Use and uptake of technology by people with dementia and their supporters during the COVID-19 pandemic.

OBJECTIVE: This rapid review aims to identify the types of technologies used by people with dementia and their supporters during the COVID-19 pandemic, and the issues which influenced technology adoption within their usual care routines. METHODS: PubMed, PsychInfo, Scopus, and Cochrane COVID reviews were searched to identify peer-review studies published since 2020. A total of 18 studies were included and synthesised thematically. RESULTS: Of these, most were conducted in the community (n = 15) with people with dementia only (n = 11) and involved qualitative methods (n = 11). The majority (n = 12) focused on digital off-the-shelf and low-cost solutions, such as free video conferencing platforms, to access care, socialise or take part in interventions. Whilst often well-accepted and associated with positive outcomes (such as improved social connectedness), lack of digital literacy or support to use technologies, limited access to appropriate technology, individuals' physical, cognitive, or sensory difficulties, were highlighted and likely to threaten the adoption of these solutions. The quality of the evidence was mixed, neither very robust nor easily generalisable which may be attributed to the challenges of conducting research during the pandemic or the need to rapidly adapt to a new reality. CONCLUSION: While COVID-19 has fast-tracked the adoption of technology, its use is likely to continue beyond the pandemic. We need to ensure this technology can leverage dementia support and care and that people with dementia are enabled and empowered to use it.

The Diagnostic Accuracy and Clinimetric Properties of Screening Instruments to Identify Frail Older Adults Attending Emergency Departments: A Protocol for a Mixed Methods Systematic Review and Meta-Analysis.

BACKGROUND: Prompt and efficient identification and stratification of patients who are frail is important, as this cohort are at high risk of adverse healthcare outcomes. Numerous frailty screening tools have been developed to support their identification across different settings, yet relatively few have emerged for use in emergency departments (EDs). This protocol provides details for a systematic review aiming to synthesize the accumulated evidence regarding the diagnostic accuracy and clinimetric properties of frailty screening instruments to identify frail older adults in EDs. METHODS: Six electronic databases will be searched from January 2000 to March 2021. Eligible studies will include adults aged ≥60 years screened in EDs with any available screening instrument to identify frailty (even if not originally designed for this purpose). Studies, including case-control, longitudinal, and cohort studies, will be included, where instruments are compared to a reference standard to explore diagnostic accuracy. Predictive accuracy for a selection of outcomes, including mortality, institutionalization, and readmission, will be assessed. Clinical and methodological heterogeneity will be examined, and a random effects meta-analysis performed if appropriate. CONCLUSION: Understanding whether frailty screening on presentation to EDs is accurate in identifying frailty, and predicting these outcomes is important for decision-making and targeting appropriate management.

Experiences and perceptions of Turkish intensive care nurses providing care to Covid-19 patients: A qualitative study.

AIM: To describe the experiences of intensive care nurses who provided care to Covid-19 patients and their perceptions towards the disease and their work conditions during the pandemic. INTRODUCTION: Identification of experiences and perceptions of intensive care nurses towards disease, care and their workplace conditions when providing care to Covid-19 patients will inform decision-makers about improvements that can be implemented. BACKGROUND: The Covid-19 pandemic has led to increased strain and workplace-related health risks to intensive care nurses, but it has also provided a unique experience and opportunities for learning and development. METHODS: A descriptive qualitative study was conducted with 10 intensive care unit nurses working in seven hospitals in Istanbul, Turkey. Snowball sampling method was used, and the data were collected by semistructured online interviews. A thematic analysis was performed. The Consolidated Criteria for Reporting Qualitative Research were followed. FINDINGS: Five major themes were identified: 'death and fear of death', 'impact on family and social lives', 'nursing care of Covid-19 patients', 'changing perceptions of their own profession: empowerment and dissatisfaction', and 'experiences and perceptions of personal protective equipment and other control measures'. DISCUSSION: Intensive care nurses experience an increased risk of infection and psychological burden, and they lack a sense of professional satisfaction. Improvements to working conditions are needed to support nurses caring for patients during the pandemic. CONCLUSION: The pandemic increased the workload and responsibilities of intensive care nurses and led to increases in their work-related health risks and challenges with care. However, it also increased nurses' awareness about the importance of their professional roles. IMPLICATIONS FOR NURSING PRACTICE AND POLICIES: There is a need to improve working conditions and develop nursing standards for the care of Covid-19 patients in intensive care units.