CHEST Guidelines-Family-Presence-for-Critically-Ill-Patients-During

Family-Presence-for-Critically-Ill-Patients-During

Pdf Summary

The article by Joanna L. Hart, MD, and Stephanie Parks Taylor, MD, discusses the impact of the COVID-19 pandemic on family presence in critical care settings, stressing the importance of revisiting visitation policies. Family engagement is crucial in critical care but COVID-19 led to restrictive visitation policies, initially appropriate for limiting virus spread. With improved knowledge and resources over time, these restrictions now pose psychological and emotional distress for patients and families, impede high-quality communication and decision-making, and potentially worsen clinical outcomes.<br /><br />The document outlines that in-person visitation enhances family-centered care in ICUs, aiding communication, integration, shared decision-making, and reducing delirium and complicated grief. Studies show that visitation can reduce ICU stays and improve family and patient experiences during end-of-life and grieving processes. There is scant evidence that family members significantly contribute to viral transmission, and current infection control guidelines effectively prevent this. Therefore, allowing family members to participate in the decision about visitation can promote autonomy and mitigate loss of control.<br /><br />The article calls for hospitals to develop policies that balance safety and family involvement during pandemics. Recommendations for policy design include: permitting at least two family members to visit, maintaining open visitation hours, using PPE judiciously, and supporting virtual communication alternatives.<br /><br />Overall, the article argues that the prolonged pandemic threatens family-centered critical care progress and emphasizes leveraging pandemic insights to safely re-integrate family presence, which is vital for patient, family, and physician well-being. Hospitals are urged to create adaptable policies through stakeholder collaboration to ensure they can swiftly respond to changing circumstances without compromising family access.

Keywords

COVID-19

family presence

critical care

visitation policies

psychological distress

family-centered care

ICU communication

pandemic insights

infection control

stakeholder collaboration