Restricted visitation policies in acute care settings during the COVID-19 pandemic: a scoping review

Abstract Background Restricted visitation policies in acute care settings because of the COVID-19 pandemic have negative consequences. The objective of this scoping review is to identify impacts of restricted visitation policies in acute care settings, and describe perspectives and mitigation approaches among patients, families, and healthcare professionals. Methods We searched Medline, Embase, PsycINFO, Healthstar, CINAHL, Cochrane Central Register of Controlled Trials on January 01/2021, unrestricted, for published primary research records reporting any study design. We included secondary (e.g., reviews) and non-research records (e.g., commentaries), and performed manual searches in web-based resources. We excluded records that did not report primary data. Two reviewers independently abstracted data in duplicate. Results Of 7810 citations, we included 155 records. Sixty-six records (43%) were primary research; 29 (44%) case reports or case series, and 26 (39%) cohort studies; 21 (14%) were literature reviews and 8 (5%) were expert recommendations; 54 (35%) were commentary, editorial, or opinion pieces. Restricted visitation policies impacted coping and daily function (n = 31, 20%) and mental health outcomes (n = 29, 19%) of patients, families, and healthcare professionals. Participants described a need for coping and support (n = 107, 69%), connection and communication (n = 107, 69%), and awareness of state of well-being (n = 101, 65%). Eighty-seven approaches to mitigate impact of restricted visitation were identified, targeting families (n = 61, 70%), patients (n = 51, 59%), and healthcare professionals (n = 40, 46%). Conclusions Patients, families, and healthcare professionals were impacted by restricted visitation polices in acute care settings during COVID-19. The consequences of this approach on patients and families are understudied and warrant evaluation of approaches to mitigate their impact. Future pandemic policy development should include the perspectives of patients, families, and healthcare professionals. Trial registration: The review was registered on PROSPERO (CRD42020221662) and a protocol peer-reviewed prior to data extraction.

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What Evidence Informs the Nursing Care of People with Class III Obesity in an Acute Care Setting? A Scoping Review.

10.21203/rs.3.rs-31488/v1 ◽

2020 ◽

Author(s):

Beverley Ewens ◽

Vivien Kemp ◽

Amanda Towel-Barnard ◽

Lisa Whitehead

Keyword(s):

Patient Care ◽

Acute Care ◽

Nursing Care ◽

Scoping Review ◽

Improve Patient Care ◽

Well Being ◽

Class Iii ◽

Inclusion Criteria ◽

Class Iii Obesity ◽

Acute Care Settings

Abstract Background: Obesity is a complex psycho-social construct which is strongly linked with health and well-being. The health and socioeconomic impacts of obesity on individuals and health care systems can be significant. The nursing care of people with Class III obesity needs careful attention to ensure the provision of appropriate care. This scoping review aims to synthesise available evidence on the nursing care of Class III obese patients in acute care settings. Methods : A scoping review informed by the Joanna Briggs Institute approach was undertaken. We searched CINAHL Plus, Medline, Scopus, Proquest Central, Web of Science and Embase databases for primary research articles relating to the nursing management of people classified as Class III obese in acute care settings. The methodological quality of all studies that met the inclusion criteria were assessed and data relating to methods and the findings extracted and synthesised into themes. Results : 3809 records were identified. Thirteen studies met the inclusion criteria and were included in the review. Three themes were generated from the synthesis of the findings: Access, knowledge and training related to equipment; Patient care; and Opportunities to improve care. Conclusions : The need for proactive planning to improve the nursing care provided to people classified as class III obese and admitted to acute care settings is vital. Access to appropriate equipment to support moving and handling and education on equipment use to prevent injury to both patients and staff is necessary. Education and support to promote engagement with patients, adapt nursing care practices and promote self-care have the potential to improve patient care and patient outcomes.

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Methods used to attribute costs avoided from pharmacist interventions in acute care: A scoping review

American Journal of Health-System Pharmacy ◽

10.1093/ajhp/zxab214 ◽

2021 ◽

Author(s):

Sujita W Narayan ◽

Ivo Abraham ◽

Brian L Erstad ◽

Curtis E Haas ◽

Arthur Sanders ◽

...

