Experiences of patients and providers while using telemedicine in cancer care during COVID-19 pandemic: a systematic review and meta-synthesis of qualitative literature.

PURPOSE: The objective of this meta-synthesis was to identify, appraise, and synthesize patients and provider's experiences while using telemedicine in cancer care during the COVID-19 pandemic. METHODS: The databases Medline, Embase, Cinahl, PsycInfo, Web of Science, and other related databases were searched. Reviewers followed the Joanna Briggs Institute (JBI) meta-aggregation method to identify categories and synthesized findings and to assign a level of confidence to synthesized findings. The listed quotations and the original author interpretations were synthesized using MAXQDA software. RESULTS: Nineteen studies were included in the meta-synthesis. Three synthesized findings emerged from 243 primary findings: telemedicine assists but cannot be a substitute for face-to-face appointments in a health care crisis and in the provision of routine care to stable patients with cancer, infrastructural drivers and healthcare provider's support and attention affect patients' experiences and feelings about telemedicine, and patients who use telemedicine expect their health care providers to devote enough time and consider emotional needs, the lack of which can develop a negative response. The methodological quality of the studies ranged between 4 and 10, and the overall level of confidence of the synthesized findings was determined to be low and medium. CONCLUSION: The findings from this meta-synthesis gave a new insight to promoting the safe and evidence-based use of telemedicine during the current pandemic and future emergencies.

Protecting healthcare workers against coronavirus disease 2019 in emergency departments at a teaching hospital in Tabriz, Iran: a best practice implementation project.

INTRODUCTION: The first case of the novel coronavirus disease (COVID-19) in Iran was officially announced on February 19, 2020, in Qom city. The prevalence of COVID-19 is higher among frontline healthcare workers (HCWs) due to their occupational exposure. OBJECTIVE: The aim of this evidence implementation project was to improve the protection of nurses against COVID-19 in the emergency department of a teaching hospital in Tabriz, Iran. METHODS: A clinical audit was undertaken using the JBI Practical Application of Clinical Evidence System (JBI PACES) tool. Ten audit criteria, representing the best practice recommendations for the protection of HCWs in the emergency department were used. A baseline audit was conducted, followed by the implementation of multiple strategies. The project was finalized with a follow-up audit to evaluate changes in practice. RESULTS: The baseline audit results showed that the compliances for four (out of ten) audit criteria (criteria 4, 7, 8 and 9), were under 75%, which indicated poor and moderate compliance with the current evidence. After implementing plans such as running educational programs and meetings, major improvement was observed in 3 criteria, criterion 4 was improved from low to excellent (41-81%), criterion 7 was promoted from low to moderate (30-62%), criterion 8 was not promoted considerably (22-27%) and criterion 9 was improved from moderate to excellent (70-84%). CONCLUSION: The results of the audit process increased COVID-19 protection measures for nurses in the emergency department. It can be concluded that educational programs and tools, such as face-to-face training, educational pamphlets, workshops and meetings can facilitate the implementation of evidence into practice.

COVID-19 outbreak and the impact on renal disorders: A rapid review.

In this rapid review, we aimed to evaluate the effect of coronavirus disease 2019 (COVID-19) on renal functions and mortality of patients with kidney diseases. We searched MEDLINE, The Cochrane Library, Scopus, Embase, Web of Science, UpToDate, and TRIP databases using the following keywords: COVID-19, COVID19, 2019-nCoV, 2019-CoV, coronavirus, SARS-nCoV-2, urology, cancer, bladder, prostate, kidney, trauma, stone, neurogenic, and reconstructive. The initial search resulted in 495 records. After the primary screening of titles, abstracts, and full texts and removing duplicates, 10 articles were selected and included in this rapid review. Moreover, we performed meta-analysis of binary data for the outcomes with sufficient data. Owing to a high level of heterogeneity because of different study designs and contexts, we used a random model for the meta-analysis. Only 5 studies were eligible for the meta-analysis. In these studies, comprising 964 COVID-19 positive patients, the cumulative event rate of acute kidney injury (AKI) was 7.1% (95% confidence interval: 1.8%-24.5%, p<0.001, I2=92.4). Based on the qualitative synthesis of the 10 included studies, patients with COVID-19 and kidney diseases had higher risk of in-hospital mortality. If AKI occurs because of the novel coronavirus, the mortality rate will be very high. Therefore, we need further investigations and more studies to recognize the extent and the cause of renal involvement in COVID-19.