ABSTRACT
Background: Centralised phlebotomy services have been an integral part of providing blood monitoring facility for people with chronic diseases prescribed vital therapies. However the patient experience is not always optimal due to the issues of congestion, parking, long waiting times and have been accentuated during COVID-19 pandemic with the need for minimising physical contact. Expert panels have advocated for the creation of innovative approaches to provide safe patient care while maintaining precautions against COVID-19 spread. Several groups have published the concept and experience of using a drive-through clinic for anticoagulation monitoring and management. There is limited data on how this model of care can impact other clinical services such as rheumatology where patient groups are more vulnerable. Objectives: In response to the growing pressure on phlebotomy service at our institution enhanced by COVID-19 pandemic, our rheumatology service implemented a drive-through phlebotomy clinic to provide the option for patients and families to stay in their vehicles whilst having venepuncture. The objectives were to evaluate the feasibility and patient experience of the service. Methods: At our large university teaching hospital, we set up a drive-through phlebotomy service provided by a senior health care assistant supervised by the lead nurse. It was located near the hospital entrance where vehicles could park for a few minutes without disrupting traffic fow. Patients were identifed from the departmental database and were offered the facility via telephone. Eligibility was assessed using a standardised proforma focusing on logistics such as ability to drive and access to a mobile phone. Appointments were scheduled in advance with patients choosing this care option. On the day, patients were screened for COVID-19-related symptoms before their appointment and were encouraged to stay in their vehicles wearing a mask before being approached by the HCA. At the end of clinic, all samples were submitted to the central laboratory. All the data was prospectively collated with patients' consent and anonymised for analysis. In addition to demographics, diagnosis and drug record, duration of visit and patient feedback was collected. Results: 112 patients were offered the service during a 12-week pilot. Mean age of the participants was 49.5 yrs (19-91) with 73 (65%) women. 74 (65%) were of Caucasian and 28 (25%) of Asian origin. 94 (84%) had infammatory arthritides and all were prescribed DMARDs and/or bone active agents. 69 (61%) had blood samples taken using this service. Most common reason to decline was an already arranged appointment with standard phlebotomy (n=14, 12.5%). Six (5%) could not be bled due to difficult venepuncture. Mean duration of appointment was 12.5 mins (5-60). 68 (60%) provided feedback with 61 (90%) rating 5/5 and 60 (89%) rating it better than standard phlebotomy. All would like to have the option for future and 67 (98%) were highly likely or likely to recommend the service to family and relatives. Conclusion: To our knowledge, this is the frst study to demonstrate the utility of drive-through phlebotomy for people with rheumatic diseases prescribed DMARDs. Excellent feedback of the participants confrms the need and desire for such innovation in health care. Prior publications have shown the benefts of such clinics in anticoagulation services. Arguably, it's more prudent to have this facility for those where there is no alternative such as point-of-care or home INR monitoring. In post COVID-19 services reconfguration with telemedicine and innovative models of care, this allowed fexibility for our department to develop and establish an alternative process. The availability of drive-through appointments and the close physical proximity to the clinic made it an appealing option for a vulnerable group of patients evidenced by their outstanding experience and feedback. Overall, an HCA-delivered, nurse-supervised drive-through pathway is highly effective, safe and provides an innovative solution to stra ned phlebotomy services.
ABSTRACT
Background/Aims Centralised phlebotomy services have been an integral part of providing blood monitoring facility for people with chronic diseases prescribed vital therapies. However, the patient experience is not always optimal due to the issues of congestion, parking, long waiting times;this has been accentuated during COVID-19 pandemic with the need for minimising physical contact. In response to the growing pressure on phlebotomy service at our institution enhanced by the COVID-19 pandemic, our rheumatology service implemented a drivethrough phlebotomy clinic to provide the option for patients and families to stay in their vehicles whilst having venepuncture. Methods At our large university teaching hospital, we set up a drive-through phlebotomy service provided by a senior HCA supervised by the lead nurse. Patients were identified from the departmental database and were offered the facility via telephone. Eligibility was assessed using a standardised proforma focusing on logistics such as ability to drive and access to a mobile phone. Appointments were scheduled in advance with patients choosing this care option. All the data was prospectively collated with patients' consent and anonymised for analysis. In addition to demographics, diagnosis and drug record, duration of visit and patient feedback was collected. Results 112 patients were offered the service during a 12-week pilot. Mean age of the participants was 49.5 yrs (19-91) with 73 (65%) women. 74 (65%) were of Caucasian and 28 (25%) of Asian origin. 94 (84%) had inflammatory arthritides and all were prescribed DMARDs and/or bone active agents. 69 (61%) had blood samples taken using this service. Most common reason to decline was an already arranged appointment with standard phlebotomy (n=14, 12.5%). Six (5%) could not be bled due to difficult venepuncture. Mean duration of appointment was 12.5 mins (5-60). 68 (60%) provided feedback with 61 (90%) rating 5/5 and 60 (89%) rating it better than standard phlebotomy. All would like to have the option for future and 67 (98%) were highly likely or likely to recommend the service to family and relatives. Conclusion To our knowledge, this is the first study to demonstrate the utility of drive-through phlebotomy for people with rheumatic diseases prescribed DMARDs. Excellent feedback of the participants confirms the need and desire for such innovation in health care. In post COVID-19 services reconfiguration, the availability of drive-through appointments and the close physical proximity to the clinic made it an appealing option for a vulnerable group of patients evidenced by their outstanding experience and feedback. Overall, an HCA-delivered, nursesupervised drive-through pathway is highly effective, safe and provides an innovative solution to strained phlebotomy services.