Keyword(s):

Acute Care ◽

Scoping Review ◽

Pharmacy Practice ◽

Economic Implications ◽

Medline Search ◽

Cost Avoidance ◽

Harmful Consequence ◽

Pharmacist Interventions ◽

Acute Care Settings ◽

Human Participants

Abstract Purpose Cost-avoidance studies are common in pharmacy practice literature. This scoping review summarizes, critiques, and identifies current limitations of the methods that have been used to determine cost avoidance associated with pharmacists’ interventions in acute care settings. Methods An Embase and MEDLINE search was conducted to identify studies that estimated cost avoidance from pharmacist interventions in acute care settings. We included studies with human participants and articles published in English from July 2010 to January 2021, with the intent of summarizing the evidence most relevant to contemporary practice. Results The database search retrieved 129 articles, of which 39 were included. Among these publications, less than half (18 of 39) mentioned whether the researchers assigned a probability for the occurrence of a harmful consequence in the absence of an intervention; thus, a 100% probability of a harmful consequence was assumed. Eleven of the 39 articles identified the specific harm that would occur in the absence of intervention. No clear methods of estimating cost avoidance could be identified for 7 studies. Among all 39 included articles, only 1 attributed both a probability to the potential harm and identified the cost specific to that harm. Conclusion Cost-avoidance studies of pharmacists’ interventions in acute care settings over the last decade have common flaws and provide estimates that are likely to be inflated. There is a need for guidance on consistent methodology for such investigations for reporting of results and to confirm the validity of their economic implications.

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Understanding what matters most to patients in acute care in seven countries, using the flash mob study design

BMC Health Services Research ◽

10.1186/s12913-021-06459-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Eva S. van den Ende ◽

◽

Bo Schouten ◽

Marjolein N. T. Kremers ◽

Tim Cooksley ◽

...

Keyword(s):

Acute Care ◽

Patient Perspective ◽

Large Scale ◽

Healthcare Professionals ◽

Well Being ◽

Good Health ◽

Care Needs ◽

Patient Centred Care ◽

Trial Register ◽

What Matters

Abstract Background Truly patient-centred care needs to be aligned with what patients consider important, and is highly desirable in the first 24 h of an acute admission, as many decisions are made during this period. However, there is limited knowledge on what matters most to patients in this phase of their hospital stay. The objective of this study was to identify what mattered most to patients in acute care and to assess the patient perspective as to whether their treating doctors were aware of this. Methods This was a large-scale, qualitative, flash mob study, conducted simultaneously in sixty-six hospitals in seven countries, starting November 14th 2018, ending 50 h later. One thousand eight hundred fifty adults in the first 24 h of an acute medical admission were interviewed on what mattered most to them, why this mattered and whether they felt the treating doctor was aware of this. Results The most reported answers to “what matters most (and why)?” were ‘getting better or being in good health’ (why: to be with family/friends or pick-up life again), ‘getting home’ (why: more comfortable at home or to take care of someone) and ‘having a diagnosis’ (why: to feel less anxious or insecure). Of all patients, 51.9% felt the treating doctor did not know what mattered most to them. Conclusions The priorities for acutely admitted patients were ostensibly disease- and care-oriented and thus in line with the hospitals’ own priorities. However, answers to why these were important were diverse, more personal, and often related to psychological well-being and relations. A large group of patients felt their treating doctor did not know what mattered most to them. Explicitly asking patients what is important and why, could help healthcare professionals to get to know the person behind the patient, which is essential in delivering patient-centred care. Trial registration NTR (Netherlands Trial Register) NTR7538.

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Cognitive Impairment and Length of Stay in Acute Care Hospitals: A Scoping Review of the Literature

Canadian Journal on Aging / La Revue canadienne du vieillissement ◽

10.1017/s0714980820000355 ◽

2021 ◽

pp. 1-19

Author(s):

Jonathan Plante ◽

Karine Latulippe ◽

Edeltraut Kröger ◽

Dominique Giroux ◽

Martine Marcotte ◽

...

