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Belser T, Exl MT, Nydahl P, Zumstein-Shaha M, Jeitziner MM. Experiences of parents visiting an adult family member in the intensive care unit accompanied by their underaged children: A qualitative study. Aust Crit Care 2024; 37:783-789. [PMID: 38631938 DOI: 10.1016/j.aucc.2024.02.004] [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: 11/06/2023] [Revised: 02/12/2024] [Accepted: 02/16/2024] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVES The objective of this study was to explore experiences and needs of parents visiting critically ill family members in intensive care units (ICUs) accompanied by their underaged children (<18 years). METHODS Six semistructured interviews with parents were conducted in a qualitative design. Data analysis and synthesis were performed using Braun and Clarke's thematic analysis. This study was conducted in five adult ICUs in Switzerland. FINDINGS Parents opted for early and truthful involvement of their children, and the majority initiated the visits themselves. Five themes were identified: feeling of shock by the entire family; crying in front of the children; feeling welcome with the children; knowing that the children can cope with it; and holding the family together. Parents felt only partially welcomed in the ICU when accompanied by their children. In one case, the parents withdrew the child from the visit. CONCLUSIONS Parents experienced the visit to a critically ill family member in the ICU with their underaged children as challenging. They were emotionally vulnerable and yet took the initiative to keep the family together. Parents had to mediate between their children, the critically ill family member, and the treatment team. Awareness of the needs of the parents visiting with underaged children is important in clinical practice. There is a need for family-centred structures and processes, including adequate visiting times and rooms suitable for children with books, pictures, and toys.
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Affiliation(s)
- Tanja Belser
- Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010 Bern, Switzerland.
| | - Matthias Thomas Exl
- Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010 Bern, Switzerland.
| | - Peter Nydahl
- Nursing Research, University Hospital of Schleswig-Holstein, Arnold-Heller-Str. 3, 24105 Kiel, Germany; Institute of Nursing Science and Development, Paracelsus Medical University, Salzburg, Austria.
| | - Maya Zumstein-Shaha
- Bern University of Applied Sciences Health, Murtenstrasse 10, 3008 Bern, Switzerland; University of Witten/Herdecke, Department of Nursing, Alfred-Herrhausen-Strasse 50, 58448 Witten, Germany.
| | - Marie-Madlen Jeitziner
- Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010 Bern, Switzerland; Institute of Nursing Science (INS), Department of Public Health (DPH), Faculty of Medicine, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland.
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Brauchle M, Deffner T, Nydahl P. Ten recommendations for child-friendly visiting policies in critical care. Intensive Care Med 2023; 49:341-344. [PMID: 36715706 PMCID: PMC9998315 DOI: 10.1007/s00134-022-06974-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 12/26/2022] [Indexed: 01/31/2023]
Affiliation(s)
- Maria Brauchle
- Department of Anaesthesiology and Intensive Care Medicine, Hospital Landeskrankenhaus Feldkirch, Carinagasse 35, 6800, Feldkirch, Austria
| | - Teresa Deffner
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Jena, Jena, Germany
| | - Peter Nydahl
- University Hospital of Schleswig-Holstein, Kiel, Haus V40, Arnold-Heller-Str. 3, 24105, Kiel, Germany.
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Hunter P, Ward H, Puurveen G. Trust as a key measure of quality and safety after the restriction of family contact in Canadian long-term care settings during the COVID-19 pandemic. Health Policy 2023; 128:18-27. [PMID: 36543694 PMCID: PMC9756649 DOI: 10.1016/j.healthpol.2022.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 12/13/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022]
Abstract
Family caregivers in Canadian long-term care homes are estimated to provide 10 h per week of direct care to approximately 30% of residents through roles including mobility support, mealtime assistance, personal care, social interaction, psychological care, care coordination, and advocacy. Despite these contributions, they continue to be viewed as visitors rather than as key participants in the interdependent relationships that support the long-term care sector. Their marginalization was evident during the COVID-19 pandemic, as Canadian public health policy focused on preventing them from entering long-term care, rather than supporting personal risk management, symptom screening, personal protective equipment, and other mechanisms for safe involvement in care. Several iatrogenic resident outcomes have been attributed to this, including decreased cognitive function, decreased mobility, increased incontinence, weight loss, increased depression and anxiety, increased responsive behaviours amongst those living with dementia, and increased delirium. In this commentary article, we argue that family caregiver presence was conflated as a risk when instead, it contributed to unintended harm. We identify nine well-known human social cognitive predispositions that may have contributed to this. We then examine their implications for trust in long-term care, and consider how quality and safety can be further fostered in long-term care by working in partnership with family caregivers to rebuild trust through enquiry and collaboration. We advocate incorporating trust as an essential measure of quality health service.
