For days Bruna Bartolini has been staying under the windows of thehospital of Civitavecchia, the Aurelia Hospital: he protests because he cannot come in to visit his eighty-one-year-old father, hospitalized in the orthopedic ward. “Dad lives in solitude, we can only see him on Tuesdays and Fridays,” he says. But what happens to Mrs. Bartolini is certainly no exception: as her father, thousands and thousands of patients in hospitals throughout Italy still have to comply with very strict prevention rules Covidwhich open the doors of the wards to visits only with very tight deadlines.
Yet it is established that the presence of relatives is a strong, sometimes decisive, help for the care of a sick person. But after the pandemic emergency, hospitals allow few visits and in a short time. Only one joint can enter, for no more than 10 minutes a day, sometimes not even every day but only – as in the case of Bruna in Civitavecchia – on certain scheduled days of the week. These are constraints which, according to many also in the world of medicine, no longer have a reason to exist in the light of the data, with the pandemic in regression and the number of sick people and deaths continuing to fall. And in fact, the Ministry of Health intends to change: Minister Orazio Schillaci is working on a review of the more restrictive measures. Revision which will take place gradually – they specify to the ministry – and which will take into account the most critical situations, the so-called frail, immunosuppressed, elderly patients. But there will certainly be a change in the rules, dictated by the improvement of the epidemic situation.
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WHO ANTICIVES THE DECISION
In some Regions it has actually been decided to anticipate the moves of the ministry. In Emilia-Romagna, for example, access for visitors is once again free, obviously in compliance with the organizational methods and visiting hours. However, the use of the Ffp2 mask remains mandatory. In Lombardy, access will always be guaranteed to carers of underage patients, to carers of pregnant women even in the labour, delivery and postpartum phases. But also to those who assist the elderly over 80, bedridden, disabled patients and limited by language barriers. In Tuscany we return to the pre-pandemic rules in the obstetrics and pediatrics wards and in the delivery room in the six birth points of the central Tuscany USL company.
“We are well aware that the comfort of family members is essential for patients – admits Carlo Palermo, national president of Anaao Assomed, the association of Italian doctors and health managers – But some restrictive measures are generally linked to patient safety, the circulation of virus which, although decreasing, still persists. Of course, in some cases the lack of nursing staff is an element that can have a certain weight in the choice that some hospitals have made. However, isolation of the sick should be avoided if there is no clinical need, and limited to organizational reasons due to epidemiological conditions. Let’s not forget that we still have important mortality due to Covid”.
DIFFERENCES
It must be said that within the same Region different criteria are applied, in each healthcare structure and in each department a different system is adopted. «This matter of visits – underlines Carlo Signorelli, full professor of Hygiene at the Vita-Salute San Raffaele University of Milan – has remained a decision of the individual hospitals, often very different from each other in terms of both logistics and organization. In any case, it is important to aim for the humanization of hospitalization, while taking into account the safety of the patient and that of health professionals”. On one point they all seem to agree: while it is true that it is not possible to return to complete isolation, it is also unthinkable to hope to restore the old pre-Covid rules. «The presence of family members is part of the treatment process and helps patients – reiterates Giovanni Migliore, president of Fiaso (the Italian Federation of Healthcare and Hospitals) – But it is clear that after the period we have lived we cannot go back to those scenes in which there were wards crowded with relatives. Mediation is now needed.” And you cannot invoke rules of access to departments that are the same for everyone. «The responsibility for the individual hospital lies with the medical director of the unit and that of the operating unit – explains Migliore – Therefore, depending on the logistical conditions, the most appropriate decisions will be taken. There will therefore be modern hospitals with common areas that have the ability to manage flows and therefore allow more numerous visits, and others that do not have the same characteristics and will not be able to do so. Let’s not forget that the hospital building heritage comes from not recent interventions. Many buildings even date back to years after the Second World War».
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