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Patient safety and hospital visiting at the end of life during COVID-19 restrictions in Aotearoa New Zealand: a qualitative study
  1. Aileen Collier1,
  2. Deborah Balmer2,3,
  3. Eileen Gilder3,4,
  4. Rachael Parke3,4
  1. 1Research Centre for Palliative Care Death and Dying (RePaDD), Flinders University, Adelaide, South Australia, Australia
  2. 2Western Australian Centre for Rural Health, The University of Western Australia, Perth, Western Australia, Australia
  3. 3School of Nursing, The University of Auckland, Auckland, New Zealand
  4. 4Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital, Auckland, New Zealand
  1. Correspondence to Dr Rachael Parke, School of Nursing, The University of Auckland, Auckland, 1142, New Zealand; r.parke{at}


Background Visiting restrictions were enacted in Aotearoa New Zealand to reduce transmission of COVID-19 and protect the healthcare system. This research aimed to investigate the experiences of families and clinicians of hospital visiting for people with palliative and end-of-life care needs during restrictions.

Methods Semistructured interviews were completed between March and October 2021 with family members and clinicians who had personally experienced enactment of visiting restrictions during pandemic restrictions. A critical realist ontology was used to approach data analysis, sorting and coding to generate themes.

Results Twenty-seven participants were interviewed, 13 being families who had experienced bereavement of a family member during the restrictions: seven nurses or physicians and seven being non-bereaved family members. Four themes were generated: patient safety—(re)defining the ‘Visitor’; the primacy of SARS-CoV-2—patient safety and negotiating risk; dying alone: enduring harms; and agency, strategies and workarounds.

Conclusion Visitor rights and visitor policy at the end of life require greater protection during a pandemic. Transparent, coherent, publicly available evidence-based guidelines that key stakeholders, including patients, families and ethicists, are included in producing, are urgently required. We want to avert a legacy of disenfranchised grief in future pandemics.

  • patient safety
  • COVID-19
  • qualitative research
  • critical care
  • visiting

Data availability statement

No data are available.

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  • Contributors All authors have contributed to the study design, data collection and analysis, and writing approval of the manuscript for submission and revision. RP acts as the guarantor for the finished work.

  • Funding This study was supported by a Health Research Council of New Zealand Activation Grant (20/1280).

  • Disclaimer The Health Research Council of New Zealand had no input into the design, conduct or analysis of the study.

  • Competing interests None declared.

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

  • 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.

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