South African Medical Research Council, Cape Town, South Africa; Department of Paediatrics and Child Health, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa.
S Afr Med J. 2021 Jan 20;111(2):100-105. doi: 10.7196/SAMJ.2021.v111i2.15388.
The COVID-19 pandemic has resulted in many hospitals severely limiting or denying parents access to their hospitalised children. This article provides guidance for hospital managers, healthcare staff, district-level managers and provincial managers on parental access to hospitalised children during a pandemic such as COVID-19. It: (i) summarises legal and ethical issues around parental visitation rights; (ii) highlights four guiding principles; (iii) provides 10 practical recommendations to facilitate safe parental access to hospitalised children; (iv) highlights additional considerations if the mother is COVID-19-positive; and (v) provides considerations for fathers. In summary, it is a child's right to have access to his or her parents during hospitalisation, and parents should have access to their hospitalised children; during an infectious disease pandemic such as COVID-19, there is a responsibility to ensure that parental visitation is implemented in a reasonable and safe manner. Separation should only occur in exceptional circumstances, e.g. if adequate in-hospital facilities do not exist to jointly accommodate the parent/caregiver and the newborn/infant/child. Both parents should be allowed access to hospitalised children, under strict infection prevention and control (IPC) measures and with implementation of non-pharmaceutical interventions (NPIs), including handwashing/sanitisation, face masks and physical distancing. Newborns/infants and their parents/caregivers have a reasonably high likelihood of having similar COVID-19 status, and should be managed as a dyad rather than as individuals. Every hospital should provide lodger/boarder facilities for mothers who are COVID-19-positive, COVID-19-negative or persons under investigation (PUI), separately, with stringent IPC measures and NPIs. If facilities are limited, breastfeeding mothers should be prioritised, in the following order: (i) COVID-19-negative; (ii) COVID-19 PUI; and (iii) COVID-19-positive. Breastfeeding, or breastmilk feeding, should be promoted, supported and protected, and skin-to-skin care of newborns with the mother/caregiver (with IPC measures) should be discussed and practised as far as possible. Surgical masks should be provided to all parents/caregivers and replaced daily throughout the hospital stay. Parents should be referred to social services and local community resources to ensure that multidisciplinary support is provided. Hospitals should develop individual-level policies and share these with staff and parents. Additionally, hospitals should ideally track the effect of parental visitation rights on hospital-based COVID-19 outbreaks, the mental health of hospitalised children, and their rate of recovery.
标题：COVID-19 大流行期间，医院如何保障患儿父母的探视权
摘要：COVID-19 大流行期间，许多医院对患儿父母的探视加以严格限制或完全禁止。本文为医院管理者、医护人员、地区级管理者和省级管理者提供 COVID-19 大流行期间患儿父母探视方面的指导建议。本文内容包括：（一）总结探视权的法律和伦理问题；（二）强调四项指导原则；（三）提出 10 条便于安全探视的实用建议；（四）如果母亲 COVID-19 检测阳性，则应注意的事项；（五）为探视父亲提供考虑因素。总之，患儿在住院期间有权探视父母，而父母也应探视其住院的子女；在 COVID-19 等传染病大流行期间，有责任以合理且安全的方式实施探视。只有在特殊情况下，如院内设施无法合理容纳父母/照护者与新生儿/婴儿/儿童时，才应将父母与子女分开。在严格执行感染防控（IPC）措施和采取非药物干预（NPI）的情况下，包括勤洗手/消毒、戴口罩和保持身体距离，应允许双方父母探视住院的子女。新生儿/婴儿及其父母/照护者具有较高的 COVID-19 感染相似性，应将他们视为一个整体，而非个体进行管理。每家医院应为 COVID-19 阳性、COVID-19 阴性或疑似病例（PUI）的母亲提供寄宿/陪住设施，严格执行 IPC 措施和 NPI。如果设施有限，应优先考虑母乳喂养的母亲，顺序如下：（一）COVID-19 阴性；（二）COVID-19 PUI；（三）COVID-19 阳性。应提倡、支持和保护母乳喂养或母乳喂养，尽可能讨论并实施母亲/照护者与新生儿的皮肤接触（IPC 措施）。应向所有父母/照护者提供外科口罩，并在整个住院期间每天更换。应将父母转介给社会服务和当地社区资源，以确保提供多学科支持。医院应制定针对个人的政策，并与员工和父母分享。此外，医院应跟踪探视权对医院 COVID-19 爆发、住院患儿心理健康和康复率的影响。
