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In this report, a nationally representative sample of kindergarten through 12th grade (K-12) public school principals were asked about their experiences with covering classrooms and hiring staff. In the spring of the 2021-2022 school year, which coincided with the coronavirus disease 2019 (COVID-19) omicron variant surge, most principals struggled to keep classrooms consistently staffed and many reported that hiring had become more challenging since the previous school year. Principals indicated that a lack of substitute teachers -- not an increase in open teaching positions -- was the main reason for classroom coverage shortages. In addition to day-to-day coverage issues, most principals reported that teacher vacancies were on the rise. Most of these principals believed that vacancies had grown more difficult to fill than in the prior school year, largely because of declining applicant counts. Principals' preferences when hiring teachers lend further insight into potential drivers of hiring challenges. A large majority of principals expressed strong preferences for like-minded teachers whose mindsets aligned with the vision and culture of the schools. Few principals prioritized the diversity of the educator workforce at their schools.
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Objectives: Extracorporeal membrane oxygenation (ECMO) is a complex life support modality. To appropriately educate ECMO clinicians, a comprehensive program is required. However, there is no universal ECMO education (EE) program exclusively for intensive care unit Registered Nurses (RNs). Moreover, with the recent Coronavirus Disease 2019 (COVID-19) pandemic, the existing nursing shortage and the ability of ECMO programs to maintain an established EE program worsened. This continuous quality improvement (CQI) aims to reestablish the quality of an EE program at a large academic medical center at one of the past pandemic epicenters. Method(s): A CQI process with the Plan-Do-Study-Act (PDSA) cycle and Ishikawa diagram for root cause analysis (RCA), intervention implementation from July 2022 to June 2023 Results: The RCA revealed intrahospital pandemicrelated restrictions for employee gathering, EE instructor unavailability, increased nursing turnover, increased nursing shortage, and incomplete recordkeeping of ECMO educational activity (EEA) RN attendance as dominant factors disrupting the established EE processes. Six interventions were implemented, with one added in later: 1. Schedule 1 Certification Lecture Day/Quarter (Q), 1 Re-Certification Lecture/Q, and 1 Circuit Skills Class/ month, and 1 Simulation Lab/month 2. Reserve an education room for all EE activities, as COVID-19 policies allow 3. Increase the number of EE instructors 4. Increase Nursing Leadership-ECMO Manager collaboration for optimal RN signup 5. Optimize EEA schedule to help balance RN staffing needs 6. Develop a Master ECMO Folder in Google Drive and maintain updated attendance Five interventions showed positive preliminary results, whereas it was too soon for any conclusion for one (Table 1). Conclusion(s): While preliminary, the achieved results justify that restoring the quality of an ECMO education program after the negative impact of the recent pandemic is possible. However, final results are necessary to infer the effectiveness of each intervention. (Figure Presented).
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Background: The coronavirus disease (COVID-19) pandemic has affected the medical education throughout the world. A study was done to assess the effect of education and psychological behavior on medical students. Aims and Objectives: The objective of the study is to evaluate the effect of COVID-19 on medical graduates in various aspects such as education, effect on clinical rotations, impact on the technology used for online classes, effect on quality of life, loneliness, sleep, and depressive symptoms. Material(s) and Method(s): A set of questions were distributed to Government Medical college, Suryapet students during November 2021-January 2022. Questionnaire aimed to study students' viewpoint of COVID-19's impact on their education, mental health, and willingness to participate clinically. Result(s): One hundred medical students from Government Medical College, Suryapet participated in this study. Most students (88%) agreed that pandemic had disrupted their medical education. About 64% agreed to attend clinical rotations and 68% of students accepting the risk of contracting COVID-19 in clinical rotations. COVID-19 had an impact on technology tools used for medical education. Students reported that COVID-19 had moderate impact on quality of life, sleep quality, anxiety, and depressive symptoms. Conclusion(s): The COVID-19 had an overall significant negative impact on undergraduate medical education. It is recommended that measures need to be taken to relieve students' stress.Copyright © 2023, Mr Bhawani Singh. All rights reserved.