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Affiliation(s)
- P.V. Hunter
- St. Thomas More College, University of Saskatchewan, 1437 College Drive, Saskatoon, SK S7N 0W6, Canada,Corresponding author
| | - H.A. Ward
- University of Saskatchewan, 105 Administration Place, Saskatoon, SK S7N 5A2, Canada
| | - G. Puurveen
- University of British Columbia, 2329 West Mall, Vancouver, BC V6T 1Z4, Canada
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Discordance among Belief, Practice, and the Literature in Infection Prevention in the NICU. CHILDREN 2022; 9:children9040492. [PMID: 35455536 PMCID: PMC9027430 DOI: 10.3390/children9040492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 11/16/2022]
Abstract
This study evaluates practices of infection control in the NICU as compared with the available literature. We aimed to assess providers’ awareness of their institutional policies, how strongly they believed in those policies, the correlation between institution size and policies adopted, years of experience and belief in a policy’s efficacy, and methods employed in the existing literature. An IRB-approved survey was distributed to members of the AAP Neonatal Section. A systematic review of the literature provided the domains of the survey questions. Data was analyzed as appropriate. A total of 364 providers responded. While larger NICUs were more likely to have policies, their providers are less likely to know them. When a policy is in place and it is known, providers believe in the effectiveness of that policy suggesting consensus or, at its worst, groupthink. Ultimately, practice across the US is non-uniform and policies are not always consistent with best available literature. The strength of available literature is adequate enough to provide grade B recommendations in many aspects of infection prevention. A more standardized approach to infection prevention in the NICU would be beneficial and is needed.
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Brauchle M, Nydahl P, Pregartner G, Hoffmann M, Jeitziner MM. Practice of family-centred care in intensive care units before the COVID-19-pandemic: A cross-sectional analysis in German-speaking countries. Intensive Crit Care Nurs 2022; 68:103139. [PMID: 34750041 PMCID: PMC8421104 DOI: 10.1016/j.iccn.2021.103139] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/18/2021] [Accepted: 08/30/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To provide insights into visiting policies and family-centred care practices with a focus on children as visitors in Intensive Care Units in German-speaking countries. METHODS/DESIGN Online-survey with a mixed methods approach. Leading clinicians (n = 1943) from German-speaking countries were invited to participate. Outcomes included the percentage of intensive care units with open visiting policies, age restrictions, family-centred care activities and barriers. SETTING Paediatric, mixed and adult units RESULTS: In total, 19.8% (n = 385) of the clinicians responded. Open visiting times were reported by 36.3% (n = 117), with significant differences between paediatric (79.2%), adult (21.3%) and mixed-age (41.2%) units (p < 0.01). Two-thirds of clinicians stated that their units had no age restrictions for children as visitors (n = 221, 68.4%). The family-centred care activities most frequently implemented were open visiting times and dissemination of information. Significantly more German units have open visiting policies and more Swiss units allow children as visitors, compared to the other countries (both p < 0.001). Barriers to family-centred care were concerns about children being traumatized, infection and workload. CONCLUSION The majority reported that family-centred care policies had been implemented in their units, including open visiting policies, allowing children as visitors without age restriction and other family-centred care activities.
