Intensive care virtual visiting practices in Australia and New Zealand following the COVID-19 pandemic: A binational survey

Family members of patients admitted to an intensive care unit (ICU) may experience adverse physical, psychological, and social impacts. Although flexible in-person visiting aims to reduce these adverse family experiences, some families encounter challenges due to geographical distances and their own frailty and work/caregiving commitments. Virtual visiting (VV), as an adjunct or alternative to in-person visiting, is a strategy that could address inequities of access. To inform future research, our objectives were to document current (post-COVID-19 pandemic) ICU visiting practices and policies specific to VV in ICUs across Australia and New Zealand (ANZ). We conducted a multicentre, cross-sectional, self-administered electronic survey sent to the lead medical director or nurse unit manager of adult/mixed ICUs in public and private hospitals across ANZ. Survey development was informed by the evidence base, our experience, and surveys conducted during the pandemic. Descriptive statistics were used to report survey results. In total, survey responses were received from 51 ICUs, comprising 26 of 31 (84%) of requested New Zealand sites and 25 of 162 (15%) of Australian sites (overall 26% ANZ response rate). While unrestricted visiting (no restriction on time or duration of visit) occurred in 53% of ICUs, only six (12%) offered 24 h/day family access. Thirty ICUs (59%) reported some use of VV although 15 of 30 (50%) reported this occurred only rarely. Ten ICUs that used VV during the pandemic now no longer provide this option. Challenges to VV included limited availability of hardware, organisational restrictions on software, and limited access to training on how to conduct a VV. Currently, in Australian and New Zealand ICUs, in-person visiting is often restricted by duration of visiting hours. The use of VV to support patients and their families in adult/mixed ICUs appears limited and may be declining. The impact of reduced access and whether use of VV improves patient- and family-centred outcomes, addresses access inequities, and should be part of future pandemic preparedness should be explored in future research.