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The shortage of medical personnel is becoming a heavy burden on modern healthcare systems around the world. All countries, without exception, turned out to be vulnerable, regardless of the level of income and available forms of medical care. This study addresses the issue of staffing at the time of transition to a new technological level of the healthcare system in the United States. The paper shows that at the present stage in the country there is a need for fundamental changes in the personnel policy in the medical field. The challenges caused by the COVID-19 pandemic not only exposed all the vulnerabilities of the national health system, but also opened up opportunities considering the lessons learned to rethink the long-term vision of solving the workforce problems directly related to the use of new technologies. Based on the analysis of statistical data and sociological research, the author identified the latest trends of overcoming barriers in the field of training and retraining of personnel in the context of the transition to digital medicine. Overexertion among medical personnel associated with increased workload has exacerbated the problem of their professional burnout. The mass protests of physicians necessitated the development of new approaches to the labor protection of employees in the medical field. Solution of such important social problems will require a long time and financial costs and is possible only through the joint efforts of the state and the entire community as a whole. © 2023, Russian Academy of Sciences.
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The current COVID-19 climate has caused an unforeseen supply shortage of iodinated contrast media (ICM) worldwide, disrupting global distribution.1 In addition, the scarcity has resulted in a ripple effect in healthcare facilities such as radiology departments where ICM is required to perform contrast-enhanced examinations. ICM plays a significant part in contrast-enhanced CT, angiography and fluoroscopic procedures within the radiology department, holding a primary role in the differentiation and diagnosis of pathologies which range from pulmonary emboli to tumours.1 Its use extends beyond radiology, where ICM is heavily relied on in cardiology, urology and gastrointestinal studies, further highlighting the heavy dependence on the critical agent.2 With the global increase in the number of CT examinations requested, where approximately 60% of studies require ICM, optimal usage of ICM must be considered to meet heightened demand.3 The shortage has represented an opportunity for imaging providers to re-examine current imaging protocols and identify whether non-contrast imaging, alternative contrast agents and other imaging modalities could be viable options moving forward.1,2 Additionally, current literature has discussed volume-reduction strategies and dual-energy use in newer-generation CT scanners to conserve ICM.1,4 This review will explore currently proposed solutions that can be implemented in the radiology department to maximise ICM supply with minimal impact on patient care.
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The antibiotic amoxicillin is usually recommended as a first-line treatment for many common infections affecting children. Repeated lockdowns related to the coronavirus disease 2019 pandemic have contributed to supply difficulties for many drugs, including antibiotics. However, the risks associated with amoxicillin supply shortages appear not to have been sufficiently assessed, and the crisis we are facing today is serious and particularly dangerous for children's health. Without rigorous measures to prevent shortages related to drug production and distribution, populations could face a post-antibiotic era in which common infections and minor injuries can result in serious life-threatening situations. The availability of medicines declared by WHO as essential should be guaranteed not only in production but also in fair distribution. And this principle must be ensured by national and international regulatory agencies.Copyright © 2023 Medico e Bambino. All rights reserved.
