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Impact of COVID-19 Pandemic on Pediatric Intensive Care Unit Visiting Policies: A Worldwide Survey
Anna Camporesi1, Anna Zanin2, Constantinos Kanaris3,4,5
1Department of Pediatric Anesthesia and Intensive Care, Children's Hospital Vittore Buzzi, Milano, Italy.
Insights
Pediatric intensive care unit (PICU) visiting policies globally changed during the COVID-19 pandemic, impacting family presence and care. These policy shifts affected parental involvement and patient well-being, highlighting the need for flexible visitation guidelines.
Area of Science:
- Pediatric critical care medicine
- Infectious disease epidemiology
- Healthcare policy and management
Background:
- Pediatric intensive care units (PICUs) globally have diverse visiting policies.
- The COVID-19 pandemic introduced concerns regarding viral transmission, necessitating policy reviews.
- Parental presence in PICUs is crucial for child well-being and family-centered care.
Purpose of the Study:
- To evaluate worldwide pediatric intensive care unit (PICU) visiting policies.
- To assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on these policies.
- To understand the implications of policy changes on patient care and family well-being.
Main Methods:
- A web-based international survey was distributed globally via social networks and email.
- Data collected from 215 valid responses across Europe, South America, North America, Asia, Central America, Oceania, and Africa.
- Analysis focused on pre-pandemic policies, pandemic-related changes, and specific restrictions like SARS-CoV-2 testing.
Main Results:
- Pre-pandemic PICU visiting policies varied significantly by continent.
- During the COVID-19 pandemic, 60% of units in Asia, Africa, North America, and Oceania altered family time schedules, compared to half in Europe, Central, and South America.
- Many PICUs implemented stricter isolation precautions and SARS-CoV-2 testing for visitors; some prohibited family visitation entirely.
Conclusions:
- The COVID-19 pandemic led to widespread changes in PICU visiting policies globally.
- These policy shifts potentially reduced parental participation in care, emotional support, and shared decision-making.
- Changes negatively impacted child and parental well-being and may have affected patient outcomes.
Abstract:
The purpose of this study was to evaluate pediatric intensive care unit (PICU) visiting policies around the world and how the coronavirus disease 2019 (COVID-19) pandemic has affected these policies, due to concerns relating to a viral transmission. A web-based international survey was designed and disseminated through social networks, emails, or direct messages. Two hundred forty-one answers were received. From these, 26 were excluded (13 due to missing location and 13 duplicated answers), resulting in a final number of 215 answers. Europe accounted for 35% of responses ( n = 77), South America 22.4% ( n = 49), North America 19% ( n = 41), Asia 16.5% ( n = 36), Central America 2.7% ( n = 6), Oceania, and Africa 2.2% each ( n = 5 each). Before the pandemic, reported admission/visiting policies already varied between continents. Family time schedules remained similar to the prepandemic period in half of European, Central, and South American units and have changed in 60% of Asian, African, North American, and Oceanian units. Access to PICUs has been granted for patients and caregivers tested negative for severe acute respiratory syndrome coronavirus 2 (SARS COV-2) in only part of studied PICUs. Isolation precautions for the visitors were intensified at the onset of the pandemic. Changes in visiting policies were observed in most PICUs worldwide during the COVID-19 pandemic, with some PICUs prohibiting any visitation by families. These changes can decrease possibilities of parental participation in emotional support and reduction of sedation needs, early mobility, and shared decision-making process and impact negatively both children and parental well-being and even patients' outcomes.
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