ABSTRACT
Background and aims: The consequences of the COVID-19 pandemic on the management of stroke patients are causing concerns. The objective was to assess the impact of changes in use of care and health reorganizations implementation, spurred by the first wave of the COVID- 19 pandemic on acute stroke management time. Methods: The study was based on a cohort of stroke patients included between January 2019 and August 2020 in a French regional stroke observatory and an ad-hoc collection of hospital reorganizations. The associations between reorganizations, use of care, and emergency unit (EU) admission-to-imaging time were analyzed through multivariate linear regression mixed models. Interaction terms between the use of care variables and the period (pre, per, post-wave) were introduced. Results: A total of 6,436 stroke patients were included in 14 hospitals. Four main trends were observed during the per-wave period compared to the pre and post-wave periods: 1) more frequent calls to Emergency Dispatch Organization (EDO) (65.5% vs 61.5% and 64.1%, p=0.083), 2) longer median times from symptoms onset- to-call to EDO (139 minutes vs. 121 minutes and 125 minutes, p=0.232), 3) longer median times from EU admission-to-imaging time (91 minutes vs. 83 minutes and 88 minutes, p=0.332), 4) less intravenous thrombolysis (14.6% vs. 19.4% and 16.7%, p=0.011). No association was found between reorganizations and EU admission-to-imaging times. Conclusions: Hospitals have demonstrated their adaptation ability during the first wave of the COVID-19 by implementing reorganizations without altering stroke pathway structuration. (Figure Presented).
ABSTRACT
Background and aims: The consequences of the COVID-19 pandemic on the management of stroke patients are causing concerns, particularly for vulnerable individuals, more likely impacted by health protection measures and modification of care support. The objective was to study the effect of the first Covid wave on the place of clinical (person at risk of severe COVID) and social vulnerabilities as health inequality on acute stroke management. Methods: The study was based on a cohort of stroke patients included between January 2019 and August 2020 in a French regional stroke observatory. The associations between vulnerabilities (clinical: age over 65 years old, cardiovascular history;socio-economic: deprivation index) and emergency unit admission-to-imaging time were analyzed through three multivariate linear regression mixed models. Interaction terms with time period (pre, per, post-wave) were introduced. Results: A total of 6,436 stroke patients were included in 14 hospitals. The models showed no statistically significant association between emergency unit admission-to-imaging time and advanced age (p=0.068), cardiovascular history (p=0.444) or deprivation (p=0.295), without any interaction with the COVID period. During the per (expb=1.169, 95%CI [1.006-1.359]) and post-wave (expb=1.072, 95%CI [0.984-1.168]) periods, the age-deleterious effect on stroke management time tended to decrease compared to the pre-wave period (expb=0.993, 95%CI [0.849- 1.162]). Conclusions: The COVID-19 pandemic induced no deep changes on the management time for the most vulnerable populations. An improvement time tendency is even noted for the elderly during the pre and post-wave periods.
ABSTRACT
BACKGROUND: The clinical teaching is the core component of the nursing curriculum, the alarming pandemic rates brought uncertainty to clinical teaching, weighing the safety of patients, students, and faculty, which demanded essential modification in clinical teaching and resulted in challenges in relation to effective response to clinical teaching requirements. This study aimed to assess the effective clinical teaching from the nurse educators' perspective during the remote teaching that followed the COVID-19 pandemic. METHODS: This study is a national Web-based descriptive study. Participants were recruited from five major Nursing Colleges in Oman. Descriptive and inferential as well as multiple linear regression analyses were conducted. RESULTS: A total of 127 nurse educators completed the survey with mean age of 43.9 (SD = 6.9) years. The overall effective clinical teaching score was 54.4 (SD = 10.9) which is considered acceptable, although the nurse educators in Oman reported the highest score on the safety dimension of the effective clinical teaching. Furthermore, females, doctoral prepared nurse educators, and those who acted as preceptors reported higher effective clinical teaching levels compared to their counterparts. The regression analysis showed that age, gender, and attending infection control training are significant predictors of effective clinical teaching. CONCLUSION: The paradigm shift in clinical teaching requires adequate measures including identification and appropriate training of clinical instructors and preceptors to meet clinical teaching demands in remote teaching. It is also important to take actions that promote and maintain the safety prioritization in bedside clinical teaching. These measures might positively impact on the nursing education process.
ABSTRACT
Organizations around the globe are currently experiencing significant decline in revenue, bankruptcy and job losses regardless of their size as a result of covid-19 pandemic. By implication, the travel bans, quarantine measures and boarder closures have also contributed immensely to the challenges of businesses. In order to sustain business operations, human resource managers need to embrace novel methods of operation to cope with the new challenges arising from the pandemic. Therefore, calculated and rapid responses in form ofpolicies, combined with strong multidimensional leadership skills are required to control the effects of Covid-19 on human resources practices on employees and the organisation as a whole. The study provides an overview of the challenges of human resource professionals, especially managers face and their roles in filling the lacuna created by the covid-19 pandemic, as well as provided recommendations in order to create a suitable teleworking and sustainable working environment among the workforce and the organization during and after the corona virus pandemic in addition to combating the current challenges created by the pandemic.