Assessing the Benefits of a Teleassessment Solution Using a FVM Perspective

The recent COVID-19 pandemic has served to highlight the benefits of digital health in general and telehealth in particular. One area of telehealth that is particularly important is that of teleassessment. Currently, we are witnessing an exponential growth in total knee and total hip replacements (TKR) (THR) due to an aging population coupled with longer life expectancy which is leading to a high likelihood of an unsustainable burden for healthcare delivery in Australia. To address this imminent challenge, the following proffers a tele-assessment solution, ARIADNE (Assist foR hIp AnD kNEe), that can provide high quality care, with access for all and support for high value outcomes. A fit viability assessment is provided to demonstrate benefits of the proffered solution. © 2022 IEEE Computer Society. All rights reserved.

Control of COVID 19: Knowledge and Practices of Health Professionals in Hospitals Towards Patients and the Environment in Morocco (Meknes)

Coronavirus 2019 is considered the health disaster of the century and has caused a wave of global panic. Healthcare professionals were at the forefront of this pandemic to provide quality care respecting the safety of patients and the environment. The objective of this study is to determine the preventive measures applied by healthcare professionals towards patients and the environment to combat Covid19. The study was realized during April and May 2020 at the public hospital dedicated to the care of Covid patients in central Morocco in Meknes. Convenience sampling was used to collect the data. 104 people participated in the study, including 61 (58.7%) nurses and 12 (11.5%) doctors. Also, 73 (70.2%) of the healthcare professionals were men and 35 (33.7%) contracted the Coronavirus during their healthcare activity. According to the participants, the causes of this infection lie mainly in their interaction with their professional environment (71.4%). The main preventive measures applied by healthcare professionals were regular hand washing and wearing 104 masks (100%), of which 88 (84.6%) used the FFP2 mask and wore personal protective equipment. However, healthcare professionals were found to adopt other environmental practices, including surface disinfection 95 (91.3%), ventilation and sterilization of premises 46 (44.2%), maintenance and sterilization of equipment 78 (75%), and effective management of hospital waste 75 (72.1%). The study concluded that the preventive measures applied by the professionals were sufficient and complied with global recommendations to minimize the risk of contamination and maintain a healthy healthcare environment for themselves and their patients. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Disrupted mana and systemic abdication: Maori qualitative experiences accessing healthcare in the 12 years post-injury.

BACKGROUND: Maori have been found to experience marked health inequities compared to non-Maori, including for injury. Accessing healthcare services post-injury can improve outcomes; however, longer-term experiences of healthcare access for injured Maori are unknown. This paper reports on data from the longitudinal Prospective Outcomes of Injury Study - 10 year follow up (POIS-10) Maori study in Aotearoa/New Zealand (NZ), to qualitatively understand Maori experiences of accessing injury-related healthcare services long-term. METHODS: Follow-up telephone interviews were conducted with 305 POIS-10 Maori participants, who were injured and recruited 12-years earlier, experiencing a range of injury types and severities. Free text responses about trouble accessing injury-related health services were thematically analysed. RESULTS: Sixty-one participants (20%) reported trouble accessing injury-related health services and provided free text responses. Three related themes describing participants' experiences were connected by the overarching concept that participants were engaging with a system that was not operating in a way it was intended to work: 1) Competing responsibilities and commitments encapsulates practical barriers to accessing services, such as a lack of time and having to prioritise other responsibilities such as work or whanau (family); 2) Disrupted mana refers to the feelings of personal disempowerment through, for example, receiving limited support, care or information tailored to participants' circumstances and is a consequence of patients contending with the practical barriers to accessing services; and 3) Systemic abdication highlights systemic barriers including conflicting information regarding diagnoses and treatment plans, and healthcare provider distrust of participants. CONCLUSIONS: Twelve years post-injury, a considerable proportion of Maori reported experiencing barriers to accessing healthcare services. To restore a sense of manaakitanga and improve Maori access to healthcare, Maori-specific supports are required and systemic barriers must be addressed and removed.

Transforming the Quality Maternal Newborn Care Framework into an index to measure the quality of maternity care.

