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AIM: It provides a comprehensive overview of coronavirus disease 19 (COVID-19) vaccination perception of health-care professionals in Dr. M. Djamil General Hospital, Padang, West Sumatera, Indonesia. METHOD(S): This study was conducted from August to September 2021. We assessed perceptions using a questionnaire survey of the health workers and disseminated using Google form. Data entry and analysis were conducted using IBM SPSS version 26. RESULT(S): A total of 645 health-care professionals participated in this study. The average age is 36.95 years with 70.35% female. Nurse and general practitioner had the highest positive perception on Sinovac (adjusted odds ratio [AOR] 7.130, 95% confidence interval (CI) 3.406-14.927, p < 0.001). Survivor of COVID-19 participants had lower positive perception on Sinovac compared to non-survivor (AOR 0.347 95% CI 0.208-0.579 p < 0.001). General practitioner had the highest positive perception on Moderna booster (AOR 5.918, 95% CI 1.804-19.414, p = 0.003). Participant who had positive perception on Sinovac also had higher positive perception on Moderna booster (AOR 13.548, 95% CI 6.689-27.442, p < 0.001). Participant with positive perception on Sinovac and Moderna booster more recommends vaccination to other compared to participant with negative perception (AOR 7.699, 95% CI 2.987-19.842, p < 0.001 and AOR 10.545, 95% CI 4.106-27.081, p < 0.001). CONCLUSION(S): Occupation and survivor of COVID-19 affecting the perceptions of vaccination. The health-care professional who had positive perception of vaccination would tend to recommend COVID-19 vaccination.Copyright © 2022 Raveinal Raveinal, Dwitya Elvira, Alexander Kam, Afdol Rahmadi, Abdul Alim Rahimi, Rivani Sintia Suratman, Annisa Ul Husni, M. Ridho Azhari.
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Background: In the current pandemic of COVID-19, hydroxychloroquine (HCQ) is recom-mended as an experimental drug for prophylaxis and treatment of the illness. Although it is a safe drug, it can rarely produce a severe drug reaction 'drug rash with eosinophilia and systemic symptoms syndrome (DRESS)', and to differentiate it from systemic viral infections is challenging. Case Presentation: A 45-year old male nurse working in a COVID-19 ward consumed HCQ weekly for two weeks for prevention of SARS-COV-2 illness. He presented with fever, pruritic maculopapular palmar rash, cervical lymphadenopathy for 12 hours and was quarantined as a suspected COVID-19 case. His laboratory tests revealed lymphopenia, eosinophilia, atypical lymphocytes, raised liver en-zymes along with IgM negative, IgG positive rapid antibody test of SARS-COV-2. However, his throat swabs for SARS-COV-2 by real-time PCR were negative on day 1 and 7. He was finally diagnosed as definite DRESS based on the RegiSCAR score of six. He responded to levocetirizine 5 mg OD and oral prednisolone 60 mg daily tapered over 7 days. Conclusion(s): DRESS due to HCQ is 'probable', 'of moderate severity', and 'not preventable' adverse effect mimicking SARS-COV-2 illness.Copyright © 2021 Bentham Science Publishers.
