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Meiers S, de Goumoëns V, Thirsk L, Abbott-Anderson K, Brysiewicz P, Eggenberger S, Heitschmidt M, Kiszio B, Mcandrew NS, Morman A, Richardson S. Nursing strategies to mitigate separation between hospitalized acute and critical care patients and families: A scoping review. Intensive Crit Care Nurs 2024; 84:103773. [PMID: 39067380 DOI: 10.1016/j.iccn.2024.103773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Revised: 07/08/2024] [Accepted: 07/10/2024] [Indexed: 07/30/2024]
Abstract
OBJECTIVE To describe the nursing strategies used to mitigate the impact of forced separation between hospitalized acute and critical care patients and their families during the COVID-19 pandemic. RESEARCH METHODOLOGY/DESIGN A scoping review was performed in accordance with JBI methodology. SETTINGS Those acute and critical care areas in which sudden, often unexpected, emergent episodes of illness or injury were treated. MAIN OUTCOME MEASURES Articles written in English and French between March 2020 and September 2023 in Medline, CINAHL Complete, APA PsycInfo, Embase and the Cochrane COVID-19 study register databases that met our inclusion criteria were included. Gray literature included dissertations, theses and Base Bielefeld Academic Search Engines. RESULTS Among the 1,357 articles screened, 46 met the criteria for inclusion. Most of the articles were published in North America. Adult critical care units were the most frequently reported settings, followed by neonatal intensive care units. The most frequently reported strategies were virtual telephone or video communications. A majority of the innovative strategies involved interprofessional collaboration at the unit level. Core components included the provision of relational nursing practices, virtual visits, tailored information, fostering relationships between family members, palliative care support regarding end of life, and general information about hospitalization and COVID-19. Pediatric care settings were more likely than adult care settings to accommodate physical visitation. CONCLUSION Nurses used synchronous, episodic, and structured virtual interactions, either alone or as part of an interprofessional team, to mitigate separation between patients and families during the COVID-19 pandemic in acute and critical care settings. IMPLICATIONS FOR CLINICAL PRACTICE Permanent policy changes are needed across acute and critical care settings to provide support for nurses in mitigating patient and family separation. We recommend that family members be considered as caregivers and care receivers, not visitors in patient and family-centered care in acute and critical care settings.
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Affiliation(s)
- Sonja Meiers
- College of Nursing, University of Wisconsin-Eau Claire, 105 Garfield Ave, P.O. Box 4004, Eau Claire, WI 54702-4004, USA; Department of Graduate Nursing, Winona State University, 400 South Broadway, Suite 204, Rochester, MN 55904, USA.
| | - Véronique de Goumoëns
- La Source School of Nursing, HES-SO, University of Applied Sciences and Arts Western Switzerland, Av. Vinet 30, Lausanne, Switzerland; Bureau d'Echange des Savoirs pour des praTiques exemplaires de soins (BEST) a JBI Center of Excellence, Avenue Alexandra Vinet 30 - 1004, Lausanne, Switzerland.
| | - Lorraine Thirsk
- Faculty of Health Disciplines, Athabasca University, 1 University Drive, Athabasca, Alberta T9S 3A3, Canada.
| | - Kristen Abbott-Anderson
- College of Nursing, University of Wisconsin-Eau Claire, 105 Garfield Ave, P.O. Box 4004, Eau Claire, WI 54702-4004, USA.
| | - Petra Brysiewicz
- School of Nursing & Public Health, University of KwaZulu-Natal, Mazisi Kunene Road, Glenwood, Durban 4041, South Africa.
| | - Sandra Eggenberger
- Glen Taylor Nursing Institute for Family and Society, Minnesota State University, 360 Wissink Hall (WH 360), Mankato, Mankato, MN, USA.
| | - Mary Heitschmidt
- RUSH System for Health, Center for Clinical Research and Scholarship, 600 South Paulina, Suite 1080 AAC, Chicago, IL 60612, USA; Rush College of Nursing, 600 South Paulina, Suite 1080 AAC, Chicago, IL 60612, USA.
| | - Blanche Kiszio
- La Source School of Nursing, HES-SO, University of Applied Sciences and Arts Western Switzerland, Av. Vinet 30, Lausanne, Switzerland; Bureau d'Echange des Savoirs pour des praTiques exemplaires de soins (BEST) a JBI Center of Excellence, Avenue Alexandra Vinet 30 - 1004, Lausanne, Switzerland.
