EP.WE.339The Role of a “Clean Ward” Model in Minimizing COVID-19 Exposure for Elective General Surgical Patients

Aims To assess if a “clean ward” model is effective in preventing peri-operative COVID-19 infection in elective general surgical patients. Methods Elective general surgical cases were audited prospectively in three thirty-day cycles - May–July 2020, September–October 2020 and December 2020–January 2021. Patients isolated for 10 days and required a negative COVID swab prior to admission. Nursing and surgical staff underwent weekly swabbing, operations were carried out in a dedicated “clean theatre” and a no-visiting policy was enforced. Inpatient COVID cases and COVID-19 status at 14 days post discharge were recorded and compared to the community COVID-19 Reproduction (R) number. Results Cycle 1, (May-Jul 20, R number=0.3-1.5) 44 elective patients. One patient was diagnosed with clinical COVID post-operatively and recovered well. Cycle 2, (Sept-Oct 20, R number=0.8-1.8) 57 patients identified. No positive COVID-19 cases during inpatient admission or at 14 days post discharge. Cycle 3, (Dec 20-Jan 21, R number=1.0-1.9) 38 elective patients. One patient tested positive for COVID-19 following transfer to the emergency surgical ward due to COVID-19 related bed pressures. No other positive cases were identified during follow up. Conclusions Despite an ongoing rise in community COVID-19 cases, the “clean ward” model appears to be effective in reducing COVID-19 transmission for elective general surgical patients. When the R number was at its highest, the only COVID positive case developed symptoms after moving from the “clean ward” system. Extrapolation of this model could be considered in re-establishing elective operating lists across the region.

Adult and Child Visiting at Urban Jails: Perspectives on Visitation Experiences and Policies among Visitors and People in Jail

Growth in the US incarcerated population over recent decades has brought a burgeoning body of research on parent-child visitations in correctional facilities. In contrast to this research, which has largely focused on prisons, this study reports survey results from over 900 visitors and incarcerated adults in an urban jail system. We center our attention on the commonality of children visiting jail incarcerated parents, the ways in which a jail system may facilitate or hamper the visitation process, and opinions on potential visiting policy modifications, including the use of video visiting. Implications for jail visitation policies are discussed.

ICU Nurses’ Perception of Visits to Patients

Introduction. Visits to patients are part of a positive and effective strategy of helping patients and their families to better adapt to the stress caused by a patient’s admission to an intensive care unit (ICU). Aim. To determine the ICU nurses’ perception of visits to patients. Methods. The study was conducted at the University Hospital Centre Zagreb (UHC). The cross-sectional study included nurses who work in ICUs. An anonymous, self-designed questionnaire was used and filled in by 44 respondents. The questionnaire consisted of 17 closed-ended questions pertaining to demographic data, questions related to information on visits and questions about the concept of open visits. Results. Out of the total number of 44 respondents, 25 respondents stated that their ICU has booklets about the manner of visits and visiting hours, and that they hand them out to families, while 19 respondents stated that they do not have such booklets. 61% of the respondents feel they have sufficient training to communicate with the patient’s family. 41% of the respondents said that the visits had a positive effect on the patient’s condition and only 2% stated that the visits had no positive effect. 57 % of the respondents think that visits sometimes have a positive effect on the patient’s condition. Of the total number of respondents, 84% feel that visiting hours should be limited. Respondents feel that visits sometimes impede them in their work (66%), while 59% of the respondents feel that visits help spread infections. Out of the total number of respondents, only 32% of them stated that they were familiar with the open ICU concept. Conclusion. More than half of the respondents stated that they have a written visiting policy on ICU wards, and that they are trained to communicate with the family members of patients. Most respondents feel that visits contribute to the spread of infections and that they would limit children’s visits to the ICU. The respondents’ poor knowledge of the open ICU concept creates one of the barriers to introducing it in their wards.

Visiting Policies of Hospice Wards during the COVID-19 Pandemic: An Environmental Scan in Taiwan

During an epidemic, almost all healthcare facilities restrict the visiting of patients to prevent disease transmission. For hospices with terminally ill patients, the trade-off between compassion and infection control becomes a difficult decision. This study aimed to survey the changes in visiting policy for all 76 hospice wards in Taiwan during the COVID-19 pandemic in March 2020. The altered visiting policies were assessed by the number of visitors per patient allowed at one time, the daily number of visiting slots, the number of hours open daily, and requisites for hospice ward entry. The differences in visiting policies between hospice wards and ordinary wards were also investigated. Data were collected by reviewing the official website of each hospital and were supplemented by phone calls in cases where no information was posted on the website. One quarter (n = 20) of hospice wards had different visiting policies to those of ordinary wards in the same hospital. Only one hospice ward operated an open policy, and in contrast, nine (11.8%) stopped visits entirely. Among the 67 hospice wards that allowed visiting, at most, two visitors at one time per patient were allowed in 46 (68.6%), one visiting time daily was allowed in 32 (47.8%), one hour of visiting per day was allowed in 29 (43.3%), and checking of identity and travel history was carried out in 12 wards (17.9%). During the COVID-19 pandemic, nearly all hospice wards in Taiwan changed their visiting policies, but the degree of restriction varied. Further studies could measure the impacts of visiting policy changes on patients and healthcare professionals.

Nurses Beliefs And Attitudes Towards Visiting Policy In The Intensive Care Units Of Ghanaian Hospitals

Background: Research and evidence supporting open and liberalized visiting policy has resulted in many hospitals adopting these policies. But, ICU nurses’ beliefs and attitudes about flexible and open visiting policy vary. Hence open visitation has not always been implemented by nurses who are the ward owners. It is vital to evaluate nurses’ beliefs about and attitudes towards visiting policy. Methods: A descriptive, cross-sectional quantitative survey was conducted in 4 public hospitals in Ghana, with a sample of 140 nurses. Data were collected with a validated scale – BAVIQ to assess the nurses’ beliefs and attitudes toward visitation. Results: Generally, nurses’ preferred restricted visiting policy based on their attitudes however, the beliefs of nurses about visiting policy were skeptical (neither agree nor disagree). The study also showed a meaningful relationship between nurses’ beliefs and their sex (p=0.02), experience (p= 0.00), educational level (p= 0.00), employment status (p=0.00) and executive position (p=0.00). It also indicated a meaningful relationship between nurses’ attitudes and their sex (p=0.00), experience (p=0.00), educational level (p=0.00), and executive position (p=0.00). Chi - square was used to compute the test. Conclusions: Based on the findings, ICU nurses’ beliefs and attitudes toward visitation support the universal concern of restricted visiting policy in Ghana. These are important factors in the implementation of flexible visiting policy in the intensive care units; the beneficial effects of open visiting policy for the nurse, the patient and the family because it enhances patient centered care and optimal health. Therefore the need for drafting a protocol and guidelines for intensive care units visiting policy in Ghana is recommended. A qualitative research in specific areas of visiting policy is recommended.