In-person, virtual visiting and telephone calls in Australia and New Zealand intensive care units: A point prevalence multicentre study mapping daytime and nighttime interactions

Alexis Tabah; Mahesh Ramanan; Kevin B Laupland; Kimberley Haines; Naomi Hammond; Serena Knowles; Kylie Jacobs; Stuart Baker; Edward Litton; Point Prevalence Program Investigators and Management Committee, The Australian and New Zealand Intensive Care Society Clinical Trials Group and The George Institute for Global Health

doi:10.1016/j.aucc.2024.101144

In-person, virtual visiting and telephone calls in Australia and New Zealand intensive care units: A point prevalence multicentre study mapping daytime and nighttime interactions

Aust Crit Care. 2024 Dec 4:101144. doi: 10.1016/j.aucc.2024.101144. Online ahead of print.

Authors

Alexis Tabah¹, Mahesh Ramanan², Kevin B Laupland³, Kimberley Haines⁴, Naomi Hammond⁵, Serena Knowles⁶, Kylie Jacobs⁷, Stuart Baker⁸, Edward Litton⁹; Point Prevalence Program Investigators and Management Committee, The Australian and New Zealand Intensive Care Society Clinical Trials Group and The George Institute for Global Health

Affiliations

¹ Intensive Care Unit, Redcliffe Hospital, Metro North Hospital and Health Services, Queensland, Australia; Queensland University of Technology, Brisbane, Queensland, Australia; Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia. Electronic address: alexis.tabah@qut.edu.au.
² Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia; Adult Intensive Care Services, The Prince Charles Hospital, Brisbane, Queensland, Australia; Intensive Care Unit, Caboolture Hospital, Caboolture, Queensland, Australia; Critical Care Division, The George Institute for Global Health, University of New South Wales, Sydney, Australia.
³ Queensland University of Technology, Brisbane, Queensland, Australia; Department of Intensive Care Services, Royal Brisbane and Women's Hospital, Brisbane, Australia.
⁴ Department of Critical Care, Melbourne Medical School, The University of Melbourne, Melbourne, Australia; Physiotherapy Department, Western Health, Melbourne, Australia.
⁵ Critical Care Division, The George Institute for Global Health, University of New South Wales, Sydney, Australia; Malcolm Fisher Department of Intensive Care, Royal North Shore Hospital, Sydney, Australia.
⁶ Critical Care Division, The George Institute for Global Health, University of New South Wales, Sydney, Australia.
⁷ Intensive Care Unit, Redcliffe Hospital, Metro North Hospital and Health Services, Queensland, Australia.
⁸ Intensive Care Unit, Redcliffe Hospital, Metro North Hospital and Health Services, Queensland, Australia; Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.
⁹ Department of Intensive Care, Fiona Stanley Hospital, Perth, Western Australia, Australia; School of Medicine, University of Western Australia, Perth, Western Australia, Australia.

PMID: 39638693
DOI: 10.1016/j.aucc.2024.101144

Abstract

Background: Family presence, in-person and via virtual visiting (video calls) and the telephone, is an integral part of patient- and family-centred critical care. Previous studies focussed on visiting policies and their effects. Data mapping the frequency and timing of these interactions are not available.

Objectives: The aims of this study were to describe the prevalence of in-person visiting and the use of telephone or video conferencing in Australia and New Zealand intensive care units (ICUs).

Design: A point prevalence survey was conducted to map visiting policies, hourly family presence at the bedside, telephone or video calls, and reasons for each interaction.

Setting: The research was conducted in a 24-h study period in October 2020, corresponding to the end of the 2nd COVID-19 pandemic wave in 40 Australia and New Zealand ICUs.

Measurements and main results: At the time of survey, 77% of ICUs had restrictions to visiting, median (interquartile range [IQR]) time of 9 (2; 24) hours with permitted visiting per day, a mean of 8 hours less than before the COVID-19 pandemic. There were 532 patients, a median (IQR) of 13 (6; 25) patients per ICU. Two patients had COVID-19. Over 24 h, 65% of patients had at least one in-person visit, median (IQR) of 1 (0; 3) hours with visitors. Telephone calls were received for 52% patients, median (IQR) of 1 (0; 2) calls. Video calls were received for 6% of the patients. In-person visits peaked between 10:00 and 12:00, with a second smaller peak between 16:00 and 17:00. Visiting continued through the evening, and 2% of the patients had visitors overnight. Telephone calls peaked at 10:00, continued through the day and evening, with few calls received overnight. In-person visits were predominantly motivated by family interactions (81%) and telephone calls by clinical updates (51%) and family interactions (47%).

Conclusions: In a low COVID-19 prevalence period, Australia and New Zealand ICUs had partially reopened to visitors. Most visits happened during the day and evening but persisted overnight. ICU resourcing and visiting policies should take these data into account to facilitate family presence at the bedside, virtual visiting, and obtaining clinical updates via telephone.

Keywords: Communication; Family-centred critical care; Virtual visiting; Visitation; Visiting.