| | - Natalie S Mcandrew
- School of Nursing, College of Health Professions & Sciences, University of Wisconsin-Milwaukee, 1921 East Hartford Avenue, Milwaukee, WI 53211, USA; Department of Patient Care Research, Froedtert & the Medical College of Wisconsin, Froedtert Hospital, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA.
| | - Aspen Morman
- College of Nursing, University of Wisconsin-Eau Claire, 105 Garfield Ave, P.O. Box 4004, Eau Claire, WI 54702-4004, USA.
| | - Sandra Richardson
- Emergency Department, Christchurch Hospital, Canterbury - Te Waipounamu - Waitaha, Health New Zealand - Te Whatu Ora, New Zealand.
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Tucker JA, Waller M, Fouquier K, Fant M, Rhoads S. Labor Support during the Early Months of the COVID-19 Pandemic in the United States. MCN Am J Matern Child Nurs 2024; 49:204-210. [PMID: 38926919 PMCID: PMC11216393 DOI: 10.1097/nmc.0000000000001021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
PURPOSE To describe the experiences of registered nurses and certified nurse midwives who provided labor support and care in the early months of the COVID-19 pandemic. STUDY DESIGN AND METHODS A descriptive, qualitative approach was used to explore nurses' and midwives' perceptions via in-depth interviews. Data were analyzed via thematic analysis. RESULTS Thirteen nurses, four of whom were also midwives, participated in semi-structured interviews. All provided care during the first 9 months of the pandemic and represented seven states across the United States. The analysis revealed an overarching theme, A New World but still a Celebration. This overarching theme encompasses participants' accounts of trying to provide the same support, presence, and celebration while dealing with constant policy changes, the impact of limited family presence in labor, and their own fears and risks. Four sub-themes were identified: The Impact of Nursing during COVID-19; Challenges, Changes, and Consequences; Unexpected Benefits; and The Cost. CLINICAL IMPLICATIONS The first year of the COVID-19 pandemic saw unprecedented challenges for nurses. Practice changes due to these changing policies had negative and positive effects. Negative practices affected family support, decreased interprofessional collaboration, and caused shorter hospital stays for new mothers. Some positive aspects of practice changes included additional time for mother-newborn bonding due to restrictive visitation policies, increased initiation of breastfeeding, and focused patient education. Nurses across the United States are still coping with practice changes from the pandemic. Our study highlights the need to support nurses in adapting care in the midst of practice changes.
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Mangla S, Stolfi A, Jasin L, Yamashita I, Bader G, Howard S, Omoloja A. Webcam Use in the Neonatal Intensive Care Unit during the First Year of the SARS-CoV-2 Pandemic. Am J Perinatol 2024; 41:e1205-e1211. [PMID: 36539207 DOI: 10.1055/a-2001-8520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate patterns of webcam use in families of patients admitted to a neonatal intensive care unit (NICU) during the first year of the pandemic and characterize the families who used the technology. STUDY DESIGN Retrospective chart review of the medical records and logins of our live webcam system was conducted for 2020. RESULTS From January 1, 2020, to December 31, 2020, 843 infants were admitted to the NICU, with lengths of stay range of 1 to 169 days. More than half (n = 496, 58.8%) of all families of infants admitted to the NICU used the webcam system during the period of study. The number of webcam users did not change between the pre-coronavirus disease 2019 (COVID-19) and during COVID-19 time periods, or during versus after NICU visitor restrictions. Among webcam users, the median (interquartile range) number of logins per day was 2.9 (2.9) and ranged from 0 to 44. There were significant differences among races, site of admission, and diagnosis groups. Families of White infants had more frequent use compared with families of Black infants. Families of infants admitted for surgical reasons had more frequent use compared with those admitted for medical reasons. Among 284 of the 496 (57.3%) webcam users, we documented logins from 37 states in the United States and from 10 different countries. CONCLUSION Webcam use is common in the NICU. There was no increase in webcam use within the first year of the COVID-19 pandemic in the NICU. More studies are needed to evaluate how this technology is used in the NICU and its impact on patients and families. KEY POINTS · Webcam use in the NICU is common.. · Visitor restrictions did not increase webcam use.. · We observed racial differences in webcam use..