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Background/Aims We evaluated the RCN Competency Framework for Rheumatology Nurses published in March 2020. The competency aims to support personal development plans, continuing professional development (CPD) and career progression for rheumatology nurses to advanced practice acting as a benchmarking tool, providing a framework to support succession planning and service development, forming the base for a nationwide standard curriculum for training. This evaluation explores rheumatology nurses' views of the competency, and identify benefits, limitations, and recommendations. Methods We used a sequential research design utilising a questionnaire circulated from 13 March to 25 April 2021 followed by semi-structured interviews between May 2021 and August 2021. Results 106 people responded to the survey, 99 (93%) working as adult rheumatology nurses. There were 55 (52%) band 7 nurses and a wide range of job titles. Most nurses, 93 (87%) had academic qualification at degree or Master's level. Most respondents 77 (73%) were from England. 74 (70%) found out about the competency via the RCN Rheumatology Nursing Forum Facebook page, or via the BSR website (35%). Most (71%) respondents had their present role for five years or more and 103 (50%) nurses had been in their role for more than 10 years. When asked whether they had used the competency in their practice, 57 (54%) said they had. Reasons for using it were;to provide a framework for learning, to use as a benchmarking tool, for CPD, for teaching, to demonstrate skills and knowledge, when managing others, to show managers how their role can develop. Redeployment due to COVID-19 and workforce issues were the main reason why the competency was not implemented fully. However, using it with new staff was cited as beneficial. Free text comments described very good detail and identification of learning needs, giving good understanding of the underpinning knowledge. 15 nurses responded for interviews and 14 were conducted. The average was 12 minutes totalling 171 minutes. We asked why they used the competency, for any potential strengths or limitations, how much time it took to complete, would they use it again, improvement suggestions, if they would recommend it to others, and whether it was easy to locate. People said a paediatric rheumatology module and an accessible course focussed on leadership is needed. When asked to summarise the competency in five words, one said it was 'a reliable tool to improve quality care and set standards for education of nurses'. Conclusion The competency was well received as a strengthening resource for UK rheumatology nurses. We recommended that these competencies are universally adopted. Further dissemination is required and education needs must be addressed. A development framework is planned. Further analysis will be published in 2022. A review of the competency is due in 2023.
ABSTRACT
Background: Data for front-line health-care workers, risk of disease is limited so as the resources available. Although inspiring stories on doctors fighting against COVID-19-19 were covered we are still unaware of the challenges at ground level. The present study throws light on it and provides way through towards resolving the issues. Objectives:1. To assess the perceptions of the doctors towards the process of COVID-19-19 crisis management. 2.To identify the challenges and recommend solutions based on their views, suggestions. Methods: A cross sectional study on perception of doctors (94) involved in COVID-19 duty was conducted during July to September 2020, with the help of pre-validated semi-structured questionnaire through online google survey form. The questionnaire had demographic details, views on before, during and after the COVID-19 duty along with 4 open ended questions on their good and bad experiences, problems & suggestions. Descriptive statistics for quantitative & thematic analysis for qualitative data was used. Results: Nonresponse rate was 26%, mean age 27.55 year. Majority were from clinical departments (78%). 42% felt that training was proper, 60% adequate PPE kit, 52.6% were aware of management strategy, 86% stressed,82% found difficulties in communication. 42% were provided proper quarantine facility yet, 58% faced discrimination. Few themes emerged under challenges like lack of resources & training, stress & burnout, for which patient sensitization, refresher training, psychological & administrative support was suggested. Conclusion: Although COVID-19 pandemic has impacted life of doctors in either way, the challenges could easily be tackled by the recommended simple solutions. © 2021, Indian Association of Preventive and Social Medicine. All rights reserved.