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Introduction: The Covid-19 pandemic has put unprecedented pressures on the National Health Service (NHS) with adult critical care being one of the key specialties that has been affected. NHS staff have been working relentlessly throughout the pandemic and adult critical care teams were at the forefront of that. Thames Valley & Wessex and Kent, Surrey & Sussex Adult Critical Care Operational Delivery Networks had heard from our unit matrons and clinical leads around their concerns for the wellbeing of their staff. We had also heard of the number of critical care nurses who have either left their roles or are planning to leave. Objective(s): As Networks our main objective was to gain a better understanding on some of the factors that locally might be influencing the wellbeing of our staff and any intentions to leave, and to see if this aligns with the published research. The Networks also planned to develop a series of recommendations based on the results from the data. Method(s): A survey was developed as a method of gathering both qualitative and quantitative self-reported data from nurses currently working on adult critical care units. All survey data collected was anonymous. This was circulated, via the unit Matrons and Nurse Leads, to nursing staff within their critical care department. Result(s): The survey produced a large amount of data, with 427 responses (approximately 15% of nurses) from 33 units across 24 questions. The data found that 51% of nurses report that Covid-19 has made them less likely to stay in their current roles. 7 in 10 reported high levels of stress because of their work with the most common cause of stress being "staff shortages" and "being asked to work on other wards". The results also showed within the next 3 years, 50% of nurses are planning on leaving their current roles in their adult critical care unit with 47% of nurses feeling they do not get adequate salary. On a positive note, 87% of nurses feel they are having a positive impact on patient care with 74% reporting that they would recommend adult critical care nursing to other nurses. Following this analysis of the data, the networks developed six recommendations that looked at repeating and sharing the report, wellbeing, salary, contributing factors for stress and dedicated time for education and development. Alongside a formal report, individual units with more than five participants were provided with an infographic, personalised to them with their results. Conclusion(s): The data showed points of significant interest for the networks and units and has generated interest from the wider critical care community, with the desire to replicate this survey Nationally. It is clear that despite 87% of nurses feeling they have a positive impact on patient care and 74% recommending critical care nursing to others, 50% of nurses are looking to leave. We need to understand this aspect in more detail along with the two key reasons for stress, moving to the wards and staff shortages.
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Introduction: Throughout the COVID-19 pandemic and in order to maintain essential operations in a socially distanced environment, many services in healthcare have undergone significant change, moving towards telemedicine solutions. This has ranged from virtual GP consultations to virtual examinations for post-graduate students. Telemedicine solutions are unlikely to provide a wholesale replacement for face-to-face patient interaction without significant deficiencies, however, they do herald new hybrid ways of working, allowing service providers to reach clients where they are. Anaesthetic followup for Obstetric clients who have undergone an anaesthetic intervention is a national recommendation by RCOA [1] and AAGBI/OAA [2]. The aim of this QI project was to launch a digital follow-up survey for Obstetric clients who underwent an anaesthetic intervention which could be utilised in a busy unit where staff shortage or high clinical workload often preclude daily face-to-face follow up. Method(s): We created a digital clients survey which is accessed by scanning a QR code. With the support of senior midwifery coordinators, large posters advertising the survey and QR code were put up in each client bay on the post-natal ward and flyers with QR codes were given to clients. Midwives reminded post-natal clients to complete the survey. We included a flyer with the QR code in discharge paperwork. The survey included an option to request a face-to face anaesthetic review. Result(s): During the trial period of three weeks, 87 inpatient and discharged post-natal clients responded via the digital follow-up tool. Discussion(s): Digital follow-up can provide an invaluable supplemental source of follow-up, supporting conventional follow-up methods and facilitating safe fast-track discharge. [Figure presented]Copyright © 2023 Elsevier Ltd
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OBJECTIVES: Manufacturer recalls and altered supply chains during the coronavirus disease 2019 (COVID-19) pandemic caused a nationwide shortage of blue-top tubes (BTTs). Most non-point-of-care coagulation tests use these tubes, leaving laboratories and health care facilities in short supply. The Department of Pathology and Laboratory Medicine at Cedars-Sinai Medical Center implemented interventions to conserve supply without sacrificing patient safety. METHODS: In a retrospective quality improvement analysis, we examined coagulation testing and BTT utilization over the 3-month interval during which our interventions were applied. Our study assessed the interventions' effectiveness by evaluating changes in BTT utilization, coagulation testing volume, and patient impact. RESULTS: Average daily use (ADU) of BTT before and after the intervention were 476 and 403, respectively-a 15.2% reduction. Notably, the Emergency Department had a reduction in ADU of 43.3%. Average daily volumes of coagulation assays performed decreased from 949 to 783-a 17.5% reduction. No adverse events from the Pharmacy Department were identified during the study period. CONCLUSIONS: Interventions resulting in significant reductions were in divisions with effective management and supervision. Success in navigating the BTT shortage stemmed from timely announcements, action, and effective communication. Our recommendations established more effective coagulation assay utilization, decreased overall BTT use, and prevented patients with coagulopathic disorders from experiencing adverse consequences.