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Affiliation(s)
- Shubham Mangla
- Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Adrienne Stolfi
- Department of Pediatrics, Wright State University, Dayton, Ohio
| | - Lisa Jasin
- Neonatal Intensive Care Unit, Dayton Children's Hospital, Dayton, Ohio
| | - Izumi Yamashita
- Neonatal Intensive Care Unit, Dayton Children's Hospital, Dayton, Ohio
| | - Greg Bader
- Clinical Informatics Department, Dayton Children's Hospital, Dayton, Ohio
| | - Savana Howard
- Neonatal Intensive Care Unit, Dayton Children's Hospital, Dayton, Ohio
| | - Abiodun Omoloja
- Department of Pediatrics, Wright State University, Dayton, Ohio
- Clinical Informatics Department, Dayton Children's Hospital, Dayton, Ohio
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Aftyka A, Rybojad B, Mędrzycka-Dąbrowska W. Neonatal Pictures in a NICU as a Mode of Nursing Intervention to Enhance Parent-Infant Bonding: Parents' Experience during the COVID Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3576. [PMID: 36834269 PMCID: PMC9958686 DOI: 10.3390/ijerph20043576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Neonatal departments around the world have changed their policies to prevent the spread of infection during the COVID-19 pandemic. The birth of an extremely premature baby can disrupt physical contact between the mother/parent and the baby. This situation affects the bonding process between mother and child. The aim of the study was to investigate the opinions of parents who receive photographs or videos of their children electronically on the usefulness of this intervention, as well as the emotional reaction of parents to the photos or videos received, and potential ways to improve the intervention. METHODS The study used a qualitative approach and relied on phenomenology, which is a research method used to study experience as experienced from the subjective point of view. Pilot interviews were conducted in January and February 2021, and the final study ran from March to June 2021. RESULTS The uploaded photographs and videos provided a useful communication tool. The parents' emotions at the proposal to send photographs of the child and while viewing the first photographs were strong and marked by considerable ambivalence. CONCLUSIONS This study showed how important it is to ensure communication between the parent and the medical staff. Despite the positive reception, in the future obtaining consent from the legal guardian for taking pictures should be considered, whether this form will be accepted, and to ensure the presence of medical staff while the parent is watching the photographs/videos, as this method of communication will not fully ensure direct skin-to-skin contact to build bonds between the parent and the infant. Neonatal intensive care units need to find strategies to mitigate the impact of separation on parental experiences and bonds should a similar situation arise in the future.
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Affiliation(s)
- Anna Aftyka
- Department of Anaesthesiological and Intensive Care Nursing, Medical University of Lublin, 20-081 Lublin, Poland
| | - Beata Rybojad
- Clinic of Anaesthesiology and Paediatric Intensive Care, Medical University of Lublin, Gebali Str. 6, 20-093 Lublin, Poland
| | - Wioletta Mędrzycka-Dąbrowska
- Department of Anaesthesiology Nursing & Intensive Care, Faculty of Health Sciences, Medical University in Gdansk, 80-211 Gdansk, Poland
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NeoConnect: The Design, Implementation, and Impact of a Virtual Family-Centered NICU Program. J Perinat Neonatal Nurs 2023; 37:61-67. [PMID: 36707750 DOI: 10.1097/jpn.0000000000000698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Familial involvement in the neonatal intensive care unit (NICU) reduces parental stress and strengthens parental-infant bonding. However, parents often face barriers to in-person visitation. The coronavirus disease-2019 COVID-19 pandemic has exacerbated limitations to parental bedside presence. OBJECTIVE To design, implement, and evaluate a technology-based program to connect NICU babies with their families during the COVID-19 pandemic. METHODS We created NeoConnect at our level IV NICU, which included parental audio recordings and video chats between parents and their babies. Parental and NICU staff input on NeoConnect was gathered via preimplementation surveys. Inaugural families and staff members completed a postparticipation survey. RESULTS Prior to implementation, all parents who were surveyed (n = 24) wished they could be more involved in their baby's care. In the first 3 months of NeoConnect, 48 families participated in the audio recording project and 14 families participated in the video chat initiative. Following implementation, 85% of surveyed staff (28/33) reported that the patients became calmer when listening to their parents' recorded voice and 100% of surveyed parents (6/6) reported that video chats reduced their stress level. CONCLUSION Harnessing technology as a tool to increase parental involvement in the NICU is feasible and beneficial for NICU patients and their families.
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