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Affiliation(s)
- Maria Brauchle
- Hospital Landeskrankenhaus Feldkirch, Department of Anaesthesiology and Intensive Care Medicine, Carinagasse 35, 6800 Feldkirch, Austria
| | - Peter Nydahl
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Gudrun Pregartner
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Auenbruggerplatz 2/9/V, 8036 Graz, Austria
| | - Magdalena Hoffmann
- Department of Internal Medicine, Medical University of Graz, Graz, Austria,Executive Department for Quality and Risk Management, University Hospital Graz, Graz, Austria,Research Unit for Safety in Health, c/o Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 1/3, 8036 Graz, Austria,Corresponding author at: Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Marie-Madlen Jeitziner
- Institute of Nursing Science (INS), Department of Public Health (DPH), Faculty of Medicine, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland,Department of Intensive Care Medicine, University Hospital Bern (Inselspital), University of Bern, Freiburgstrasse 4, 3010 Bern, Switzerland
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Niinomi K, Mihira H, Ochiai R, Misawa A, Takigawa K, Kashiki N, Kakee N, Takata H, Ishida Y, Higaki T. Hospital Support for Siblings of Children With Illness in Japan. Front Pediatr 2022; 10:927084. [PMID: 35712629 PMCID: PMC9195589 DOI: 10.3389/fped.2022.927084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 05/10/2022] [Indexed: 11/13/2022] Open
Abstract
Recent years have seen increased attention to the needs and support of siblings of children with chronic illness, and reports of intervention studies on siblings are gradually increasing worldwide. In Japan, the basic policy approved by the Cabinet in 2021 of The Basic Law for Child and Maternal Health and Development stipulates promoting support for the siblings of children with chronic illness, medical care, and disabilities. Simultaneously, practical reports are emerging. However, reports on the actual state of sibling support at medical institutions in Japan are limited. This study aimed to describe the actual state of support for siblings of children with illness in Japanese medical institutions using a cross-sectional design. Responses were obtained from 207 of 484 registered training facilities for Board-Certified Pediatricians of the Japan Pediatric Society through anonymous questionnaires investigating the actual state of siblings' support. Descriptive statistics were calculated, and the state of siblings' support was described. Fifty-two participants (25.1%) answered that the entire ward, including two outpatient departments, provided siblings' support, while 37 (17.9%) answered some staff made an effort, and 117 (56.5%) did not. Support mentioned included conversing with siblings, actively speaking to siblings, calling siblings' names, and counseling care through the parents. Of the 45 cases (21.7%) where siblings were invited to events and gatherings, 10 (22.2%) were siblings-centered events. Some cases involved collaboration with local sibling support groups such as non-profit organizations. This study clarified the actual state of siblings' support, and further expansion of this support is required.
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Affiliation(s)
- Kazuteru Niinomi
- Department of Integrated Health Sciences, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Hajime Mihira
- Education and Research Center of Legal Medicine, Chiba University, Chiba, Japan
| | - Ryota Ochiai
- Department of Nursing, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Akiko Misawa
- Yamashiro Minami Health Care Center of Kyoto Prefecture, Kizugawa, Japan
| | - Kuniyoshi Takigawa
- Department of Education, Faculty of Human Development and Education, Kyoto Women's University, Kyoto, Japan
| | - Nagako Kashiki
- Graduate School of Education, Ehime University, Matsuyama, Japan
| | - Naoko Kakee
- Division of Bioethics, National Center for Child Health and Development, Tokyo, Japan
| | - Hidemi Takata
- Department of Regional Pediatrics and Perinatology, Graduate School of Medicine, Ehime University, Toon, Japan
| | - Yasushi Ishida
- Pediatric Medical Center, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - Takashi Higaki
- Department of Regional Pediatrics and Perinatology, Graduate School of Medicine, Ehime University, Toon, Japan