Subject(s)
COVID-19 , Humans , Retrospective Studies , Blood Coagulation Tests , Pandemics/prevention & controlABSTRACT
Anyone who works in clinical oncology care sees it, experiences it, or feels it on a daily basis: a real or perceived shortage of nurses and, specifically, experienced clinical oncology nurses.
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Medical Oncology , Oncology Nursing , HumansABSTRACT
After COVID-19, financing for emerging nation reserves in renewable energy bases was deemed a crucial aspect of sustainable development. Investing in biogas energy plants can be highly beneficial for lowering the use of fossil fuels. Using a survey of shareholders, investors, biogas energy professionals, and active social media participants in Pakistan, this study evaluates the intentions of individual investors to invest in biogas energy plants. The primary purpose of this study is to increase investment intent for biogas energy projects following COVID-19. This study focuses on financing biogas energy plants in the post-COVID-19 era and evaluates the research's assumptions using partial least squares structural equation modeling (PLS-SEM). The study employed the technique of purposive sampling to acquire data for this investigation. The results indicate that attitudes, perceived biogas energy benefits, perceived investment attitudes, and supervisory structure evaluations inspire one's propensity to finance biogas vitality plant efforts. The study found a link between eco-friendly responsiveness, monetary benefits, and investors' actions. The aspiration of investors to mark such reserves was set up to be unpretentious by their risk aversion. Conferring to the facts, evaluating the monitoring structure is the critical factor. The previous studies on investment behavior and other forms of pro-environmental intent and action yielded contradictory results. In addition, the regulatory environment was evaluated to see how the theory of planned behavior (TPB) affects financiers' objectives to participate in biogas power plants. The consequences of the study indicate that feelings of pride and discernment of energy expansively affect people's desire to invest in biogas plants. Biogas energy efficacy has little effect on investors' decisions to invest in biogas energy plants. This study offers policymakers practical ideas on enhancing investments in biogas energy plants.
Subject(s)
COVID-19 , Social Media , Humans , Biofuels , Climate Change , Economic Development , Inventions , PandemicsABSTRACT
BACKGROUND: In areas of low physician density, especially as regards dermatologists in France, there is an increasing interest in tele-expertise. This is particularly the case in the Sarthe department, where the number of physicians continues to decline and access to care was further limited by the COVID 19 epidemic. STUDY DESIGN: We retrospectively collected data from tele-expertise requests submitted to Le Mans General Hospital by general practitioners via a dedicated platform between May 6, 2019, and April 9, 2021. RESULTS: Six hundred and forty three requests relating to 90 different diagnoses were recorded during this period. One hundred and thirty four patients (20% of requests) were invited to attend a face-to-face consultation within an average of 29â¯days. DISCUSSION: Through the use of tele-expertise at Le Mans Genreal Hospital it was possible to introduce a means of tackling the problem of the lack of dermatologists in the Sarthe department. Rapid responses enabled the number of consultation requests to be reduced, leading to fewer population displacements in the context of the present pandemic. CONCLUSION: These initial results are encouraging and confirm that tele-expertise seems a satisfactory option to optimize access to care for populations in areas of low physician density.