BACKGROUND: The Quality Maternal and Newborn Care (QMNC) Framework describes the care that childbearing women and newborn infants need in all settings. It comprises five components and was designed for use in planning, workforce development, and resource allocation, aimed at improving the quality and cost effectiveness of maternal and newborn care globally. The purpose of this paper is to describe the first phase of a project designed to transform the Framework into a quantitative tool for service user assessment of the quality of maternity care. METHODS: Each component of the original Framework content was developed into a draft service user questionnaire and distributed to an expert panel, drawn from a range of low-, middle-, and high-resource countries. The panel consisted of five Framework authors, nine midwife researchers, six midwives, and five service user (consumer) advocates. Two rounds of discussion and revision were undertaken with the expert panel who commented on the importance, relevance and clarity of questions, and then on their necessity, wording, and order. A third round involved two experts in survey design. RESULTS: Following 24 responses in the first round, the questions were refined and returned to the panel. After incorporating the second-round comments from 16 experts, the survey was then sent to two experts in questionnaire design and construction. Face validity was affirmed through this consultative process. CONCLUSIONS: Despite Covid-19 pandemic-related restrictions, this robust iterative consultative process with an international expert panel has resulted in the prototype QMNC Framework index (QMNCFi)-a questionnaire designed for use in diverse settings to assess the quality of maternity care. The QMNCFi's psychometric properties are now being tested in an international online survey.

Using an audio computer-assisted self-interview (ACASI) to screen older adults for fall risk in an outpatient primary care setting: OJNI

Background: Older adults face an increased risk for falling and resulting injury due to age-related physiological changes (Sharif et al., 2018). Effective fall risk screening programs in the primary care setting may be a promising approach to reduce the incidence of falls within this population (Siegrist et al., 2016). The use of technology can be beneficial in supporting care delivery and further reducing the risk. Purpose: This article discusses the implementation of a fall risk screening and reduction program in a primary care setting. The program uses resources of the Centers for Disease Control and Prevention’s (CDC) Stopping Elderly Accidents, Deaths & Injuries (STEADI) Initiative and the development of an Audio Computer-Assisted Self-Interview (ACASI). This study aimed to increase community-dwelling older adult safety by identifying and reducing fall risk. Clinical Relevance: ACASI is an effective alternative to traditional interview methods due to its speed in data capture and the potential for increased accuracy of self-reported data. Introducing ACASI technology in nursing practice is an innovative approach to collecting patient data in a manner that limits physical interaction, reduces bias, and promotes safe social practices, especially when considering the current COVID-19 pandemic. Approach: Participants were recruited from an outpatient facility and consented to participate in the study. Chart reviews were conducted to identify eligible participants. To determine the baseline fall risk scores, questionnaires were presented to participants in the form of an ACASI. This technology was used to communicate the assessment questions and facilitate data collection. Evidence-based informational materials were administered to participants to provide education on fall prevention safety and limiting fall risk. Eight weeks after receiving education on fall risk reduction behavioral and environmental modifications, a follow-up, ACASI- formatted questionnaire was administered to assess for a change in fall risk scores. Results: The research findings demonstrated a significant reduction in fall risk scores (t (40) = -2.220, p =.032) from pre- to post-assessment. Overall fall risk scores among the participants decreased by 43% within a 12-week timeframe. One in four adults age 65+ report falling, resulting in over 50% of all injury-related deaths (Haddad et al., 2018). Individuals who suffer from falls are not only predisposed to injury and untimely death, but also decreased mobility, decreased independence, hospitalization, and nursing home placement (Phelan et al., 2016). The cost to medically treat a fall is approximately $10,000 in direct fees (Dellinger, 2017). Costs associated with caring for fall-related injuries exceed $30 billion each year (Phelan et al., 2016).  The National Patient Safety Goals, established by The Joint Commission (TJC) in 2003, is a safety and quality improvement program to help healthcare organizations target concerning areas of need (The Joint Commission, 2022a). Sentinel Event Alerts, which warn healthcare organizations about risks to patient safety, are included with the safety goal reports. Injurious patient falls have regularly ranked in the top 10 among the TJC’s list of Sentinel Events (The Joint Commission, 2022b). Most falls among older adults result from a combination of risk factors. Approaches to assess and manage modifiable risk factors have been identified as effective interventions for individuals at risk of falling (Phelan et al., 2016). Primary care practitioners can play a key role in identifying and reducing fall risk among patients by identifying and discussing risk factors during regular office visits. The physiologic changes and high incidence of falls in the elderly make it necessary to conduct regular fall risk assessments and interventions among this population (Siegrist et al., 2016). Among the leading fall risk assessment resources that have recently been developed is the Centers for Disease Control and Prevention’s (CDC) STEADI (Stopping Elderly Accide ts, Deaths & Injuries) Initiative (Centers for Disease Control and Prevention, 2017c). STEADI offers healthcare providers a standardized approach to conduct fall risk screenings, assessments, and interventions for older adults (Howland et al., 2018). Technology can assist in screening patients for fall risk in the form of an Audio Computer-Assisted Self-Interview (ACASI). An ACASI-administered survey is a method of data collection that allows participants to complete interviews on their own without the presence of a human interviewer. Questions and response options are displayed as digital text on a personal electronic device and read aloud to participants. The participants listen to the pre-recorded questions and respond by selecting their answers directly on the screen. ACASI is believed to improve the quality of data collection by minimizing data entry errors. Additional benefits of using ACASI, as opposed to traditional survey questionnaires, include increased privacy for participants, accessibility for illiterate participants, reduced staff time for interviewing, and increased data validity for sensitive questions (Kane et al., 2016). In this study, an ACASI was developed and administered to participants in tandem with CDC STEADI (2017c) resources, as part of a fall risk screening and reduction program to identify and reduce the risk of falling among community-dwelling older adults.