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Scanferla E, Gorwood P, Fasse L. Familial experience of acute bacterial meningitis in children: a transversal qualitative study using interpretative phenomenological analysis. BMJ Open 2021; 11:e047465. [PMID: 34285009 PMCID: PMC8292830 DOI: 10.1136/bmjopen-2020-047465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES To capture the subjective experience of close family ascendants of acute bacterial meningitis survivors and to explore how they give meaning to this specific experience. DESIGN A qualitative study of indepth interviews using interpretative phenomenological analysis. PRIMARY OUTCOME Main meaning-making processes of participants' experience. SETTINGS Participants were recruited through two associations of people affected by meningitis and their family ascendants. PARTICIPANTS Convenience sampling of 11 women whose children or grandchildren were between 0.2 and 20 years old at the time of their meningitis diagnosis (M=4.06, SD=7.3). On average, 9.39 (SD=5.4) years had passed between the onset of illness and the interview. RESULTS Six superordinate themes (meningitis disease; healthcare services and professionals; knowledge/ignorance; repercussions of the meningitis experience: 'life afterwards'; sick child attitudes/behaviour; and sibling attitudes/behaviour) and two main meaning-making processes in relation to participants' experience of meningitis were identified: (1) the sick child becoming a 'hero': comparison with other children; and (2) engaging action/attitude: finding the 'positive' of the traumatic experience and engaging action to improve the care system. These two processes underpin the psychological adjustment to meningitis and its consequences. CONCLUSIONS This study provides a unique insight into close family members' first-hand experience with acute bacterial meningitis. Findings highlighted factors characterising the disease experience, the psychological adjustment of meningitis survivors' families and their meaning-making processes. These findings are important for research and clinical practice, demonstrating the multidimensional impact of the disease on family ascendants, their need for professional psychological support and the importance of direct involvement of parents in identifying key aspects of care.
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Affiliation(s)
- Elisabetta Scanferla
- CMME (Clinique des Maladies Mentales et de l'Encéphale), GHU Paris psychiatrie et neurosciences, Paris, France
- ED 450, Université de Paris, Paris, France
| | - Philip Gorwood
- CMME (Clinique des Maladies Mentales et de l'Encéphale), GHU Paris psychiatrie et neurosciences, Paris, France
- U1266, INSERM, Institute of Psychiatry and Neuroscience of Paris (IPNP), Université de Paris, Paris, France
| | - Léonor Fasse
- LPPS, EA4057, Université de Paris, Paris, France
- Département de Soins de Support, Gustave Roussy Institute, Villejuif, France
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Yi YZ, Su T, Jia YZ, Xue Y, Chen YZ, Zhang QS, Chow CB, Lee WGP, Cheung PY. Family-centered care management strategies for term and near-term neonates with brief hospitalization in a level III NICU in Shenzhen, China during the time of COVID-19 pandemic. J Matern Fetal Neonatal Med 2021; 35:5923-5926. [PMID: 33752556 DOI: 10.1080/14767058.2021.1902499] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Adopting the family-centered care (FCC) approach in the neonatal care has been shown to improve breastfeeding rate and parental satisfaction. To minimize the transmission of COVID-19, family visit in neonatal intensive care unit (NICU) was suspended in China. In order to maintain the benefits of FCC, the Hong Kong University-Shenzhen Hospital NICU modified FCC strategies. We evaluated the effects of new strategies and aimed to share our results and experience with other NICUs during the COVID-19 pandemic. METHODS Using prospectively collected hospital databases, we retrospectively compared the demographic and clinical data of neonates, rates of breastfeeding at discharge, nosocomial infection and parental satisfaction one month before (open group) and after (closed group) the implementation of alternative FCC management strategies when family visit was suspended during COVID-19 pandemic. RESULTS During the COVID-19 pandemic, we organized a multidisciplinary task force and adopted strategies of triage and screening, management of suspected infants, and breastfeeding promotion with effective communication. The nosocomial infection rate and parental satisfaction for open and closed groups (144 and 108 term and near-term neonates with brief hospitalization, respectively) were not different (1% vs. 0%, p = 1.00; 98.6 vs. 98.8, p = .80; respectively). Breastfeeding rate at discharge decreased but the difference was not significant (74% vs. 80%, p = .29). CONCLUSIONS In our experience, in term and near-term neonates with brief hospitalization, the alternative FCC strategies maintained high parental satisfaction without increased nosocomial infection rate, but strong support for breastfeeding was needed. Through multidisciplinary collaboration, the continuation of "modified" FCC in a level III NICU is feasible in the context of COVID-19 pandemic with reduced family visitation and participation in the care.