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COVID-19 , Physicians , Telemedicine , Male , Humans , Retrospective Studies , Hospitals, General , COVID-19/epidemiology , FranceABSTRACT
Intro: The need for re-use of gloves as an alternative to single use was raised in times of resource shortages because during the coronavirus disease 2019 pandemic, marked increase in healthcare associated infection was reported, which might owing to shortage of personal protective equipment. we aimed to evaluate the risk of microbial transmission by comparing residual microorganism after multiple patient contact according to with or without gloves in clinical practice. Method(s): Three researchers made rounds of patients while touching the same area successively followed by alcohol-based hand rub: one with bare hands, one with single gloves, and one with double gloves. Hand imprints were obtained before and after rounds, and cultured to count colony-forming units (CFU). The number of colonies was compared between groups in a semi-quantitative manner by hand area. Finding(s): Mean CFU counts after round were 10.06 for bare hands, 31.22 for single-gloved hands, and 49.67 for double-gloved hands (p=0.084). The most commonly identified microorganism after rounding was coagulase-negative Staphylococci (77.8%, 42/54), followed by Bacillus species (62.9%, 34/54). Carbapenem-resistant Acinetobacter baumannii was confirmed from a pair of double-gloved hand specimens after the rounds. That round included a patient with the same organism with the same antibiotic susceptibility results. More microorganisms were remained after alcohol-based hand rub on gloved hands than on bare hands. Conclusion(s): From our results, the possibility of microbial transmission seems more likely in gloved hands than in bare hands even after alcohol-based hand rub. Therefore, we do not recommend the re-use of gloves after alcohol-based hand hygiene.Copyright © 2023
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Introduction: Enteral feeding is a physiologic process of providing adequate nutrition and has been shown to improve both mortality and quality of life in patients with inadequate oral intake. Improved critical care medicine and recent wave of Coronavirus Disease 2019 (COVID-19) has left us with a large proportion of patients needing alternative enteral nutrition. Although rare, intussusception is an important differential for patients presenting with acute abdominal pain post makeshift percutaneous endoscopic gastrostomy (PEG) tube placement. Case Description/Methods: A 58-year-old male was admitted to the hospital for coffee ground emesis over three days accompanied with epigastric pain. He had right sided hemiparesis secondary to cerebrovascular accident with PEG tube for enteral nutrition. Examination was significant for epigastric tenderness with normal bowel sounds. PEG tube aspiration revealed bile-tinged fluid. Significant labs included white blood cell count of 11,600 /mm3, hemoglobin 10.2 g/dL, and lactic acid of 2.3 mmol/L. A computerized tomography of the abdomen with IV contrast showed a small segment duodeno-duodenal intussusception at the horizontal segment around the distal end of the tube was noted (Figure A). An urgent esophagogastroduodenoscopy (EGD) revealed a Foley catheter acting as a makeshift PEG tube extending across the pylorus into the duodenum. The distal tip of the Foley catheter was visualized with an inflated balloon seen in the third portion of the duodenum (Figure B) The inflated catheter balloon acted as a lead point causing intussusception in a ball-valve effect. The balloon was deflated, and the catheter was replaced (Figure C) with a 20 Fr PEG tube. Discussion(s): Gastric outlet obstruction is an uncommon complication reported in few cases caused by migration of the gastrostomy tube. Rarely this migrating gastrostomy tube can invaginate the duodenum or the jejunum causing intussusception. Only handful of cases have been reported in the literature. Patients usually present with epigastric pain, vomiting or rarely hematemesis. CT scan of the abdomen is the investigation of choice. Amidst the pandemic and supply shortage, Foley catheters have been deemed as a viable alternative to gastrostomy tubes and are being used more often. It is important to recognize this rare complication and use of balloon catheter should raise further suspicion. Timely endoscopic intervention can help avoid bowel necrosis and surgical intervention.
