 6, 2020. Accessed August 31, 2020.
Melanie Smith JV. “You Can See Your Loved One Now.” Can Visitor Restrictions During COVID Unduly Influence End-of-Life Decisions? Garrison, NY: The Hastings Center; 2020.
Gostin LO, Friedman EA, Wetter SA. Responding to COVID-19: how to navigate a public health emergency legally and ethically. Hastings Cent Rep. 2020;50(2):8–12.
Solomon MZ, Wynia MK, Gostin LO. COVID-19 crisis triage—optimizing health outcomes and disability rights. N Engl J Med. 2020;383(5):e27.