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1.
European Geriatric Medicine ; 13(Supplement 1):S181, 2022.
Article in English | EMBASE | ID: covidwho-2175481

ABSTRACT

Introduction: Oldest old patients may have unusual SARS-COV2 presentation which can jeopardize diagnosis and management. The aim of this study is to compare the clinical characteristics and outcomes of oldest old (C 85 years) and of old patients (75-85 years) admitted with COVID-19 in Belgian hospitals during the first wave of the pandemic. Method(s): We conducted a multi-center, retrospective, observational study in ten Belgian hospitals. We reviewed the electronic medical records of patients >= 75 years hospitalized with COVID-19 from March 2020 to June 2020. ResultsA total of 986 patients was included in the RedCap register (Old group: N = 507;Oldest old group: N = 479). Before hospitalization, the Oldest old presented more geriatric syndromes including comorbidity, frailty, falls, cognitive impairment and incontinence. At admission, the Oldest old presented less cough, less headache and less fever but significantly more delirium than Old. The Oldest old were less frequently admitted to Intensive Care Units. A geriatrician was consulted to help in decision making process more often for the Oldest old. The global mortality of the cohort was 47%, with no difference between the two groups. Patients of Oldest Old group were more often institutionalized after hospitalization, and less often referred for rehabilitation. Key conclusion: The ''oldest old'' patients present more geriatric syndromes, which make them vulnerable toward dependence and institutionalization after hospital, without having a higher mortality rate than the ''younger old'' patients. A geriatrician expertise is necessary in the management of these oldest old patients.

2.
Archives of Disease in Childhood ; 107(Supplement 2):A376-A377, 2022.
Article in English | EMBASE | ID: covidwho-2064050

ABSTRACT

Aims The Covid-19 pandemic has significantly impacted the education of doctors in training, with disruption to training events and teaching, as well as staff redeployment. During the initial wave of the pandemic, patient numbers in paediatrics were low and there was time for reflection, leadership and management opportunities. However, post lockdown there were significantly more paediatric attendances to A&E, resulting in surges of admissions never previously seen at that time of year, putting a substantial strain on the medical team. In our paediatric department, we found that our established hour-long weekly lunchtime teaching and education programme was no longer sustainable. We therefore developed a new format - a microteaching programme to ensure evidencebased, relevant teaching was maintained at a time of highly stretched resources. Methods In December 2020 the microteaching programme was launched;the concept was five-minute teaching sessions rostered between junior doctors following Thursday morning handover so more of the multidisciplinary team, including nurses and medical students, could attend. The teaching could take any format such as quizzes, powerpoints or games and focussed on common paediatric topics. Feedback was collected after each session. The programme was reinforced with the new intake of junior doctors in August 2021. To obtain feedback on the effectiveness of the new format, an online survey was sent to all grades from foundation doctors and trainee Advanced Nurse Practitioners to consultants, to capture quantitative alongside qualitative data in November 2021. Results There were eleven responses to the survey, with 81.8% having attended the microteaching programme. Those who had not attended were excluded from subsequent quantitative analysis. Reasons for non-attendance were thematically analysed and found to be based on working patterns, such as working less than full time. 88.8% of respondents felt microteaching content was relevant to their training and 100% agreed it was at an appropriate level. 100% felt they had learnt something from microteaching with two-thirds of respondents strongly agreeing with this statement. Barriers to regular teaching included unanticipated staff movement due to urgent clinical need, senior staff being unaware of the scheduled teaching programme or concern about ward pressures and workload. Respondents felt microteaching was a useful concept that ensures teaching takes place, helps keep knowledge up-to-date and prompts further reading. Conclusion Despite the Covid-19 pandemic significantly impacting trainees' teaching, the implementation of the microteaching programme locally, and subsequent survey, have demonstrated a positive way for learning opportunities to continue despite clinical pressures. The survey highlights the need for senior support to ensure the value of teaching is recognised and designated teaching time is kept. It emphasises the need for re-evaluation of the teaching rota to minimise disruption secondary to staff movement. Following feedback, to maximise the impact of each session at the start of the new teaching rota, we will summarise key points via email so trainees unable to attend can still benefit. Overall, the microteaching programme enables key concepts to be presented during morning handover and allows educational opportunities to continue without adversely impacting on clinical duties in the paediatric department.

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