| Popis: |
BackgroundIn April 2020, in response to the emerging COVID-19 pandemic, NHS England recommended limiting visiting to hospital inpatients, with resultant changes to our hospital policy of open visiting limiting visits to a single carer. In addition, changes to the way healthcare professionals interacted with carers had to be implemented, such as remote meetings, use of personal and protective equipment and social distancing.ObjectivesOur objective was to understand the impact of these changes on carers of children requiring intensive care during the Pandemic.MethodsA patient reported experience measure (PREM) focusing on experiences of attending the hospital and the impact of the necessary changes was developed by clinicians, family liaison nurses and the PREM team at our institution. The PREM was distributed to carers whose child was either a planned or emergency admission to the Paediatric, Neonatal or Cardiac intensive care units between December 2020 and March 2021. Quantitative and thematic analysis of responses was undertaken.ResultsTo date, 80 PREMs have been given to carers and 67 completed questionnaires have been received (76% response rate). Overall levels of satisfaction were very high, with 94% reporting that they were very or mostly satisfied with the intensive care team and the service they provided. Nearly two-thirds of the carers were concerned about catching COVID whilst on the intensive care unit but this decreased to 43% for other public areas of the hospital, such as the cafeteria.All carers understood the need for them to wear a mask but only 65% agreed that staff were able to interpret and respond appropriately to their emotions when they were wearing one. One third of respondents reported that they did not get the emotional support they needed from family or friends. Some carers found the restricted visiting policy challenging, with 24% reporting that it was not acceptable that the sole carer permitted at the bedside could not change as needed. This was supported by the qualitative comments, which indicated that whilst parents understood the rationale for the one carer policy, it caused additional distress.Loneliness and lack of physical contact were identified by parents as particularly stressful, together with the need to cope alone with complex information. Carers described being ‘fully alone’ without their partners, which affected the mental health of both parents and resulted in feelings of despair and confusion.ConclusionsOur intensive care is one of the largest paediatric units in the UK and during the pandemic we increased our capacity to accommodate intensive care patients from other paediatric units that reconfigured to treat adult patients. During the pandemic, our usual approach to carer support was challenged by visiting and communication restrictions, the impact of which may have long-term consequences. Despite these challenges, we were able to sensitively provide the high standards of care expected by patients and their families. |
