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Neonatology
Original research
Parental perceptions of the impact of neonatal unit visitation policies during COVID-19 pandemic
  1. Hemananda Muniraman1,2,3,
  2. Mahmoud Ali4,
  3. Paul Cawley5,
  4. Jessica Hillyer4,
  5. Adam Heathcote6,
  6. Vennila Ponnusamy7,
  7. Zoe Coleman2,
  8. Kendall Hammonds8,
  9. Chandni Raiyani8,
  10. Eleanor Gait-Carr9,
  11. Sarah Myers9,
  12. Katie Hunt5,
  13. Vinayak Govande4,
  14. Anoo Jain5,
  15. Reese Clark10,
  16. Cora Doherty9,
  17. Venkata Raju4,
  18. Paul Clarke6,11
  1. 1Department of Pediatrics, Creighton University School of Medicine, Omaha, Nebraska, USA
  2. 2Saint Joseph’s Hospital and Medical Center, Phoenix, Arizona, USA
  3. 3Neonatology Association Limited, Obstetrix Medical Group of Phoenix, Mednax, Phoenix, United States
  4. 4Division of Neonatology, Department of Pediatrics, Baylor Scott and White McLane Children’s Medical Center, Temple, Texas, USA
  5. 5Division of Neonatology, Department of Paediatrics, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
  6. 6Neonatal Intensive Care Unit, Jenny Lind Children's Hospital, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, Norfolk, UK
  7. 7Neonatal Intensive Care Unit, Ashford and St Peter’s Hospitals NHS Foundation Trust, Chertsey, Surrey, UK
  8. 8Baylor Scott and White Research Institute, Temple, Texas, USA
  9. 9Neonatal Intensive Care Unit, University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff, UK
  10. 10MEDNAX Inc, Sunrise, Florida, USA
  11. 11Norwich Medical School, University of East Anglia, Norwich, United Kingdom
  1. Correspondence to Dr Hemananda Muniraman; hemu_muniraman{at}mednax.com

Abstract

Objectives To ascertain parental perceptions of the impact of restricted visiting policies to neonatal intensive care units during the current COVID-19 pandemic.

Design Cross-sectional survey of parents impacted by visitation policies.

Setting Six tertiary level neonatal units, four from the UK and two from the USA, participated in the study.

Participants Parents and families of infants hospitalised in the participating centres between 1 May 2020 and 21 August 2020.

Methods Online-based and/or paper-based survey, querying the visitation policies and their impact on parents’ ability to visit, care for and bond with their infants.

Results A total of 231 responses were received. Visitation limited to a single visitor with no restrictions on duration was the most frequently reported policy; 140/217 (63%). Visitation policies were perceived as being restrictive by 62% (138/219) of the respondents with 37% (80/216) reporting being able to visit less often than desired, 41% (78/191) reporting being unable to bond enough and 27% (51/191) reporting not being able to participate in their baby’s daily care. Mild to severe impact on breast feeding was reported by 36% (75/209) of respondents. Stricter policies had a higher impact on families and were significantly associated with a lack of bonding time, inability to participate in care and an adverse impact on breast feeding.

Conclusions Visitation policies during the COVID-19 pandemic varied between centres and over time with stricter restrictions implemented earlier on in the pandemic. Parents reported significant impacts on their ability to visit, care for and bond with their infants with perceived severity of impact worse with stricter restrictions.

  • neonatology
  • health services research
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjpo-2020-000899

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    Footnotes

    • Twitter @hmuniraman, @PaulCawleyUK, @AdamHeathcote, @NeoImprOutcomes, @drpaulclarke

    • Contributors HM conceptualised and designed the study, designed the data collection instrument, obtained ethical/institutional research board approval, collected data, drafted the initial manuscript and revised the manuscript. MA, JH, AH, EG-C, SM,and ZC, recruited participants, collected data, reviewed and revised the manuscript. KH and CR designed and performed the data analysis, reviewed and revised the manuscript. VP, CD, AJ, VG and VR coordinated and supervised data collection and critically reviewed the manuscript for important intellectual content. PCawley coordinated and supervised data collection, revised and critically reviewed the manuscript for important intellectual content. PClarke co-designed the data collection instrument, coordinated and supervised data collection revised and critically reviewed the manuscript for important intellectual content. RC critically reviewed the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work. HM is guarantor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval The study was determined exempt from requiring full review by the institutional review board at St Joseph’s Hospital and Medical Center (PHXNR-20-500-170-73-21) and was approved by MEDNAX Research Advisory Committee (RA ID: 607025162). All participating centres obtained approval from their respective research governance managers and/or ethics/institutional boards prior to commencing the study.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon reasonable request. Deidentified participant data are available upon request.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.