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| Name | Class |
|---|---|
| Golden Jubilee National Hospital | OTHER_GOV |
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Patients are part of a family network. When any person in a family becomes critically unwell and requires the assistance of an Intensive Care Unit (ICU), this has an impact on all members of that family.
COVID-19 changed visiting for all patients in hospitals across Scotland. It is not known what effect these restrictions will have on patients' recovery, nor do we understand the impact it may have on their relatives or staff caring for them. This study will look at the implications of the visiting restrictions as a consequence of the COVID-19 pandemic upon patients without COVID-19 who are in the cardiothoracic ICU. It will also explore the impact of these restrictions on them, their relatives and staff.
This study will be carried out within a single specialised intensive care unit in Scotland using mixed methods.
The first arm of this study will use retrospective data that is routinely collected in normal clinical practice. The investigators will compare patient outcomes prior to COVID-19 with outcomes following the implementation of COVID-19 visiting restrictions. The aim is to establish if the restrictions on visiting has an impact on the duration of delirium. Delirium is an acute mental confusion and is associated with longer hospital stays and worse outcomes in this patient group.
The second arm of this study involves semi-structured interviews with patients, relatives and staff that will allow deeper exploration of the issues around current visiting policy. The interviews will last approximately 1 hour and will address these issues. They will then be transcribed word for word and analysed using grounded theory, meaning the theories will develop from the data as it is analysed.
This study will look at the implications of visiting restrictions on patients without COVID-19 who are in the intensive care unit. It will also explore the impact of these restrictions on them, their relatives and staff.
The investigators hypothesise that the restriction of visiting has a negative impact on recovery of patients, families of patients and staff caring for patients without COVID-19 in the cardiothoracic ICU.
In order to answer this hypothesis, the wider implications of COVID-19 will be explored, not only with patients, but also relatives and staff involved in the care of these patients.
The research questions this study aims to answer are:
In order to answer these research questions the investigators will carry out a single centre mixed method observational study. This study will consist of two arms.
The first arm of this study will utilise retrospective data that is routinely collected in normal clinical practice in this single centre. This will be used to compare to patient outcomes prior to COVID-19 with outcomes following the implementation of COVID-19 visiting restrictions.
The second arm of this study involves semi-structured interviews with patients, relatives and staff that allow deeper exploration of the issues around current visiting policy.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group 1 | Admitted prior to COVID visitation restrictions introduced | ||
| Group 2 | Admitted following the introductions of visitation restrictions due to COVID 19 pandemic |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| COVID visitation restrictions | Other | Visitation to patients in hospitals in Scotland was ceased due to the COVID 19 pandemic. Slow reintroduction of visitors has been introduced, however not to the pre COVID 19 levels. This study will examine the effects of these restrictions on patients in the cardiothoracic critical care unit that do not suffer from COVID 19. |
| Measure | Description | Time Frame |
|---|---|---|
| Duration of delirium | Number of days patient found to have delirium using the Confusion Assessment Method for the ICU (CAM-ICU) | From the date of admission to the Intensive Care Unit (ICU) until discharge from the ICU or death, whichever came first, up to 12 months. |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of delirium | CAM-ICU | From the date of admission to the Intensive Care Unit (ICU) until discharge from the ICU or death, whichever came first, up to 12 months. |
| Length of critical care stay |
| Measure | Description | Time Frame |
|---|---|---|
| Exploring the experiences of patients, relatives and staff of the visitation restrictions during the COVID-19 pandemic | Semi structured interviews | 18 months |
Arm 1
Inclusion Criteria:
Length of stay within critical care > 4 days
Age > 18 years
Patients who have been admitted:
Exclusion Criteria:
Arm 2
Inclusion Criteria:
For Patients:
Length of stay within critical care > 4 days
Age > 18 years
Reason for admission
Provision of informed consent
For relatives:
Age > 18 years
Relative of a patient that has been in critical care > 4 days
Relative of a patient who has been admitted:
Relative of a patient admitted for > 4days
For Staff:
Exclusion:
For patients:
For relatives:
For Staff:
• Age < 18yrs
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The patient population of this unit comprises of adults undergoing cardiac or thoracic surgical procedures, the majority of which are elective operations. Other patients who receive care on this unit routinely are patients requiring level 3 care following out of hospital cardiac arrest or requiring therapies for advanced heart failure.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Leah Hughes | Contact | 0141 951 5305 | leah.hughes@gjnh.scot.nhs.uk | |
| Ben Shelley | Contact | 0141 951 5000 | benjamin.shelley@glasgow.ac.uk |
| Name | Affiliation | Role |
|---|---|---|
| Ben Shelley | National Waiting Times Centre Board | Study Chair |
| Leah Hughes | National Waiting Times Centre Board | Principal Investigator |
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Results to be published in a peer reviewed journal
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|
Days
| From the date of admission to the ICU until discharge from the ICU or death, whichever came first, up to 12 months. |
| Length of hospital stay | Days | From the date of admission to the hospital until discharge from the hospital or death, whichever came first, up to 12 months. |
| Doses of specified drugs during ICU admission | From the date of admission to the ICU until discharge from the ICU or death, whichever came first, up to 12 months. |
| Length of time ventilated | Days | From the date of admission to the ICU until discharge from the ICU or death, whichever came first, up to 12 months. |
| Mortality | 6 months |
| ID | Term |
|---|---|
| D002318 | Cardiovascular Diseases |
| D003693 | Delirium |
| D016638 | Critical Illness |
| D013896 | Thoracic Diseases |
| D012131 | Respiratory Insufficiency |
| D006331 | Heart Diseases |
| D006333 | Heart Failure |
| ID | Term |
|---|---|
| D003221 | Confusion |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D012140 | Respiratory Tract Diseases |
| D012120 | Respiration Disorders |
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