• Kirsten M Fiest, Karla D Krewulak, Natalia Jaworska, Krista L Spence, Sara J Mizen, Sean M Bagshaw, BurnsKaren E AKEALi Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.Unity Health Toronto-St. Michael's Hospital, Toronto, ON, Canada, Deborah J Cook, Robert A Fowler, Kendiss Olafson, Scott B Patten, Oleksa G Rewa, Bram Rochwerg, Sean Spence, Andrew West, Henry T Stelfox, Jeanna Parsons Leigh, and Canadian Critical Care Trials Group.
• Department of Critical Care Medicine, Alberta Health Services & University of Calgary, Calgary, AB, Canada. kmfiest@ucalgary.ca.
• Can J Anaesth. 2022 Oct 1; 69 (10): 124812591248-1259.

PurposeDuring the first wave of the COVID-19 pandemic, restricted visitation policies were enacted at acute care facilities to reduce the spread of COVID-19 and conserve personal protective equipment. In this study, we aimed to describe the impact of restricted visitation policies on critically ill patients, families, critical care clinicians, and decision-makers; highlight the challenges faced in translating these policies into practice; and delineate strategies to mitigate their effects.MethodA qualitative description design was used. We conducted semistructured interviews with critically ill adult patients and their family members, critical care clinicians, and decision-makers (i.e., policy makers or enforcers) affected by restricted visitation policies. We transcribed semistructured interviews verbatim and analyzed the transcripts using inductive thematic analysis.ResultsThree patients, eight family members, 30 clinicians (13 physicians, 17 nurses from 23 Canadian intensive care units [ICUs]), and three decision-makers participated in interviews. Thematic analysis was used to identify five themes: 1) acceptance of restricted visitation (e.g., accepting with concerns); 2) impact of restricted visitation (e.g., ethical challenges, moral distress, patients dying alone, intensified workload); 3) trust in the healthcare system during the pandemic (e.g., mistrust of clinical team); 4) modes of communication (e.g., communication using virtual platforms); and 5) impact of policy implementation on clinical practice (e.g., frequent changes and inconsistent implementation).ConclusionsRestricted visitation policies across ICUs during the COVID-19 pandemic negatively affected critically ill patients and their families, critical care clinicians, and decision-makers.© 2022. The Author(s).

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