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Nurses are one of the most important personnel that plays a major role in ensuring safe and high-quality care to the patients. Their attitudes toward patient safety could affect the patient experience in the hospital setting. Contrasting evidence in the previous study on the relationship between duration of working experience with the attitude toward patient safety warranted further exploration in the current pandemic era. The purpose of this study was to determine the perception of attitude towards patient safety and other associated factors. A cross-sectional study was conducted involving nurses from selected teaching hospitals in Klang Valley, Malaysia during the Covid-19 pandemic period. Data was collected using validated online Safety Attitude Questionnaires (SAQ). The target group was nurses in charge of general medical and surgical wards and was conveniently sampled. A total of 152 nurses participated and had working experience of more than 2 years (93.4%). The majority of positive responses were observed in 4 domains which were the teamwork climate, safety climate, job satisfaction, and stress recognition. The highest positive responses were found for the safety climate domain. In terms of negative responses, it was observed to be highest in the preparation of the unit management domain. However, there was no significant association between any domains with age group, gender, or working experience. In conclusion, the perception of the nurses toward patient safety attitude might be influenced by the managerial style, geographical work setting, and different job scopes. The leaders in a healthcare facility or service delivery should consider focusing on a strategy to ensure adequate management support for the medical personnel that might influence their attitude to patient safety culture in the future.Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
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Background: Nursing practice in Ireland are continually evolving. The introduction of the respiratory CNS/ANP role is one of the most significant changes in recent years. Respiratory CNS/ANP have responsibilities under their scope of practice NMBI (2015) to contribute to the education of their colleagues and patients. The respiratory CNS and ANP brings benefits for patients and consultants, however, raises issues in relation to boundaries affecting identity. Aim(s): Exploring the experience of respiratory CNS/ANP education, knowledge, learning and wellbeing in their clinical health environment. Methodology: This qualitative study is influenced by hermeneutic phenomenology. Ethical approval and permission were obtained, and a gatekeeper forwarded study information to potential participants. Fifteen participants participated in one-to-one semi-structured interviews, via digital media, recorded and transcribed. Result(s): Findings suggest that respiratory CNS/ANP enhance nursing professionalisation which was especially during COVID-19 pandemic and contribute to the empowerment of nursing and nurse education. Respiratory CNS/ANP enhances, compliments nursing practice, enabling a more agentic practitioner, though challenges to this have been identified. Conclusion(s): This study provides an account of the practice and experiences of respiratory CNS/ANP in the Irish health care setting, developing direct knowledge from those experiences. Findings from this research can inform those with direct responsibility for the regulation of respiratory CNS/ANP nursing practice and those responsible for education and research in the nurse context.
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Aim: The satisfaction of proffering radiological health care considerably contributes to the improvement and quality of health care in health care institutions, especially in the extraordinary situations, such as the viral Coronavirus disease infection where patients are being treated under special conditions. Very often, the problem regarding the understanding among the patients and the healthcare workers can occur. The primary purpose of the research is to determine the contentment of infected Covid-19 patients with the provided service of the radiological diagnostics department. Method(s): The study was conducted at the Public Health Institution Brcko District Health Center" (Dispensary for lung diseases) and TBC (ATD). The number of partic-ipants was 700. The questionnaire consisted of 19 questions. Laschinger's customised and standardized questionnaire called HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems), a questionnaire about the patient's contentment with the quality of health care, was used for the purpose of research analysis(1). The Pearson correlation coefficient and the ANOVA test were used for statistical data pro-cessing. Result(s): The given results have shown that the patients rated the quality of health care with a number 4 which indicates that they are somewhat satisfied with the provided quality. When asked about level of adequate care during their imaging, patients were less satisfied with nurses and technicians in comparison to the medical radiology en-gineers. Conclusion(s): The obtained results can contribute to a better understanding of patients as well as the improvement of health systems in the form of new health care reforms, as well as to make progress in educating health workers how to communicate with patients.Copyright © 2019 by Acta Medica Saliniana.
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Introduction: Healthcare Professionals (HCPs) involved in managing Coronavirus Disease 2019 (COVID-19) pandemic were instructed to wear Personal Protective Equipment (PPE) to protect themselves from contracting virus. However, PPE use can sometimes lead to adverse events which create greater impact on health status of HCPs. Thus, the prevalence of adverse events and associated risk factors should be estimated for taking necessary preventive measures. Aim(s): To evaluate the prevalence of adverse events in HCPs due to PPE use during second wave of COVID-19 in Tamil Nadu, India. Material(s) and Method(s): A cross-sectional study was conducted in different levels of healthcare centres in Tamil Nadu, India, from April to May 2021. Data were collected using a pre-validated questionnaire from HCPs of any discipline who were directly involved in managing COVID-19 patients. A total of 282 responses were collected through Google forms and proportion of HCPs who experienced adverse events due to PPE and percentage of different adverse events associated with PPE wearing were assessed. Data were analysed using Chi-square test. Result(s): Out of 282 respondents of the survey included 224 doctors, 34 nurses and 24 lab technicians with a mean age of 30 years. There were 164 females and 118 males. A total of 177 (62.76%) participants experienced adverse events which included dehydration, thirst and heat, headaches, inability to go to restroom and other urinary/respiratory problems. With respect to duration of exposure to PPE, 163 (57.8%) HCPs had >6 hours/day and 102 (36.2%) had 4-6 hours/day. It was observed that factors such as age, gender, profession, various wards posted for COVID-19 duty and duration of PPE worn daily were significantly associated with adverse events to PPE (p-value<0.05). Conclusion(s): The results of the study concluded that higher prevalence of adverse events with PPE was seen among doctors and nurses. Most common encountered adverse events were dehydration, headache and skin problems, which have been associated with prolonged use of PPE.Copyright © 2023 Journal of Clinical and Diagnostic Research. All rights reserved.