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Extracorporeal Membrane Oxygenation is a resource intensive therapy;heavily reliant upon specialized equipment, unique disposables, and skilled staff. The Covid-19 pandemic and following events exposed flaws in multiple phases of the care delivery system. The combination of high patient census, acuity, manufacturing delays, and supply chain disruptions led to our center's reassessment of the way in which limited resources are utilized. As a combined pediatric and adult center, we possess the ability to share resources amongst all patient populations. Currently, the majority of our equipment and disposables support a heavier use of Centrimag. We adjusted our general weight guidelines in order to best serve the most patients. (<8kg Sorin Rollerhead, 8-20kg Sorin Revolution, >20kg Centrimag.) Presently, a major challenge is the cessation of production of the -inch Better Bladder. The ECMO Coordinator team collaborated with key physician stakeholders. It was decided that the fluid reservoir and air trap benefits of a bladder outweighed the risks of running without one on our Sorin Rollerhead circuit. We designed a circuit with a 3/8 Bigger Better Bladder. Recognizing the increased risk of clotting with the 3/8 segment, we added a post-oxygenator shunt. This allows for adequate blood flow to maintain circuit integrity, while limiting the amount of flow to the patient. The nationwide nursing shortage is well-known. Though our multidisciplinary ECMO Specialist Team supports nursing and respiratory therapy, the nursing shortage still impacts our staffing models, resulting in the inability to safely staff bedside nurses and ECMO specialists. At times of high census, ECMO patients are cohorted into one geographical location. This allows for a temporary 2:1 staffing model for Centrimag patients. Our goal remains to staff pediatric cases as a 1:1 ECMO Specialist assignment. The ability to obtain this is assessed shift to shift;factoring patient stability, experience of the ECMO specialist, and unit staffing. The collaboration with ICU Nurse Managers, Hospital Supervisors and Central Staffing Office is imperative to the success of staffing model alterations. Our ECMO department has increased its FTEs, implementing a core team to be preassigned to two ECMO beds. The objective is to alleviate the burden on ICU staffing, limiting the number of nurses pulled from staffing grids. In uncertain times, flexibility is vital. It is important to remain vigilant and proactive. Our ECMO program feels that continuous assessment of supplies, equipment, and open communication has been the key to successfully serving our patients.
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The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2, created a worldwide need for supplementary PPE to protect frontline workers who were working tirelessly to save the lives of those exhibiting symptoms. At the same time, supply chains were interrupted due to mass reductions in their workforce who were affected by the disease. Factories producing additional PPE were hampered by these workforce reductions and were increasingly challenged to increase operations in order to meet the international demand. Local distributors were left with minimal supplies and supply chains experienced rapidly diminishing supplies of critical items, meaning they were unable to meet the needs of logarithmic increases in sick patients. This chapter details the changes that a small hospital-based supply chain team, responsible for supplying one of the hospitals at the epicenter of the COVID-19 crisis in New York City, made in the face of this crisis and how they effectively organized delivery and disbursement of PPE and critical supplies in less than 3 weeks. Lessons learned are included in this chapter as a guide for success of supply chain management during a large-scale, worldwide shortage in essential materials and equipment. © SBH Health System 2022.
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Background: Total parenteral nutrition (TPN) is a life-saving therapy for patients with chronic intestinal failure. TPN typically consists of macronutrients (amino acids, dextrose, and lipids) as well as micronutrients (multi-vitamins [MVI] and trace elements) to meet fluid, calorie, and micronutrient needs. With the early years of PN administration, multiple deficiencies were noted leading to guidelines regarding need for daily use of essential trace element and MVI preparation for parenteral use. Unfortunately, during the last few years we have seen multiple shortages of PN related supplies including the most recent shortage of parenteral MVI preparation. Major organizations such as ASPEN have developed recommendations regarding management of shortages, however their clinical impact has not been fully evaluated. The current study evaluated the impact of MVI shortage on change in clinical practice and the prevalence of deficiency. Method(s): A retrospective review of electronic medical records for patients who received TPN during time of shortage in IV multivitamins supply due to COVID-19 crisis between January 2021 and June 2021. In our program, the shortage affected one TPN supplier. We included patients who received their TPN from affected supplier and who were tested for micronutrients including Vitamins A, B12, C, and D in the 6 months preceding the shortage in supply (period 1) as well as during the shortage period (period 2). Period 1 was defined as from July 1, 2020, to December 31, 2020, and period 2 was defined as from January 1, 2021, to June 30, 2021. In addition to baseline clinical characteristics, we captured changes in studied micronutrients. Result(s): Current retrospective analysis of a prospectively maintained database noted 21 patients (mean age of 63.3 +/- 13.8, 62% female) were impacted by MVI shortage during study period (Table 1). Most common primary diagnosis was Crohn's disease (33.3%) followed by enterocutaneous fistula (19%), and gastrointestinal dysmotility (14.3%). In 19/21 (90%) patients, MVI was administered 3 days per week in PN. In the remaining two patients who had short bowel,MVI was continued 7 days per week. Additionally, 19/21 (90%) patients also were supplemented orally with Vitamin D (17/21), Vitamin B12 (5/21), MVI (3/21), Vitamin C (1/21). There was a decline in average Vitamin C levels between the two study periods (Table 2) with a trend towards a decline in average 25-hydroxy vitamin D levels, while mean vitamin A and B12 levels did not change significantly. There was a significant increase in Vitamin D and C deficiencies, while no increase in deficiencies in Vitamin E, A, and B12 levels was noted (Figure 1). Conclusion(s): Unfortunately, shortages of key PN related supplies have become commonplace in the last few years. The most recent shortage affected MVI supplies. Our group managed the shortage through a combination of reduction of parenteral MVI administration to 3 days per week along with additional supplementation of specific micronutrients orally. Although with this strategy, there was an increase in Vitamin D and C levels falling below reference range, no significant deficiencies were noted. (Table Presented).