Keyword(s):

Cognitive Impairment ◽

Length Of Stay ◽

Acute Care ◽

Scoping Review ◽

Research Question ◽

Positive Association ◽

Well Being ◽

Future Research ◽

Care Hospital ◽

The Impact

Abstract Older persons experiencing a longer length of stay (LOS) or delayed discharge (DD) may see a decline in their health and well-being, generating significant costs. This review aimed to identify evidence on the impact of cognitive impairment (CI) on acute care hospital LOS/DD. A scoping review of studies examining the association between CI and LOS/DD was performed. We searched six databases; two reviewers independently screened references until November 2019. A narrative synthesis was used to answer the research question; 58 studies were included of which 33 found a positive association between CI and LOS or DD, 8 studies had mixed results, 3 found an inverse relationship, and 14 showed an indirect link between CI-related syndromes and LOS/DD. Thus, cognitive impairment seemed to be frequently associated with increased LOS/DD. Future research should consider CI together with other risks for LOS/DD and also focus on explaining the association between the two.

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Reasonable adjustments for people with intellectual disability in acute care: a scoping review of the evidence

BMJ Open ◽

10.1136/bmjopen-2020-039647 ◽

2021 ◽

Vol 11 (2) ◽

pp. e039647

Author(s):

Mairead Moloney ◽

Therese Hennessy ◽

Owen Doody

Keyword(s):

Intellectual Disability ◽

Acute Care ◽

Scoping Review ◽

Service Provision ◽

Care Setting ◽

Acute Care Setting ◽

Inclusion Criteria ◽

Health Service Provision ◽

Acute Care Settings ◽

Fair Access

ObjectivesPeople with intellectual disability are vulnerable in terms of health service provision due to increased comorbidity, higher dependency and cognitive impairment. This review explored the literature to ascertain what reasonable adjustments are evident in acute care to support people with intellectual disability, ensuring they have fair access and utilisation of health services.DesignScoping review.SettingAcute care settings.MethodsFive databases were systematically searched to identify studies that reported on the implementation of reasonable adjustments. Authors worked in pairs to screen studies for inclusion, data were extracted and charted and findings were synthesised according to content and themes.ResultsOf the 7770 records identified, six studies were included in the review. The volume of evidence was influenced by specific inclusion criteria, and only papers that reported on the actual implementation of a reasonable adjustment within an acute care setting were included. Many papers reported on the concept of reasonable adjustment; however, few identified its applications in practice.ConclusionsThe scoping review highlights a lack of research on the practice and implementation of reasonable adjustments within acute care settings. There is a need for increased support, education and the provision of intellectual disability specialists across acute care settings.

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The Unique Environmental Influences of Acute Care Settings on Patient and Physician Well-Being: A Call to Action

Journal of Emergency Medicine ◽

10.1016/j.jemermed.2017.08.092 ◽

2018 ◽

Vol 54 (1) ◽

pp. e19-e21 ◽

Cited By ~ 5

Author(s):

Bernard P. Chang ◽

George Gallos ◽

Lauren Wasson ◽

Donald Edmondson

Keyword(s):

Acute Care ◽

Environmental Influences ◽

Well Being ◽

Call To Action ◽

Acute Care Settings

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Strategies aimed at preventing chronic opioid use in trauma and acute care surgery: a scoping review protocol

BMJ Open ◽

10.1136/bmjopen-2019-035268 ◽

2020 ◽

Vol 10 (4) ◽

pp. e035268

Author(s):

Mélanie Bérubé ◽

Lynne Moore ◽

François Lauzier ◽

Caroline Côté ◽

Kelly Vogt ◽

...

