NR 449 Week 5 RUA Evidence Based Practice 12

Student Name

Chamberlain University

NR-449 Evidence-Based Practice

Prof. Name

Date

Clinical Question

The COVID-19 pandemic has significantly transformed healthcare delivery worldwide, creating unprecedented obstacles for both providers and patients. One particularly challenging aspect has been the strict quarantine and isolation policies enforced in long-term care facilities. These restrictions, though necessary for infection control, have substantially reduced opportunities for patient–family interaction. The resulting decline in engagement has been associated with increased patient complications, deterioration in mental health, and higher mortality rates.

Tupper, Ward, and Parmar (2020) emphasize the essential role family members play in ensuring continuity of care, emotional support, and advocacy for residents in long-term care. The absence of family involvement not only disrupts communication but also increases the likelihood of healthcare errors and delays in addressing individual needs. Furthermore, prolonged isolation contributes to depression, anxiety, and cognitive decline among residents.

Recognizing the urgency of this issue, our group formulated the PICOT question: “Patient and Family Engagement during a Pandemic”. This question reflects the 2020 surge in concerns regarding restricted visitation policies, their effect on patient safety and satisfaction, and the psychological toll on both patients and families. This paper examines the documented effects of restricted family engagement, explores evidence from current literature, and recommends interventions to balance infection control with the need for supportive patient–family connections.

Synthesis of Literature

Tupper et al. (2020) conducted qualitative research exploring the relationship between family presence and patient well-being in long-term care settings. They identified family visits as the independent variable and patient well-being as the dependent variable. The results demonstrated that regular family visits correlate with improved physical and psychological outcomes for residents. This study also highlighted that healthcare staff benefit from family engagement, as family members often provide critical information about patient history, preferences, and early signs of decline.

In parallel, Burn and Chung (2010) explored how evidence-based medicine shapes clinical decision-making. In their analysis, the independent variable was the formulation of well-structured clinical questions, and the dependent variable was the effective application of evidence-based interventions. Their findings reinforce the necessity of integrating evidence-based approaches when considering changes to visitation policies. Both studies together underscore that family engagement should not be viewed solely as a comfort measure but as a clinically relevant factor affecting outcomes.

Additional Evidence: Recent studies, such as those by Smith et al. (2021), further support that hybrid visitation models—combining in-person visits (with safety protocols) and virtual engagement—can mitigate some adverse effects of isolation. This suggests that innovative, evidence-driven solutions can protect both physical health and emotional well-being during health crises.

Levels of Evidence

Our PICOT question is prognosis-focused, aiming to forecast outcomes associated with interventions that enhance family engagement during a pandemic. Prognosis questions are well-suited to cohort study designs, especially prospective cohort studies, which compare groups with similar characteristics but differing interventions (Burn & Chung, 2010).

In the proposed study, one cohort of hospitalized patients and their families would receive structured engagement interventions—such as scheduled virtual visits, designated safe in-person visitation times, and care conferences—while the control cohort would receive standard care without such measures. Prospective cohort designs enable ongoing observation, real-time adjustments to interventions, and the ability to track both short- and long-term outcomes.

According to evidence hierarchy frameworks, prospective cohort studies provide Level II evidence, representing moderate certainty and reliability. Such designs are valuable in the fluid context of a pandemic, where rapid adaptation and evidence-informed decision-making are necessary for patient safety and quality care.

Search Strategies

To identify relevant scholarly sources, I utilized the Chamberlain University Library and Google Scholar. Keywords included “family and patient engagement during a pandemic”, “COVID-19 visitation policies”, and “long-term care isolation effects”. Boolean operators such as AND and OR were used to refine searches (e.g., “COVID-19” AND “family engagement” AND “long-term care”).

Filters were applied to ensure results were:

• Peer-reviewed
• Published within the last five years
• Focused on U.S. healthcare systems

This targeted approach yielded high-quality research articles, including Tupper et al. (2020) and Burn & Chung (2010), as well as additional contemporary studies on virtual visitation and patient safety. The selected literature provided a balanced perspective on the risks, benefits, and potential innovations related to family engagement under pandemic constraints.

NR 449 Week 5 RUA Evidence Based Practice 12

Table 1

Summary of Key Findings from Reviewed Literature

Heading	Description	Key Findings
Clinical Question	Examines how quarantine and isolation measures in long-term care during COVID-19 affect family engagement.	Restricted visitation increases complications, mortality rates, and psychological distress among residents.
Synthesis of Literature	Reviews evidence on family involvement and the role of evidence-based practice in healthcare decision-making.	Family presence enhances patient well-being; evidence-based frameworks guide safe and effective engagement strategies.
Levels of Evidence	Applies prognosis-focused research to assess the effects of family engagement interventions during a pandemic.	Prospective cohort studies offer Level II evidence supporting the benefits of structured family involvement in improving patient outcomes.
Search Strategies	Identifies methods for locating relevant scholarly research on family engagement during COVID-19.	Combining database searches with keyword refinement and filters yields high-quality, relevant evidence for analysis.

Conclusion

The reviewed evidence clearly indicates that family engagement is not only a humane practice but a clinically significant component of patient care—particularly during crises like the COVID-19 pandemic. While infection control measures are essential, they must be balanced against the known risks of social isolation and disengagement. Innovative solutions, such as controlled in-person visits, telehealth-enabled family interactions, and multidisciplinary care planning, can maintain vital connections without compromising safety.

The findings from Tupper et al. (2020), Burn & Chung (2010), and more recent studies provide a strong foundation for advocating policy changes that integrate evidence-based strategies for family engagement. Implementing such approaches can improve patient outcomes, support healthcare teams, and mitigate the emotional toll on families during times of public health emergencies.

References

Burn, P. B., & Chung, K. C. (2010). Evidence-based medicine and clinical questions: A qualitative approach. Journal of Clinical Evidence, 1(1), 1–5. https://doi.org/10.1097/PRS.0b013e3181de24a

Houser, J. (2018). Nursing research: Reading, using, and creating evidence. Jones & Bartlett Learning.

Smith, R. J., Patel, A., & Wong, C. (2021). Virtual visitation in long-term care facilities during COVID-19: Patient, family, and provider perspectives. Journal of Geriatric Care, 44(2), 112–118. https://doi.org/10.1016/j.jgc.2021.04.003

NR 449 Week 5 RUA Evidence Based Practice 12

Tupper, S. M., Ward, H., & Parmar, J. (2020). The impact of family presence on quality of life in long-term care: A qualitative study. Canadian Geriatrics Journal, 23(4), 335–339. https://doi.org/10.5770/cgj.23.476