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Intro: The Out-Patient Parenteral Antimicrobial Therapy (OPAT) is a form of Antimicrobial Stewardship that is now widely-practise throughout the world. However, in Malaysia, this has just only begun to take root and the OPAT in Universiti Malaya (UM) has only just begin operating on 2 August, 2018. The OPAT in Universiti Malaya has been operating for 4 years and is a collaboration between the General Medical Unit and the Infectious Control Unit. Method(s): This was a longitudinal study of all the patients that has been admitted to the OPAT since the start of the service. For each patient the starting and ending date in OPAT, anitbiotic used, the diagnosis, the referring unit, and any problems were recorded. Finding(s): The total patient-days of antibiotics served in the OPAT was 4978, with a mean duration of 66.37 days per patient and a median of 31 days. The majority of cases was referred from the medical department with 41 cases (54.67%) followed by Surgery with 22 cases (29.33%). Ertapenem was the most common antimicrobial served with 39 patients on it (52%) and ceftriaxone was second with 8 patients served (10.67%). All antibiotics have been agreed upon by the Infectious Disease Unit. In our study, 2 patients in OPAT has died but the rest none of them were admitted for hospital associated infection. Discussion(s): We found that OPAT on average save at least ten beds per day in the hospital. The patients are happy because they do not need to be warded in hospital to receive their antimicrobials. However, we faced limitations in recruitment of patients to the OPAT during the COVID-19 pandemic, staff shortages, the lack of infusion pumps for serving multidose antimicrobials, and bureacratic red-tape. Conclusion(s): OPAT was useful in reducing bed occupancy rate and hospital associated infection. Patients also are happy with the service.Copyright © 2023
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BACKGROUND: In the search for innovative methods to improve the quality and efficiency of health services, integrated clinical pathways (ICPs) have been introduced. AIM: As there is a gap in research on ICP efficiency, the aim of the study was to investigate the role and impact of collaboration and communication among three interprofessional ICP teams on the self-assessment of efficiency of ICPs. METHOD(S): A cross-sectional study was conducted using a descriptive quantitative with a survey (n = 152) and qualitative methods with a focus group (n = 27) and in-depth interviews (n = 22) in a typical general hospital in Slovenia. RESULT(S): The results showed that health-care professionals found patient health care and the work of healthcare professionals' better quality with ICP than without ICP. The ICPs team members assessed communication, cooperation, and effectiveness in the ICP team as relatively good but identified the lack of staff as the main reason for their limitations. The impact of ICP team collaboration and communication on ICP safety exists but it does not explain a sufficient proportion of the variance and the corelation is medium strong. The result also revealed that the COVID-19 pandemic did not primarily affect ICP team members' fear of possible infection, as studies have shown in the first wave of the COVID-19 pandemic, but rather staff shortages leading to increased fear of errors and possible complaints and lawsuits from patients and relatives. CONCLUSION(S): Measures are needed for the additional employment of team members and the retention of current staff through financial compensation and the promotion of supportive workplace characteristics.Copyright © 2023 Mateja Simec, Sabina Krsnik, Karmen Erjavec.