Keyword(s):

Acute Care ◽

Scoping Review ◽

Optimal Strategies ◽

Acute Care Surgery ◽

Public Health Issue ◽

Published Data ◽

Cochrane Central Register ◽

Opioid Use ◽

Chronic Opioid Use ◽

Care Surgery

IntroductionGlobally every year, millions of patients sustain traumatic injuries and require acute care surgeries. A high incidence of chronic opioid use (up to 58%) has been documented in these populations with significant negative individual and societal impacts. Despite the importance of this public health issue, optimal strategies to limit the chronic use of opioids after trauma and acute care surgery are not clear. We aim to identify existing strategies to prevent chronic opioid use in these populations.Methods and analysisWe will perform a scoping review of peer-reviewed and non-peer-reviewed literature to identify studies, reviews, recommendations and guidelines on strategies aimed at preventing chronic opioid use in patients after trauma and acute care surgery. We will search MEDLINE, EMBASE, PsycINFO, CINHAL, Cochrane Central Register of Controlled Trials, Web of Science, ProQuest and websites of trauma and acute care surgery, pain, government and professional organisations. Databases will be searched for papers published from 1 January 2005 to a maximum of 6 months before submission of the final manuscript. Two reviewers will independently evaluate studies for eligibility and extract data from included studies using a standardised data abstraction form. Preventive strategies will be classified according to their types and targeted trauma populations and acute care surgery procedures.Ethics and disseminationResearch ethics approval is not required as this study is based on the secondary use of published data. This work will inform research and clinical stakeholders on the required next steps towards the uptake of effective strategies aimed at preventing chronic opioid use in trauma and acute care surgery patients.

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Screening for depression and anxiety among patients with acute coronary syndrome in acute care settings: a scoping review

JBI Evidence Synthesis ◽

10.11124/jbisrir-d-19-00316 ◽

2020 ◽

Vol 18 (9) ◽

pp. 1932-1969

Author(s):

Tania S. Marin ◽

Sandra Walsh ◽

Nikki May ◽

Martin Jones ◽

Richard Gray ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Acute Care ◽

Scoping Review ◽

Depression And Anxiety ◽

Coronary Syndrome ◽

Acute Care Settings

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Associations between contextual and compositional characteristics of early childcare facilities with health, health behaviours and well-being among young children aged 06 years: protocol for a scoping review

BMJ Open ◽

10.1136/bmjopen-2020-037038 ◽

2020 ◽

Vol 10 (9) ◽

pp. e037038

Author(s):

Jennifer Hilger-Kolb ◽

Sven Schneider ◽

Raphael Herr ◽

Nina Osenbruegge ◽

Stephanie Hoffmann ◽

...

Keyword(s):

Young Children ◽

Scoping Review ◽

Selection Process ◽

Life Stage ◽

Well Being ◽

Primary Data ◽

Cochrane Library ◽

Key Characteristics ◽

Scoping Reviews ◽

Early Childcare

IntroductionEarly childhood is an important life stage which is crucial for determining health and health inequalities in later life. At the meso-level (institutional-level), early childcare facilities (eg, kindergartens, preschools) are the most important agent of socialisation next to families in young children aged 06 years. In recent years, an increasing amount of studies has focused on contextual and compositional characteristics of early childcare facilities and their association with health (eg, self-rated health), health behaviour (eg, physical activity) and well-being (eg, emotional well-being) in this age group. However, as currently no overview of the available literature on this topic exists, we will conduct a scoping review including various study designs (eg, cross-sectional studies, prospective studies, qualitative studies).Methods and analysisWe will follow the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. A systematic search of the following scientific databases will be conducted: PubMed/Medline, PsycInfo, Sociological Abstracts, Education Resources Information Center and The Cochrane Library. During the selection process, we will follow a two-step process. First, two reviewers will independently screen titles/abstracts of all potentially eligible articles by applying a set of previously defined inclusion and exclusion criteria. After the completion of the title/abstract screening, full texts of the remaining articles will be screened following the same procedure. To determine inter-rater agreement between reviewers, we will calculate Cohen’s Kappa after both steps. Key characteristics (eg, country of origin, sample size, study design) of included articles will be extracted. We will map the evidence available by providing a summary table on the key characteristics extracted and by presenting the associations using various types of illustrations.Ethics and disseminationSince no primary data will be collected for this review, ethical approval is not required. Our findings will be published in an international peer-reviewed journal and presented at national and international conferences.

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