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Affiliation(s)
- Yan-Zhi Yi
- Department of Pediatrics, University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Ting Su
- Department of Pediatrics, University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Yi-Zhen Jia
- Core Laboratory, University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Yin Xue
- Department of Pediatrics, University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Yu-Zhi Chen
- Department of Pediatrics, University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Qian-Shen Zhang
- Department of Pediatrics, University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Chun-Bong Chow
- Department of Pediatrics, University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Winnie Gun-Ping Lee
- Department of Pediatrics, University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Po-Yin Cheung
- Department of Pediatrics, University of Hong Kong-Shenzhen Hospital, Shenzhen, China.,Department of Pediatrics, University of Alberta, Edmonton, Canada
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Kidszun A, Neurohr A, Gröndahl B, Tippmann S, Schreiner D, Winter J, Mahmoudpour SH, Gehring S, Mildenberger E. Low Frequency of Viral Respiratory Tract Infections During Family-Centered Neonatal Intensive Care: Results of a Prospective Surveillance Study. Front Pediatr 2020; 8:606262. [PMID: 33313030 PMCID: PMC7701331 DOI: 10.3389/fped.2020.606262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 10/19/2020] [Indexed: 11/28/2022] Open
Abstract
Background: Viral respiratory tract infections (VRTI) may cause severe respiratory and sepsis-like symptoms in infants hospitalized in the neonatal intensive care unit (NICU). Little is known about the frequencies of VRTI in relation to visiting policies in the NICU. Objective: Aim of this study was to evaluate the frequency of symptomatic and asymptomatic VRTI in our family-centered NICU. Methods: This was a 12-month, prospective, observational study from February 2018 to January 2019. Infants hospitalized ≥72 h were eligible for the study. To determine the frequency of VRTI, multiplexed point-of-care testing (mPOCT) of symptomatic infants was combined with a weekly screening of all infants. Our 10-bed NICU is 24/7 open to families and visitors. The number of simultaneous visitors is restricted to two per patient. Parents and visitors are instructed in hand hygiene and advised to avoid visits in cases of respiratory illness. Siblings irrespective of age may visit the NICU following a physical check-up. Results Multiplexed point-of-care testing (71 symptomatic episodes) combined with the weekly screening (272 episodes) yielded in 21 positive samples from 2 of the 67 infants enrolled in the study. Both infants were first detected during symptomatic episodes. Rhino-/enterovirus were detected in all cases. Conclusion: Respiratory viruses were detected during symptomatic and asymptomatic episodes but affected <3% of infants enrolled in the study. In our unit, a low frequency of VRTI was attained despite adherence to family integrated care including liberal visiting policies for younger siblings.
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Affiliation(s)
- André Kidszun
- Department of Neonatology, University Medical Center, Mainz, Germany
| | - Anna Neurohr
- Department of Neonatology, University Medical Center, Mainz, Germany
| | - Britta Gröndahl
- Department of Pediatric Infectious Diseases, University Medical Center, Mainz, Germany
| | - Susanne Tippmann
- Department of Neonatology, University Medical Center, Mainz, Germany
| | - Daniel Schreiner
- Department of Neonatology, University Medical Center, Mainz, Germany
| | - Julia Winter
- Department of Neonatology, University Medical Center, Mainz, Germany
| | - Seyed Hamidreza Mahmoudpour
- Institute of Medical Biostatistics, Epidemiology, and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.,Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Stephan Gehring
- Department of Pediatric Infectious Diseases, University Medical Center, Mainz, Germany
| | - Eva Mildenberger
- Department of Neonatology, University Medical Center, Mainz, Germany
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Valls-Matarín J, Peradejordi-Torres RM, Calvet-González E, Jorge-Castillo A, Calvo-Alonso S, Sandalinas-Mulero I. Visit of minors in an intensive care unit. What is the opinion of health staff? ENFERMERIA INTENSIVA 2019; 31:52-59. [PMID: 31253587 DOI: 10.1016/j.enfi.2019.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 12/05/2018] [Accepted: 01/10/2019] [Indexed: 11/25/2022]