The impact of COVID-19 on long-term care facilities and their staff in Israel: Results from a mixed methods study.

AIM: We examined the impact of COVID-19 regarding organizational and management issues at Israeli long-term care facilities. BACKGROUND: Residents in facilities were very vulnerable to significant disease and mortality during COVID-19. METHODS: A survey of 52 facilities in Israel was conducted in 2020, consisting of closed- and open-ended questions. Mixed methods were used to analyze data both quantitatively and qualitatively. RESULTS: Three main effects emerged: worsened financial status of long-term-care facilities resulting from high expenditures for preventive measures and reduced revenue due to deaths and fewer resident admissions, increased workload due to decreased workforce and additional duties, and negative mental health effects on staff because of increased workload and the conflict between maintaining good clinical practice and following COVID-19 regulations. CONCLUSION: The development of government directives needs to take into account potential conflicts between the directives and quality care principles and to provide a balanced approach that assures humane care. Facilities and their staff lacked adequate pandemic-related guidance and support. IMPLICATIONS FOR NURSING MANAGEMENT: The results highlight the need to address staff shortages and training, to provide more support and clearer guidance to facilities and their staff, and to devise a framework and strategies for future health crises.

Organisation of cancer care in troubling times: A scoping review of expert guidelines and their implementation during the COVID-19 pandemic.

This scoping review mapped the main themes in existing expert guidelines for cancer care issued during the COVID-19 crisis from the period of March 2020-August 2021. The guidelines published during the research period principally relate to the first two waves in Europe and until the beginning of the vaccination campaign. They elaborated recommendations for cancer care reorganisation, in particular triage and quality of care issues. The article highlights the ethical, epistemological, as well as practical reasons that guidelines were not always followed to provide some lessons learned for future crises to enable better guideline development processes. We also elaborate early evidence on the impact of triage decisions and different perspectives on cancer care reorganisation from ethics and social science literature.

Emergence of 30 AI Based Solutions to Tackle COVID-19 in India: Are These Tools Helpful or Not?

Digital technology has gained a great eminence in the healthcare sector of India, with involvement of both public and private sectors and has undergone a drastic change to deal with the situation of covid-19 pandemic. With this, scope of digitally driven healthcare solutions gets widened and technologies such as ML, VR, AR, AI etc. emerges as a significant option. As per the report of PWC, India accounts highest use of Artificial Intelligence(AI) technology in the difficult times of covid-19 and around 73% of healthcare and pharma companies had adopted AI. This paper focuses specifically on technology of AI which provides many features such as Access improvement, quality care, better information, better outcomes, enhanced information flow etc. AI and its associated solutions have proven to be a boon in tackling the Covid-19 situation. This paper presents at a glance, a list of 30 AI based solutions formulated in order to combat the situation of covid-19 pandemic. This paper helps the future researchers to analyze the purpose and features of existing AI solutions for covid-19.Thus encourage the research community to invest in the field of AI. © 2021 IEEE.

Work environment challenging Irish public health nurses' care quality: First postnatal visit.

OBJECTIVES: Exploring views and experiences of public health nurses of their work environment and measurement of care practices at first postnatal visits. DESIGN: An exploratory qualitative design. Data collected using four focus groups and analyzed using thematic analysis. SAMPLE: Nineteen public health nurses from four health service regions in Ireland participated. RESULTS: Two themes emerged. Theme one identified "challenges of providing a quality service." Public health nurses identified workload demands and that the working environment can detract from the ability to provide a quality service. Challenges within the home, language barriers, and lack of support from management were key issues. Theme two identified "challenges of measuring quality of public health nursing practice." While Measuring practice through quantitative outcomes such as key performance indicators were viewed as inadequate to measure the quality of care provided, positive views of using quality process indicators to measure the quality of their practice emerged. CONCLUSIONS: Key issues concern the working environment of public health nurses and challenges of providing and measuring care practices. Absence of appropriate supports and resources means public health nurses work hard to provide quality care. Public health nurses were confident they would score high on quality process measurements of their practice.

Breast Cancer Management During COVID-19 Pandemic in Madrid: Surgical Strategy.