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In Bangladesh, coronavirus disease 2019 (COVID-19) has been highly prevalent during late 2020, with nearly 500 000 confirmed cases. In the present study, the spike (S) protein of severe acute respiratory coronavirus 2 (SARS-CoV-2) circulating in Bangladesh was genetically investigated to elucidate the diversity of mutations and their prevalence. The nucleotide sequence of the S protein gene was determined for 15 SARS-CoV-2 samples collected from eight divisions in Bangladesh, and analysed for mutations compared with the reference strain (hCoV-19/Wuhan/WIV04/2019). All the SARS-CoV-2 S genes were assigned to B.1 lineage in G clade, and individual S proteins had 1-25 mutations causing amino acid substitution/deletion. A total of 133 mutations were detected in 15 samples, with D614G being present in all the samples; 53 were novel mutations as of January 2021. On the receptor-binding domain, 21 substitutions including ten novel mutations were identified. Other novel mutations were located on the N-terminal domain (S1 subunit) and dispersed sites in the S2 subunit, including two substitutions that remove potential N-glycosylation sites. A P681R substitution adjacent to the furin cleavage site was detected in one sample. All the mutations detected were located on positions that are functionally linked to host transition, antigenic drift, host surface receptor binding or antibody recognition sites, and viral oligomerization interfaces, which presumably related to viral transmission and pathogenic capacity.
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COVID-19, the disease caused by SARS-CoV-2 infection, has been declared a pandemic by the WHO in March 2020. This outbreak poses serious concerns to the global education system. Many educational institutions around the world have closed their campuses and moved to online teaching-learning mode. After the approval from UGC, the validation of online courses has increased in India. The digital initiatives of MHRD for secondary as well as higher education during COVID-19 are the Diksha portal covers e-Learning content for students, teachers, and parents associated with the program, video lessons, worksheets, textbooks, and assessments. It has been almost 15 months since the Indian education system under lockdown. All education bodies including private/Government have started or trying to start is online classes/webinars for students. As today is the era of technology, it provides plenty of opportunities: innovation in learning, ease of creation, embracing international social context, providing new resources and understanding, and increased access to information. Information and communications technology have a vital role in human life as oxygen. The use of technology is a means that the technology replaces traditional learning approaches, it is just to support the new learning skills and approaches. The current prospective cross-sectional study emphasizes discussing the educational spectrum during digital literacy at times of pandemic and lockdown and also evaluates the stress levels of students due to e-learning.
Subject(s)
COVID-19ABSTRACT
Since March 11, 2020, when the World Health Organization proclaimed the fast spread of SARS-CoV-2 a worldwide pandemic, the majority of afflicted nations have continued to adopt non-pharmaceutical interventions (NPIs, such as physical separation, hand cleanliness, and mask usage), which have been effective in suppressing viral transmission. However, given the fast spread of SARS-CoV-2 and the outbreak's high fatality rate, it is generally agreed that a safe and effective vaccine is essential for controlling the pandemic. Vaccination coverage is one of the most effective and cost-efficient health interventions available for the prevention and control of infectious illnesses, including the COVID-19. While producing an effective and safe COVID-19 vaccine is not straightforward, it's manufacturing, storage, distribution, and administration may offer additional difficulties, particularly in underdeveloped nations. The purpose of the present study sought to determine the general population's acceptability, the prevalence of vaccine hesitancy, and the influence of social media and peer groups towards the COVID19 vaccination in India.
Subject(s)
COVID-19ABSTRACT
Covid 19 pandemic has not only led to disruption of public health but it has also resulted in massive economic shock across the world due to business interruptions and shutdowns form social distancing measures. Different communities are facing varying consequences but daily wage workers and farmers remain the most effected groups. This has also led to risk of unemployment, which has worst impact on livelihood of common man. According to WHO, nearly half of the world’s 3.3 billion global workforce are at risk of losing their live hood. These economic crises have shown effect on the psychological and social well being of individual. The research agenda includes accessing the current socioeconomic status of general public. Their financial stability in global crisis and whether they can recover their loss.The current article will be carried out to assess the socioeconomic status of general public and their financial stability or loss incurred with pandemic.