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Introduction: The COVID-19 pandemic forced many established processes to be assessed and changed, prompting new ways of working to overcome obstacles. This opened the door to a new patient referral pathway, with a nurse led screening clinic a viable option for patients as well as a development opportunity for nursing staff. Method(s): All outpatient clinics were cancelled in March 2020, with consultant slots reinstated as telephone only from April. Referrals were previously booked into a new patient consultant clinic followed by investigative blood work, before a second appointment for results. It became impractical for new referrals to be processed due to the impossibility of remote investigative blood tests, and the lack of an initial face to face review. Referrals are now screened by the attending consultant who ascertains urgency and which blood tests are required, before the patient is booked into a nurse appointment within the following month. This is a first face to face consultation where a full history is taken including medical diagnoses, family and bleed history, medications, allergies, social factors and surgical challenges. The consultation is documented electronically and blood samples are taken. The results are monitored by the nurses and repeat samples +/- further investigations are obtained, to ensure all results are available for the 1st consultant clinic appointment. Result(s): This new process enables us to safely manage urgency of appointments with clear, relevant history taking and extensive and accurate blood work being completed. This ensures all referrals into the consultant clinic are relevant and appropriate with the focus on diagnosis and discharge, as the doctor will be equipped with a full set of blood work and appropriate results. The number of patients reviewed has been steadily increasing, with 30 adults and 13 children in the past 12 months. Discussion/Conclusion: This approach enables safe screening for new patients whilst actively managing valuable consultant clinic appointment slots. It is important to be aware of the time requirement for the reviewing nurse to complete this appointment, and ensure staffing is sufficient to enable a thorough nurse led consultation to take place. Going forward we plan to formalise appointments in an official nurse screening clinic, and will also look to audit patients already seen, to ensure this approach is received as intended and to continue to obtain best practice.
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Background: The Covid-19 pandemic has hit Western India hard, with Pune district reporting extremely high numbers of cases. During this time, the KEM Hospital Research Centre (KEMHRC), Pune undertook a study determining COVID-19 seropositivity within villages in the Pune district. Aim(s): To engage various stakeholders in establishing sentinel sero-surveillance to monitor the trend of SARS-CoV-2 infection transmission in the general population in rural Western India. Method(s): An extensive stakeholder engagement drive was undertaken to drive successful recruitment and implementation of our study. Between February 2021 and May 2021, we conducted 150 meetings with a range of community stakeholders including: village heads;nurses;community health workers and local government representatives, in open-aired community spaces. We advised community members on the purpose and significance of the study, clarified any concerns, and gathered and incorporated their inputs regarding study implementation. Result(s): The team built trust with local communities through these meetings with continued engagement during field work and data collection helping build rapport and create ownership of the study. KEMHRC successfully enrolled 14,500 individuals residing in 150 villages in Pune district. Conclusion(s): The feedback sharing process is important in ensuring that engagement with the community is not limited to a one-time activity but continuous. Training & supplying opportunities can also generate stakeholder engagement champions. Effective communication, active engagement are key elements for effective engagement in research.