BACKGROUND: From the first case of SARS-CoV-2 infection in Wuhan (China), the infection spread all around the world causing a pandemic of coronavirus disease-2019 (COVID-19). Spain has been one of the most severely affected countries, and Madrid has reported a high number of cases and deaths. We discuss our strategies for optimal breast cancer management during COVID-19 pandemic. PATIENTS AND METHODS: This was a retrospective observational study at Clínico San Carlos Hospital to analyze the management of patients with breast cancer during the pandemic outbreak and the surgical strategy after the pandemic outbreak. We created a practical and dynamic tool based on a "traffic light" system for prioritizing surgical time. Every patient was contacted by telephone with a preoperative COVID-19 protocol. After surgical procedures, patient satisfaction was assessed using the European Organisation for Research and Treatment of Cancer in-patient satisfaction with cancer care questionnaire (EORTC IN-PATSAT32). RESULTS: Patients with breast cancer actively treated with surgical procedures were put on a waiting list and received systemic therapy. Telemedicine was used to evaluate any side effects and to avoid unnecessary hospital visits. Surgery was only considered after the pandemic outbreak, and then, only those procedures designed to minimize surgical complications and, therefore, reduce hospital stay. We also measured patients' satisfaction with medical and nursing scales that resulted in a "very good" evaluation tending to "excellent". CONCLUSION: It is necessary to adapt management of oncology treatment and surgical strategy to optimize resources during the COVID-19 pandemic. Patients' perception of care quality and the degree of patients' satisfaction with health services has potential relevance in the absence of outcome data.

Considerations When Using Telemedicine As the Advanced Practice Registered Nurse.

Accessibility to health care is crucial to management of chronic and acute conditions. Although the severe acute respiratory syndrome coronavirus 2 pandemic significantly impacts the issue of access to health care, with the introduction of Waiver 1135, telehealth has become a positive strategy in increasing safe access to health care. This report addresses considerations to take into account when advanced practice registered nurses use telehealth to facilitate access to care.

Rapid Implementation of Telemedicine During the COVID-19 Pandemic: Perspectives and Preferences of Patients with Cancer.

INTRODUCTION: The use of telemedicine in oncology practice is rapidly expanding and is considered safe and cost effective. However, the implications of telemedicine on patient-physician interaction, patient satisfaction, and absence of the personal touch have not been studied to date. Following the spread of COVID-19, telemedicine services were rapidly incorporated at the Oncology Division of Tel Aviv Medical Center. We aimed to evaluate patients' perspectives and preferences regarding telemedicine and to assess whether this virtual communication platform affects the patient-physician relationship. METHODS: Between March 2020 and May 2020, adult cancer patients who conducted at least one successful telemedicine meeting were interviewed by trained medical personnel. The interview was based on validated patient satisfaction questionnaires and focused on patient-physician interaction in relation to the last in-patient visit. RESULTS: Of 236 patients, 172 (74%) patients agreed to participate. The study population comprised mainly patients with gastrointestinal malignancies (n = 79, 46%) with a median age of 63 years (range 21-88). The majority of patients were male (n = 93, 54%). Eighty-nine (51.7%) patients were receiving active oncologic treatment, and 58 (33.7%) were under routine surveillance following completion of active therapy. Almost all had a sense of secured privacy (n = 171, 96%), the majority of patients affirmed that their concerns were met (n = 166, 93%) and perceived that eye contact with the treating physician was perceived (n = 156, 87%). Only a minority felt that the absence of physical clinic visits harmed their treatment (n = 36, 20%). Most patients (n = 146, 84.9%) wished to continue telemedicine services. A multivariate analysis revealed that higher satisfaction and visits for routine surveillance were both predictors of willingness to continue future telemedicine meetings over physical encounters (odds ratio [OR] = 2.41, p = .01; OR = 3.34, p = .03, respectively). CONCLUSION: Telemedicine is perceived as safe and effective, and patients did not feel that it compromised medical care or the patient-physician relationship. Integration of telemedicine is ideal for patients under surveillance after completion of active oncologic treatment. Physician communication skills workshops are warranted with implementing this platform. IMPLICATIONS FOR PRACTICE: During the COVID-19 pandemic, telemedicine was rapidly implemented worldwide to facilitate continuity of quality care and treatment. Despite many potential setbacks, telemedicine has become a useful and safe tool for oncology practitioners to care for their patients. The use of telemedicine regarding patients' perspectives, emotions, and patient-physician communication in daily oncology practice has not been studied to date. This study demonstrated telemedicine is perceived as safe and effective and does not compromise medical care or the patient-physician relationship. Its use is ideal for surveillance after completion of active oncologic treatment. Physician communication skills workshops are warranted with implementing this platform.