ABSTRACT
Background Developments in digital health have the potential to transform the delivery of health and social care by creating new opportunities for healthcare professionals to deliver care. For example, during the COVID19 pandemic, palliative care services have used digital health to support communication with staff, patients and caregivers. However, there is limited data on staff perspectives of using digital health for communication during the pandemic, which limits our ability to learn how digital health tools can be used beyond the pandemic to support palliative care communication in clinical practice. Method(s) We developed an electronic questionnaire (requiring multiple choice and free text responses), for UK based palliative care healthcare professionals, to identify how they have used digital health to support communication in clinical care during the COVID19 pandemic. We circulated the questionnaire through professional networks and through social media. The questions involved: (1) communication within the multidisciplinary team (MDT), (2) education and (3) to support communication with patients and carers. We used thematic analysis to analyse free text responses and identify themes. Results Two hundred and thirty-four palliative care professionals participated. Most (n= 227, 97%) had increased their use of digital health, to support communication, since the pandemic started. We identified benefits and challenges for digital health communication, which we summarised into themes to identify facilitators and barriers for future use of this technology in clinical practice. Conclusion(s) Since the pandemic, palliative care professionals described increased use of digital health to support communication. We have identified facilitators and barriers for future practice. We believe that should work should identify support to enable organisations to implement the models of care needed to improve access and quality of palliative care services.
ABSTRACT
Background/aims: Developments in digital health has the potential to transform the delivery of health and social care by creating new opportunities for healthcare professionals to deliver care. For example, during the COVID-19 pandemic, palliative care services have used digital health to support communication with staff, patients and caregivers. However, there is limited data on staff perspectives of using digital health for communication during the pandemic, which limits our ability to learn how digital health tools can be used beyond the pandemic to support palliative care communication in clinical practice. Methods: We developed an electronic questionnaire (requiring multiple choice and free text responses), for UK based palliative care healthcare professionals, to identify how they have used digital health to support communication in clinical care during the COVID-19 pandemic. We circulated the questionnaire through professional networks and through social media. The questions involved: (1) communication within the multidisciplinary team (MDT), (2) education and (3) to support communication with patients and carers. We used thematic analysis to analyse free text responses and identify themes. Results: Two hundred and thirty-four palliative care professionals participated. Most (n= 227, 97%) had increased their use of digital health, to support communication, since the pandemic started. We identified benefits and challenges for digital health communication, which we summarised into themes to identify facilitators and barriers for future use of this technology in clinical practice. Conclusions: Since the pandemic, palliative care professionals described increased use of digital health to support communication. We have identified facilitators and barriers for future practice. We believe that should work should identify support to enable organisations to implement the models of care needed to improve access and quality of palliative care services.
Subject(s)
COVID-19 , Immunoglobulin G , COVID-19/prevention & control , COVID-19 Vaccines , Humans , Vaccine EfficacyABSTRACT
Introduction: With the spread of COVID-19 pandemic, healthcare workers and patients look for alternate medicines including Siddha, Ayurveda, Unani and other forms of traditional medicines as we still do not have promising antiviral drugs for COVID-19. Objective: To evaluate the in-vitro antiviral activity of Fema Sakthi™ (FS) by eliciting the inhibition of cytopathic effect of Human Coronavirus (HCoV) on African Green Monkey kidney cells (VERO cells). Materials and Method: The cytopathic effect (CPE) was performed on Vero cells with Human Coronavirus 229E, a type of Coronavirus associated with respiratory infections. The Median Tissue Culture Infectious Dose (TCID50) was evaluated using Reed-Muench method. 100 TCID50 of HCoV 229E viral suspensions were added to VERO cell culture to induce the cytopathic effect. Uninfected and untreated cells were used as control and five concentrations (62.5, 125, 250, 500 & 1000 µg/mL) of Fema Sakthi™ (FS) were used to study the anti-viral activity. After incubation for 72 hours, the cell viability was observed under the inverted microscope after staining with 0.1% crystal violet. Results: Fema Sakthi™ (FS) was found to exhibit inhibition of cytopathic effect at lower concentrations (62.5, 125 and 250 µg/mL) but at higher concentrations (500 and 1000 µg/mL), the formulation itself was cytotoxic to the cells. Conclusion: This preliminary study showed that FS has antiviral activity at lower concentrations 62.5, 125 and 250 µg/mL on the VERO cells. However, further specific studies have to be carried out to confirm the anti-viral activity and clinical efficacy using other preclinical and clinical models of Human Coronavirus (HCoV) including COVID-19. Copyright (c) 2022: Author(s).
ABSTRACT
Background: Many palliative care organisations use journal clubs to support educational development for staff. However, to date, the potential to use journal clubs to directly improve clinical care in hospices (through quality improvement activity) has not been described in the literature. Aims: We describe the development of a multidisciplinary hospice journal club, through which aimed to (1) develop research questions to clinical care problems in the hospice and (2) identify solutions to these problems to improve care delivery. Methods: In January 2019, we established fortnightly journal club meetings, which provided staff with the opportunity to present hospice-relevant palliative care research. In these meetings, we discussed the main findings, clinical practice implications and future research questions. Initially, the meetings were in-person, but we later hosted these online (via Microsoft Teams) due to the Covid19 pandemic, which enabled virtual participation. We used the research questions generated to inform future quality improvement work. We asked staff to complete a feedback survey to determine their views of the process. Results: We have conducted 30 journal club meetings, which have generated 124 research questions. Thirteen meetings were virtual. We have conducted quality improvement work using these research questions to improve clinical care. Nineteen staff (representing 5 clinical sites) completed feedback. The feedback was positive, with participants stating that the journal club was educational, clinically relevant and enjoyable. The main problem identified by participants were technological issues relating to participating in the virtual meetings. Conclusion / Discussion: We have demonstrated how a palliative care journal club can be used to improve clinical care in a hospice. Our experience can be used by other palliative care settings to engage staff in research and improve care for those with serious illness.
ABSTRACT
Aims: Our project aims to address staff wellbeing and explore, as a hospice team, some emotional challenges presented by the COVID-19 pandemic. Difficult decision making has caused moral distress amongst staff, and it has been essential to address this in order to prevent overwhelming trauma, promote mental resilience and foster hope. Methods: Providing a safe environment was essential for staff to share their feelings. Under the theme 'Let it go' for one week staff were asked to anonymously write down their feelings and take a treat thanking them for their input. An overwhelming response demonstrated the pressure placed on people's feelings of safety and emotional wellbeing. Hospice staff each received an anonymous personal thank you card, lifting spirits and promoting feelings of value. With staff engagement promising we posed the next question: 'What has COVID taught you?' Another positive response shown that whilst contending with morally traumatic situations in this time, staff demonstrated support for their own psychological resilience in extremely challenging situations. Feedback from this work was anonymised and displayed in the hospice, with staff were invited to view their work. Finally staff were encouraged to share their hopes and wishes for the year ahead, displaying these encouraged our team to begin looking forward and feeling hope in a difficult time. Results: Results have been positive. A new feeling of openness and the ability to understand and reflect upon the challenges of COVID have contributed to a positive feeling in the hospice. The understanding that we all share common emotional responses is a powerful realisation, and staff have shown bravery in sharing their moral injury. Conclusion: This project has had a huge impact. Staff have felt safe to share feelings which is essential to support resilience. It is important that moving forward through the pandemic we continue wellbeing support and nurture self-care skills.