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Purpose: The violence against healthcare workers is one of the world's serious public health and patient care challenges. This is often exacerbated during emergencies, and the same has been observed during COVID-19. Method(s): The study reported an analysis of media reports during the first and second waves of the COVID-19 pandemic from India. We searched and analysed violent incidents against healthcare workers reported in English & Hindi online media. Our media analysis also reported perpetrators and triggers to mitigate violence against healthcare workers. Finding(s): We studied 51 incidents of violence, during March 2020-August 2021, as per our inclusion criteria. The majority of this reported violence occurred from the government hospitals (45.1%), followed by the community (29.4%), private hospitals (19.6%), quarantine facilities (4.0%), and burial grounds (1.9%). Doctors were targeted in the majority (82.3%), followed by other hospital staff (security and support) (33.3%), nurses (9.8%), ANMs (3.9%), and ASHA (2.0%). The majority of reported incidents were related to physical violence (58.9%), followed by verbal and physical combined (23.5%), sexual harassment (9.8%), and verbal (7.8%). The preparators of violence were family members (53.0%), community (31.4%), police officials (7.8%), and patients (7.8%). Conclusion(s): The actions required to mitigate the violence against healthcare workers require a multipronged approach with the introduction of strict policy measures and their implementation. The mandatory training of healthcare workers in soft and communication skills, protection, and coping mechanisms to prevent and de-escalate such incidents.Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
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Background: Workplace violence (WPV) has consequences both for healthcare workers and healthcare organizations. Nurses are the most exposed healthcare workers to vertical WPV. Aims and Objectives: Describe the Italian WPV and identify its predictive factors. Method(s): This is a secondary analysis conducted in hospital pneumology settings from a larger study between January and April 2021. Data were collected through the Practice Environment Scale of the Nursing Work Index (PES-NWI;Likert scale 1 to 4) and the Violence in Emergency Nursing and Triage (VENT) Questionnaire. Result(s): The analysis was conducted on 484 pulmonary nurses (72.9% female;mean age 38.9 years, SD 9.8). Thirty-four per cent (n=164) of them have had an experience of WPV in last year and/or their last week and 16.7% (n=81) only in their last week. Comparing main results between nurses with WPV vs no WPV the number of patients was higher for nurses with WPV (MD +4.8;p<.001). The PES-NWI results were significantly worse for nurses with WPV: global mean scores (MD +0.2;p<.001);nurse participation in hospital affairs (MD +0.3;p<.001);nurse manager ability leadership, and support of nurses (MD +0.2;p<.001);physician-nurse relationship (MD +0.2;p<.001). Conclusion(s): Public health companies should reduce WPV by investing in resources for the management and prevention of the phenomenon. Integrated and multimodal programs of prevention and management of WPV are useful to combat it. Improving the work environment and job satisfaction should reduce WPV.
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The COVID-19 pandemic has influenced the way patch testing is carried out at our tertiary centre. From July 2020 we introduced 'semi-virtual patch testing', where suitable patients remove patches at home on day 2 (D2) and take photos, which were reviewed during the D4 face-to-face appointment. Our aim was to assess the continued efficacy and practicality of this service, as well as the photo quality, patient satisfaction and environmental impact of the changes. Data were collected from patients attending patch testing at the Bristol Royal Infirmary from August to December 2021. Patients/carers were asked at their D4 clinic appointment to complete a pre-prepared questionnaire, with their consent, regarding their patch test experience. A clinician (consultant or clinical fellow) concurrently filled out a questionnaire on image quality. These data were collated with data obtained via telephone questionnaires (July-November 2020). Data were available for 181 patients (age range 0-89 years, 74.8% female and 25.2% male). Ninety-seven per cent (n = 135/139) were happy to have patch testing during the pandemic. Ninety-three per cent (n = 130/140) removed their patches at home on D2. Only 3.9% (n = 5/129) would have preferred to attend hospital. Information was provided by multiple sources: verbally by a nurse (95.2%), a doctor (60.7%), a written information sheet (88.1%) and a video (29.8%). Almost all patients (n = 127/ 136) felt confident/fairly confident removing the patches at home, and 85.0% (n = 108/127) reported it saved > 1 h. Seventy-four per cent (n = 95/129) would have had to take time off work/caring commitments to attend. Almost all patients (n = 131/135) reported that their overall experience was good or very good. Seventy per cent (n = 59/84) of patients travelled independently to their appointment, and 79.8% (n = 67/84) came by car/taxi. The mean mileage (one way) to attend the appointment was 13.3 (range 0.2-46.5;n = 98). Ninety-seven percent (n = 89/92) used a smartphone device for D2 photos. The overall presentation of the D2 reading was clear in 91.2% (n = 83/91), adequate in 6.6% (n = 6/91) and inadequate in 2.2% (n = 2/91). Image focus and colour exposure was good/adequate in 97.8% (n = 90/92) and 97.2% (n = 70/72), respectively. Virtual reading negatively affected the final interpretation of the patch test in 2.2% (n = 2/89) of patients and 9.4% (n = 16/170) would have had additional tests added on D2 if they had attended, the results of which were followed-up virtually. Our review of semi-virtual patch testing in our centre demonstrates this method as being an excellent option for most patients, with very limited adverse clinical impact. There were high levels of patient satisfaction, a reduced need for time away from work/home and a reduction in travel required. The vast majority of patients can competently remove their patch tests and produce high-quality images with good focus and colour exposure, mostly using smartphone technology.
