Contagions return to grow and so some hospitals, such as Sant’Anna di Como, close their doors, again preventing access to patients’ families. It’s a script we’ve already seen. Except that, unlike what happened two years ago, we now have two new awarenesses. The first: the correct use of gowns and masks protects against the virus (and today there is no shortage of dpi); the second: it is now evident, documented and measured that the proximity of a loved one generates incontrovertible benefits to the patient, the family member, the health professionals.
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“Today there are many doubts about the real usefulness and necessity from the health point of view of the application of such restrictive rules, which in my opinion are inconsistent or not updated”, he underlines Elisabetta Cerutti, head of resuscitation at the United Hospitals of Ancona. She is so convinced of this that already in October 2020, anticipating most of her colleagues from all over Europe, she authorized the entry of family members into her post-surgical intensive care and organ transplant ward for non-Covid patients.
3800 visits and no contagion
“As of 19 October 2020 to date, the number of family visits in our non-Covid ICU has been 3838. We can provide this figure as we have archived all self-declarations signed by visitors prior to entering ICU. thirteen months we have not registered any infections “.
His was an innovative, courageous, but not unconscious choice: “It was not a miracle – he says – or a stroke of luck. We were and are still well aware of the possible risks of transmission of the infection within the ward and of the serious consequences that this can entail, so we have developed a well-structured access protocol “.
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The rules require that the number of visitors per patient be reduced and the accesses staggered to avoid overcrowding. Furthermore, all visitors always wear surgical masks and disinfect their hands. After taking the temperature, the family member is accompanied directly to the relative’s bed and stays for the desired time.
“We have never requested antigenic or molecular swabs from family members, but we have checked the green pass since it was made mandatory. The green pass is also checked to the doctors and nurses in the ward and everyone always keeps the mask during working hours” .
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Thinking back to the reasons that led her to make that choice, she clarifies: “Making sure that family members could be close to their relatives in such a difficult moment in life did not seem like a gift, a benevolent concession or a surrender to sentimentality. . It was – and still is – a medical act in which priority is given to the psychophysical well-being of people, and it is a moral duty that presupposes respect for the rights of the individual, his dignity and freedom “.
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Today, with this well-established experience, he makes a heartfelt appeal to his colleagues: “I would like the increase in infections these days not to lead to a new closure of all departments to family members. A company that accepts the risk of the transmission of Covid with the resumption of all commercial, cultural and recreational activities (from restaurants to museums; from stadiums to spas) motivated by legitimate economic needs, it is not clear why it should not accept it where it is aimed at alleviating people’s suffering “.
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Unfortunately, observes the primary, “the idea that family members are responsible for the spread of the infection is difficult to unhinge”. Yet, he adds, “most of the infectious clusters are due to patients who did not swab at the ward access or to healthcare personnel. At the Ospedali Riuniti of Ancona, in this year and a half, at least three clusters of Covid-19 infection in wards completely closed to visitors, while none in ours, thus showing that family members are not a problem “.
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Visits also allowed in Covid intensive care
Even when, in the period March-April 2021, following a new surge in infections, his therapy was involved in the assistance of Covid patients, the primary did not fail in its commitment and continued to guarantee access to family members.
“Although the indications of the health directorates were still very restrictive in this sense and access was not contemplated, we, once again aware of the risks, but also of the need to allow visits for the well-being of patients, family members and our same team, we have built an ad hoc procedure to regulate access to the Covid area in the smallest details “.
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The results were very positive: “The family members who had doubts about the treatments carried out, once entered were able to verify our work and had more confidence in us. Many were impressed by the technologies applied, others by the fatigue experienced in wearing the devices. of protection. Some were moved and we with them “.
The primary tells us that the discomfort, the frustration, the pain, the feeling of helplessness that hit the family members and the operators themselves on the occasion of the first wave, when all the departments were armored, had left an indelible mark.
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“Many family members told us how painful it was for them not to be able to see their relative, give a last farewell, a last look. Some kept asking us if we really had done everything possible to save their loved one, others finished the lockdown are came to visit us to give a face to those voices that every day marked their hopes and their sufferings “.
Even in Covid resuscitation, the access protocol was very accurate. “On the agreed day and time, the visitor was welcomed by a health worker with the task of helping him to correctly wear the protective devices (the same as those worn by doctors and nurses), before being accompanied to the patient’s bed. meticulous attention to undressing, performed under the supervision of the nurse “.
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Nothing was left to chance. The procedure bears the signature of the nursing coordinator Nadia Moroni, of the infectious disease consultant Alessandro Fiorentini, and that of other colleagues who had already allowed visits to Covid wards in their hospitals. Among them, Dr. Marco Vergano of San Giovanni Bosco of Turin, coordinator of the study group of Bioethics of Siaarti (Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care), and of Dr. Paolo Malacarne, Head of Reanimation at the Cisanello hospital in Pisa according to which “the risk that opening the Intensive Care Unit increases the risk of infection for patients is unfounded. This is demonstrated by years and years of research. In any case, essential hygiene and organizational rules must be respected” .
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Today it is easier to enter resuscitation than obstetrics
In any case, the primary school continues, “nowadays it is easier for family members to enter critical and emergency wards rather than ordinary hospital wards, such as obstetrics or surgery, or rehabilitation wards”. In fact, she says that many family members contacted her to inform her that after being discharged from her ward they no longer had the opportunity to see their relative.
“The father of a very young girl hospitalized for trauma, who stayed with her every afternoon for a month when she was in intensive care, returned to us in tears to tell us that what he had experienced as a hope, namely the transfer of his daughter towards a rehabilitation institution, it had become a nightmare since he had been denied access. He had not seen her again for weeks precisely in the phases of her gradual recovery, when the presence of a family member could be important “.
Yet, in the decree of July 22, 2021, the Government introduced an article that, starting from August 6, extends the possibility for family members in possession of a Green Pass to assist relatives not affected by Covid in all departments. Law no. 87 of 17 June also provides that accompanying persons may remain in waiting rooms and in the emergency wards (when it is not Sars-Cov-2). However, some rights remain only on paper.
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