Use of Video Technology in End-of-Life Care for Hospitalized Patients During the COVID-19 Pandemic

Author:

Elma Asiana1,Cook Deborah2,Howard Michelle3,Takaoka Alyson4,Hoad Neala5,Swinton Marilyn6,Clarke France7,Rudkowski Jill8,Boyle Anne9,Dennis Brittany10,Vegas Daniel Brandt11,Vanstone Meredith12

Affiliation:

1. Asiana Elma is a research assistant, Department of Family Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.

2. Deborah Cook is a distinguished university professor, Department of Medicine, Division of Critical Care and Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, and a physician, Critical Care Program, St Joseph’s Healthcare, Hamilton, Ontario, Canada.

3. Michelle Howard is an associate professor, Department of Family Medicine, Faculty of Health Sciences, McMaster University.

4. Alyson Takaoka was a research assistant, Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University.

5. Neala Hoad is a registered nurse, Critical Care Program, St Joseph’s Healthcare Hamilton.

6. Marilyn Swinton is a research coordinator, School of Rehabilitation Science, Faculty of Health Sciences, McMaster University.

7. France Clarke is a critical care research coordinator, Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University and a respiratory therapist, Critical Care Program, St Joseph’s Healthcare Hamilton.

8. Jill Rudkowski is an associate professor, Division of Critical Care, Department of Medicine, Faculty of Health Sciences, McMaster University, and head of service, Intensive Care Unit and Medical Step-Down Unit, St Joseph’s Healthcare Hamilton.

9. Anne Boyle is an associate clinical professor, Department of Family Medicine and a physician, Division of Palliative Care, St Joseph’s Healthcare Hamilton.

10. Brittany Dennis is an internal medicine resident, Department of Medicine, Division of Critical Care, Faculty of Health Sciences, McMaster University.

11. Daniel Brandt Vegas is an associate professor, Department of Medicine, Division of General Internal Medicine, Faculty of Health Sciences, McMaster University.

12. Meredith Van-stone is an associate professor, Department of Family Medicine, Faculty of Health Sciences, McMaster University.

Abstract

Background Infection control protocols, including visitor restrictions, implemented during the COVID-19 pandemic threatened the ability to provide compassionate, family-centered care to patients dying in the hospital. In response, clinicians used videoconferencing technology to facilitate conversations between patients and their families. Objectives To understand clinicians’ perspectives on using videoconferencing technology to adapt to pandemic policies when caring for dying patients. Methods A qualitative descriptive study was conducted with 45 clinicians who provided end-of-life care to patients in 3 acute care units at an academically affiliated urban hospital in Canada during the first wave of the pandemic (March 2020-July 2020). A 3-step approach to conventional content analysis was used to code interview transcripts and construct overarching themes. Results Clinicians used videoconferencing technology to try to bridge gaps in end-of-life care by facilitating connections with family. Many benefits ensued, but there were also some drawbacks. Despite the opportunity for connection offered by virtual visits, participants noted concerns about equitable access to videoconferencing technology and authenticity of technology-assisted interactions. Participants also offered recommendations for future use of videoconferencing technology both during and beyond the pandemic. Conclusions Clinician experiences can be used to inform policies and practices for using videoconferencing technology to provide high-quality end-of-life care in the future, including during public health crises.

Publisher

AACN Publishing

Subject

Critical Care Nursing,General Medicine

Reference52 articles.

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