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Background In response to the COVID pandemic when new robust discharge criteria were introduced to facilitate early discharge to optimise hospital capacity, Virtual Frailty Ward (VFW) was established. VFW provides nurse-led telephone follow-up for patients discharged primarily from the Emergency Department (ED) and the Acute Frailty unit (AFU). Objectives We aim to provide continuity of care by following up frail elderly patients at home, reviewing their medical, functional and social progress post discharge and ensuring they received adequate support to avoid hospital re-admission. Methods The service is overseen by the Lead Frailty Practitioner, supported by Consultant Geriatricians. Calls are made Monday to Friday by a team of Advanced Specialist Nurses. The case load is split up into 3 categories with different levels of priorities - 1: at least weekly calls;2: Fortnightly calls;3: Monthly calls. This service engages closely with community partners such as community frailty service, social care, district nurses and general practitioners. Results In year 1 (1/4/2020-31/3/2021), we had 598 patients on this VFW. 93 patients were referred to therapy team for urgent equipment to maintain safety, 73 patients were referred to community frailty and 112 patients had urgent discussions with GP to avoid hospital admissions. The 30 days readmissions rate was 14%. 547 patients were discharged. In year 2 (1/4/2021 - 31/3/2022), we had 297 patients. 49 patients were referred to therapy team, 32 patients were referred to community frailty team, and 41 patients required input from GP. The 30-day readmission rate was 11%. 224 patients were discharged. Conclusion VFW is a cost- effective service that has helped to reduce length of stay of frail elderly patients in an acute hospital setting, maintaining patient safety and prevent hospital re-admission, co-ordinated with community services. Our service has been highlighted in the recent GIRFT report on improving clinical practice.
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Background: The COVID-19 pandemic has placed great strain on standard outpatient services including those with IBD. There has been interest in using guided self-management and patient-initiated review to allow patients to manage their condition, while at the same time reserving outpatient capacity for those needing seen urgently. We developed a pathway for patients with stable ulcerative proctitis, which included a leaflet on symptom managment and when to contact the IBD nurses if ongoing symptoms. Method(s): Patients were identified from clinic lists cancelled during the pandemic who had a diagnosis of ulcerative proctitis. Case notes were reviewed to ensure a correct diagnosis and inclusion criteria met(stable disease, no immunosuppressant treatment). These patients were sent a Guided Self-Management leaflet in the post. A follow on questionnaire was sent 6 months after ensuring patients were happy with the information received. Non-responders were sent a second questionnaire and/or telephone call. Result(s): 37 Patients were identified. We received responses (via post, phone or email) from 28/37 patients (76%). 10/28 (36%) didn't receive or do not recall receiving the leaflet. 18/28 (64%) received the leaflet. Of those who received the leaflet, 16/18 felt it was easy to understand and contained enough information to confidently manage their symptoms. 2 patients had 1 flare and 3 patients had multiple flares after receiving the leaflet. Of those with flares, 2 patients were able to self-manage their proctitis using the guided self help information. 2 patients had to contact the IBD nurses. These patients were called back within 24 hours and received useful advice. One patient had forgotten to use the leaflet. No one required rescue steroids or admission to hospital. Overall, 17/18 (94%) felt the service was good or excellent compared to previous clinic review systems. Conclusion(s): These results suggest patients are receptive to using guided self-management and patient-initiated review. Although we were not expecting to see many flares, given the low risk selected group, the results suggest patients can successfully manage flares and contact our services for support if required. It is a concern a significant proportion of patients did not recall receiving the leaflet. Although this is a small subgroup, the results show clinic time can be saved which remains a pressurised resource as we recover from the pandemic. The principles of guided self management and patient initiated review could be applied to other patient groups(eg stable UC patients not on immunosuppressants). In future it would be important to ensure patients receive and understand the leaflet. A clinic appointment prior to discharge into such pathways should be considered.
