'A Forever Imprint on Me…I Couldn't Be There When He Needed Me the Most': Care Partner Experiences of Patient Safety During Covid-19 Restrictions

“这对我来说永远留下了印记……在他最需要我的时候,我却不在身边”:新冠疫情限制措施期间护理伙伴对患者安全的看法

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Abstract

BACKGROUND: It is believed that engaging care partners (CPs) in patient safety is a potential strategy to ensure patients' well-being during hospital admissions. When present, CPs who feel comfortable can be 'safety nets', monitoring and acting to prevent healthcare-related harm. However, there are limitations in evidence about CPs' perspectives regarding and experiences of safety engagement at the direct care level and the implications if they have restricted access, such as during the Covid-19 pandemic. OBJECTIVE: To understand CPs' experiences of patient safety when, due to Covid-19 restrictions, they were unable to be present in the hospital during a patient admission. METHODS: A descriptive, exploratory qualitative study was conducted in an acute care hospital in Ontario, Canada, and four Canadian organisations that support CPs. One-to-one semi-structured interviews and reflexive thematic analysis were completed. FINDINGS: Twelve CPs participated. Overall, they believed hospital restrictions had consequences on patient safety and was troubling for them and their loved ones, as illuminated in the three main themes: Stress Escalates Amid Disrupted, Ineffective Communications Between CPs and Patients/Healthcare Professionals; CPs' Patient Safety Concerns Change and are Heightened in Their Absence From the Bedside, Calling for New Tactics, and Hospital Access Restriction Negatively Impacts CPs' Well-Being, Necessitating Creative Ways to Bolster Their Strength. DISCUSSION: The findings give insight into CPs' engagement in patient safety at the direct care level and the importance of being present, given the types of contributions they want to make. Communication was paramount, and the scope of their involvement-the nuances of which became more apparent in their absence-affirmed how connected CPs are and need to be within the health team for successful risk reduction. Disconnecting CPs from engaging in safety diminished the patient's protection, and instead of reducing CP fears related to involvement, it escalated newfound worries and stressors. CONCLUSION: This study highlights CPs' experiences with patient safety when they cannot be at the bedside and their crucial role in mitigating risks, and, in anticipation of future public health crises, as well as ongoing care approaches, questions the risk in prohibiting and not fostering CPs' involvement at the bedside. PATIENT OR PUBLIC CONTRIBUTION: Twelve CPs of adult patients with lived experiences of engaging in patient safety participated in this study. These CPs were unable to be present with the patient during their admission due to visitor restrictions implemented as a result of Covid-19.

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