Abstract
AIM To determine the opinion of healthcare staff (HS) on the presence of minors in an adult intensive care unit. METHOD Transversal descriptive research study in an adult intensive care unit with 62 people, between September/December 2017. The Knutsson questionnaire was used with 10 closed questions with space for comments, and 2 open questions. Selection of the respondents was by means of convenience sampling. Descriptive statistics with absolute frequencies and percentages. Chi-squared-test or Fisher. Significance p<.05. RESULTS 61 questionnaires were collected: 70.5% nursing staff (NS). Fifty percent of medical staff (MS) would restrict the entry of 0 to 6-year old minors versus 76.2% NS (p=.04). Of the MS, 16.7% would restrict the visits of minors between the ages of 7 and 12 versus 46.5% NS (p=.02). Seventy-five percent of HS thought that minors' access could entail a risk of infection for the children. Of the survey respondents, 60% believed that the environment could intimidate the minor, and 66.7% thought that the patient's condition could affect the child. They would permit 0-6-year-old minors to access the ICU if the patient was dying (70.6% MS/41% NS, p=.04), awake and alert (77.8% MS/57.5% NE) and close relatives (parents) (66.7% MS/60% NS). CONCLUSIONS HS support minors visiting an adult adult intensive care unit if they are>6 years old. HS show a more positive attitude towards visits in special circumstances such as close relatives, awake patient, and death regardless of their age. The reasons for restriction of visits are: environment, patient's condition and risk of infection. NS show a less positive attitude in relation to visits.
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Affiliation(s)
- J Valls-Matarín
- Unidad de Cuidados Intensivos, Hospital Universitari Mútua Terrassa, Terrassa, España.
| | | | - E Calvet-González
- Unidad de Cuidados Intensivos, Hospital Universitari Mútua Terrassa, Terrassa, España
| | - A Jorge-Castillo
- Unidad de Cuidados Intensivos, Hospital Universitari Mútua Terrassa, Terrassa, España
| | - S Calvo-Alonso
- Unidad de Cuidados Intensivos, Hospital Universitari Mútua Terrassa, Terrassa, España
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Pichler K, Assadian O, Berger A. Viral Respiratory Infections in the Neonatal Intensive Care Unit-A Review. Front Microbiol 2018; 9:2484. [PMID: 30405557 PMCID: PMC6202802 DOI: 10.3389/fmicb.2018.02484] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Accepted: 09/28/2018] [Indexed: 01/24/2023] Open
Abstract
Although infrequent, respiratory viral infections (RVIs) during birth hospitalization have a significant impact on short- and long-term morbidity in term and preterm neonates. RVI have been associated with increased length of hospital stay, severe disease course, unnecessary antimicrobial exposure and nosocomial outbreaks in the neonatal intensive care unit (NICU). Virus transmission has been described to occur via health care professionals, parents and other visitors. Most at risk are infants born prematurely, due to their immature immune system and the fact that they stay in the NICU for a considerable length of time. A prevalence of RVIs in the NICU in symptomatic infants of 6–30% has been described, although RVIs are most probably underdiagnosed, since testing for viral pathogens is not performed routinely in symptomatic patients in many NICUs. Additional challenges are the wide range of clinical presentation of RVIs, their similarity to bacterial infections and the unreliable detection methods prior to the era of molecular biology based technologies. In this review, current knowledge of early-life RVI in the NICU is discussed. Reviewed viral pathogens include human rhinovirus, respiratory syncytial virus and influenza virus, and discussed literature is restricted to reports based on modern molecular biology techniques. The review highlights therapeutic approaches and possible preventive strategies. Furthermore, short- and long-term consequences of RVIs in infants hospitalized in the NICU are discussed.
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Affiliation(s)
- Karin Pichler
- Division of Neonatology, Intensive Care and Neuropediatrics, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Ojan Assadian
- Department for Hospital Epidemiology and Infection Control, Medical University of Vienna, Vienna, Austria
| | - Angelika Berger
- Division of Neonatology, Intensive Care and Neuropediatrics, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
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