Communication and Virtual Visiting for Families of Patients in Intensive Care during COVID-19: A UK National Survey.

Rationale Restriction or prohibition of family visiting to intensive care units (ICU) during the COVID-19 pandemic poses substantial barriers to communication, and family- and patient-centred care. Objectives Our objective was to understand how communication between families, patients and the ICU team was enabled during the pandemic. Secondary objectives were to understand strategies used to facilitate virtual visiting and associated benefits and barriers. Methods Multi-centre, cross-sectional, self-administered electronic survey sent (June 2020) to all 217 UK hospitals with at least one ICU. Results Survey response rate was 54%; 117/217 hospitals (182 ICUs). All hospitals imposed visiting restrictions with visits not permitted under any circumstance in 16% of hospitals (28 ICUs); 63% (112 ICUs) permitted family presence at end of life. Responsibility for communicating with families shifted with decreased bedside nurse involvement. A dedicated ICU family liaison team was established in 50% (106 ICUs) of hospitals. All but three hospitals instituted virtual visiting, although there was substantial heterogeneity in the videoconferencing platform used. Unconscious or sedated ICU patients were deemed ineligible for virtual visits in 23% of ICUs. Patients at end of life were deemed ineligible for virtual visits in 7% of ICUs. Commonly reported benefits of virtual visiting were reducing patient psychological distress (78%), improving staff morale (68%) and reorientation of delirious patients (47%). Common barriers to virtual visiting related to insufficient staff time, rapid implementation of videoconferencing technology, and challenges associated with family member ability to use videoconferencing technology or have access to a device. Conclusions Virtual visiting and dedicated communication teams were common COVID-19 innovations addressing restrictions to family ICU visiting, and resulting in valuable benefits in terms of patient recovery and staff morale. Enhancing access and developing a more consistent approach to family virtual ICU visiting could improve quality of care, both during and outside of pandemic conditions.