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Introduction: Acquire new knowledge whilst thinking over the old, and you may become a teacher of others1 Critical care nursing in the 21st Century is at a crossroads. COVID-19 has demonstrated more than ever the central importance of well-educated critical care nurses to the delivery of high quality and safe care. The world has woken up to the fact that neither beds nor ventilators an intensive care unit make. There is much to learn from the past two years that will inform our future. But I believe there is another history -an earlier one that has not yet been told. This is equally important to our learning and identity as nurses. But is in danger of being lost. The contemporary history of intensive care medicine in Britain describes how innovations and advancements in medicine, surgical techniques, pharmacology, engineering, and science have -since the 1950s -interconnected to create today's 21st Century critical service.2 We read of the medical greats, the barriers they overcame to become the 'firsts' in application of techniques that are commonplace and readily accepted canons in treating the critically ill in our care. The history occasionally alludes to the nursing role or misses it completely. There is no doubt nursing was fundamental to the proliferation of intensive care in Britain from the 1960s. Yet, this is largely missing from the historical record or written from the medical perspective. A nurse contributor to the Wellcome Witnesses Seminar reflecting on the nursing contribution wrote: 'If you did a nursing/ICU seminar you'd get another perspective and more nurses attending'2 This is the basis for this research. The finding of nurses lost voices. Captured critical care nurses' stories will, through a process of narrative analysis, be critically evaluated and shared. Not simply as interesting anecdotes -but as a basis for enhancing professional identity and belonging -to learn from, inspire, and inform the future. 'Thinking historically does not just mean thinking about the past;it involves seeing oneself in time, as an inheritor of the legacies of the past and as a maker of the future'3 Objectives: Research aim -to explore this history form the perspective of retired nurses and one ICU at North Manchester General Hospital working between 1967 & 2000. To share with conference emerging findings. To stimulate a conversation about this hidden history and the possibilities it offers future professional learning. Methods: Oral history and narrative analysis. Oral history is described as a research methodology that collects histories of neglected ordinary people that would otherwise be lost.4 And deemed crucial to the capturing of nursing work.5 Results: Ongoing archival work -13 interviews recorded (2 male nurses/1 consultant). Thematic analysis. Emerging themes: unique professional relationships built as hierarchies flattened. Shared education. Increased autonomy. Separate. Special. Pushed boundaries. Conclusion: Incomplete, yet this work and sharing stories from the foundations of critical care nursing has the power to motivate and inspire the professional critical care nurse of 2021 - more than education -history, legacy, pride.
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This study aims to analyze nurses' knowledge levels and attitudes towards COVID-19 during the second peak period of the COVID-19 epidemic in Turkey and test the structural relationship between knowledge levels and attitudes with structural equation modeling. The hospital-based cross-sectional study design was employed in the study. The research population consisted of nurses working in three different private hospitals in Istanbul, with international quality and accreditation certificates. The data were collected by the researchers themselves by using face-to-face and online survey techniques. The total number of questionnaires that were evaluated and used in the analysis of the data is 390. SPSS and AMOS package programs were used in the analysis of the data. The quantitative research method was used. Descriptive statistics, independent sample t-test, ANOVA test, and structural equation modeling were applied to the data. Structural equation analysis revealed the direct effect of the nurses' COVID-19 knowledge level on attitude toward COVID-19 has an acceptable index of fit. Furthermore, the relationship between the level of knowledge toward COVID-19 and the female gender was found to be significant. In general, the level of knowledge of the nurses participating in the study about COVID-19 was found to be high, and it was observed that they had a more optimistic attitude towards preventing COVID-19 and keeping the process under control. An increase in knowledge about COVID-19 has led to an increase in the behavior of a more optimistic attitude towards prevention and control of COVID-19.