ABSTRACT
Background: When transferring patients admitted to hospitals due to coronavirus disease 2019 (COVID-19), it is necessary to take appropriate measures to maintain the safety of patients and staff. The aim of this study was to design a checklist and evaluate in-hospital transfer status of patients with COVID-19 disease in emergency departments. Methods: In this cross-sectional study, a checklist for evaluation of in-hospital transfer of patients with COVID-19 in the emergency department was designed, and then assessed. The initial in-hospital transfer checklist was prepared based on data from guidelines and published articles regarding patients with COVID-19. Its validity was confirmed using face validity (by 20 emergency nurses). Then, the items were evaluated in terms of content validity in both quantitative and qualitative methods. To evaluate the content validity in a quantitative way, the content validity ratio (CVR) coefficient and the content validity index (CVI) were used. Waltz and Basel methods were used to determine CVR from the panel of experts and for CVI, respectively. Using the final checklist, the transfer status of patients with COVID-19 in three stages (before, during, and after transfer) by three samplers, from May to September 2020, in the emergency departments of selected hospitals in Qazvin City, Iran. Findings: In this study, the modes of transmission of 167 patients during 501 observations were investigated. Errors occurred in 50.9% of transfers, especially during transfer (32.9%), the most important cases of which included reduction of arterial blood oxygen saturation, decrease and increase in blood pressure, and incompliance with transfer protocols including non-disinfection of transmission routes (73.7%), lack of hand hygiene (74.6%), and non-replacement of personal protective equipment (60.5%). Conclusion: The results of the study showed that the most accidents were reduction of arterial blood oxygen saturation and hypotension, respectively, which occurred in terms of time, mainly during patient transfer. © 2021 Isfahan University of Medical Sciences(IUMS). All rights reserved.
ABSTRACT
Background: The aim of this study was to determine the predictors of disease severity and death in patients hospitalized with coronavirus disease 2019 (COVID-19) in the Infectious Diseases Center of Qazvin University of Medical Sciences, Qazvin, Iran. Methods: A total of 228 patients with COVID-19 were included in this cross-sectional study. Of these, 114 patients were alive and 114 patients were dead, who were selected using the available sampling method. The logistic regression analysis method (Inter model) was used to predict the effective factors of severity of disease and mortality of patients and control of confounders. Findings: Multivariate logistic regression analysis showed that increase in C-reactive protein (CRP), blood urea nitrogen (BUN), and potassium (K), and decrease in the mean time from onset of symptoms to hospitalization could be predictors of death in patients with COVID-19. Moreover, the deceased patients were older than the surviving group. There was also a significant difference between the two groups of deceased and survivors in terms of the presence of underlying diseases of hypothyroidism and chronic kidney insufficiency (P < 0.001). Conclusion: According to the results of this study, measuring electrolytes at the beginning of hospitalization, and then serially, is recommended to take corrective measures in the field of disease control. © 2021 Isfahan University of Medical Sciences(IUMS). All rights reserved.
ABSTRACT
Background: The aim of the present study was to determine the challenges of medical students in the clinical education environment during the outbreak of Covid-19 to understand their experiences. Methods: This qualitative study was performed based on the hermeneutic phenomenological approach and Van Manen's analytical method from 10th of August to 12th of September 2020 in different departments of Qazvin University of Medical Sciences, Iran. In this phenomenological study, using the purposive sampling method, the participants were selected from among medical students. The data were collected through semi-structured interviews with 12 medical students. All the interviews were recorded and transcribed, and then, the codes, categories, and themes were extracted using Van Manen's analytical method. Results: The 5 main themes of the present study were 'inefficient clinical education', 'dealing with real work conflicts', 'the future professional challenges', 'the challenges related to organizational policy', and 'the challenges related to the sense of stigma among the medical staff. The most important challenges consisted of 'moving away from the educational goals due to reduced attendance at the clinical setting', 'the cancellation of some clinical courses', 'the creation of stress in the students by professors', 'fear of getting sick and transmitting the disease to family members', 'fatigue and heavy sweating due to caring for a large number of patients while wearing isolation gowns', 'the prolongation of the students' studies and delay in starting their thesis'. Conclusion: The results of this study provided a deeper insight into the perceptions, feelings, and experiences of medical students during the coronavirus pandemic. © 2021, Vesnu Publications. All rights reserved.
ABSTRACT
Background: Coronavirus disease 2019 (COVID-19) is the largest and most severe epidemic since the 1918 flu, and its emergence has created unprecedented challenges to public health. Clinical manifestations in patients are very diverse, and can range from asymptomatic disease to severe illness with death. The main purpose of this study was to compare the outcomes of patients with Covid-19 with early pulmonary, gastrointestinal, and neurological symptoms in patients admitted to hospitals in Qazvin City, Iran. Methods: This was a retrospective study with 300 samples, performed after obtaining ethics license and obtaining patient consent. The samples were selected using purposive method. Confirmation of COVID-19 was done due to having a lung scan confirmed by an internal medicine or infectious disease specialist, as well as having a positive polymerase chain reaction (PCR) test. Exclusion criteria also included pregnancy. Findings: The group of patients presented with early pulmonary symptoms were significantly different from the other two groups in terms of mortality, intensive care unit, intubation and hospitalization (P < 0.050). Conclusion: Patients presenting with early pulmonary symptoms should be given priority in hospitalization. © 2021 Isfahan University of Medical Sciences(IUMS). All rights reserved.
ABSTRACT
Background: Coronavirus disease 2019 (COVID-19) is the largest and most severe epidemic since the 1918 flu, and its emergence has created unprecedented challenges to public health. Clinical manifestations in patients are very diverse, and can range from asymptomatic disease to severe illness with death. The main purpose of this study was to compare the outcomes of patients with Covid-19 with early pulmonary, gastrointestinal, and neurological symptoms in patients admitted to hospitals in Qazvin City, Iran.