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Coronavirus disease 2019 (COVID-19), as a public health emergency, is a serious threat to human health. Cancer patients have a high risk of being infected with COVID-19. As one of important means of cancer treatment, radiotherapy has become an important alternative to surgery during the epidemic of COVID-19. The radiotherapy department of Peking Union Medical College Hospital ensured the smooth development of radiotherapy work on the setup of prevention and control systems for COVID-19 by establishing admission strategies for cancer patients, disinfection, isolation, daily management measures, scientific exploration, and clinical practice. In this paper, the associated strategies are summarized and analyzed, which can provide experience and reference for radiotherapy treatment under public health emergencies.Copyright © 2021, Peking Union Medical College Hospital. All rights reserved.
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Introduction:The COVID-19 pandemic has been felt in all areas of health care. We performed a weekly survey amongst the members of the European Society of Oncology Pharmacy (ESOP) to better understand its effects and how they evolved over time. We specifically studied alterations in the care for patients with cancer as well as in the work of oncology pharmacists. Method(s):An online survey was developed by ESOP to compile data about the effects of COVID-19 on the work practices of professionals working in the field of oncology pharmacy. The survey was distributed electronically on a weekly basis from April 6thto June 28th. Result(s):A total of 1146 responses were gathered from respondents in 60 different countries. At any given time point, between 25% and 38% of the respondents had staff infected with COVID-19. In total, 29% of hospital pharmacists reported shortages of drugs necessary for the treatment of COVID-19 patients, and almost 50% also faced shortages of drugs necessary for the treatment of cancer patients. In addition, the majority of hospital pharmacists reported a decrease in planned surgery for oncology patients, as well as a decrease in the amount of chemotherapy preparations. Community pharmacists faced shortages of personal protective equipment in 40% of cases and shortages of drugs in 60%. Conclusion(s):The work of oncology pharmacists both in the clinical setting as well as in the community has been effected profoundly by the COVID-19 pandemic.Copyright © 2021 Lippincott Williams and Wilkins. All rights reserved.
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Background: In December 2019, a respiratory illness due to a novel coronavirus, SARS-CoV-2, was first identified in Wuhan, China. SARS-CoV-2, termed COVID-19, is now a worldwide pandemic and has been identified in 216 countries and areas or territories (WHO, 2020). As of May 15th, 2020, there have been more than 4.2 million confirmed cases and 294,190 deaths worldwide. Purpose(s): Ensure patient safety, drug availability, and therapeutic efficacy for all COVID-19 patients. Implement a number of changes to urgently meet the institution's patient care needs. Method(s): Data were collected from a 62-year-old male patient admitted with severe COVID-19 to the intensive care unit in April 2020. The following pharmacy services were then provided: first, constant review and interpretation of new clinical data;second, patient eligibility assessment and obtaining medication through compassionate use protocols;third, evidence-based interventions (e.g. drug-drug interaction, drug-disease interaction, and dose adjustments);fourth, limit unnecessary nebuliser use. Last but not least, educate patients and the public on effective strategies to prevent acquisition and further spread of infection (e.g. social distancing, optimal hand hygiene, and personal protective equipment). Result(s): With standard care and the compassionate use of Hydroxychloroquine, Azithromycin, Zn supplements, and Tocilizumab under close monitoring, the patient successfully recovered and was discharged on May 4th, 2020. Conclusion(s): Pharmacists play a vital role within a multi-disciplinary healthcare team to optimise patient care during this COVID-19 pandemic.
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Introduction. Breast Units (BU) represent an opportunity to adequately manage and improve quality of care for patients with breast cancer. The presence of specific national guidelines should promote safe and good quality, integrated care. In fact, the presence of a multidisciplinary team of specialists whose workflows follow specific guidelines, set to the highest European standards, should ensure that patients in Breast Units receive appropriate care at diagnosis and throughout the course of the disease. Methods. Two surveys were developed and administered to Breast Unit coordinators and patients throughout Italy. The surveys investigated the provision of healthcare services and the implementation of a new organizational model over two time periods: the first wave of the coronavirus disease 2019 (COVID-19) pandemic from March 2020 to August 2020 and the second wave from September 2020 to December 2020. The surveys aimed to assess the continuity of care during the pandemic from the clinician and patient perspective. Results. Patients observed a reduction in the postponement of care between the first wave of COVID-19 and the second wave. Some services were delayed, particularly in the second wave where a large number of services were not rescheduled. Management of the COVID-19 pandemic resulted in many healthcare professionals being reallocated to other duties and hospital departments. The effect of this was particularly relevant for both patients and clinicians, with few healthcare professionals having the capacity to focus on conditions other than COVID-19. In the first wave of the pandemic 42 percent of professionals were redeployed, compared with 27 percent in the second wave. Conclusions. This study demonstrates how COVID-19 affected the care of patients with breast cancer in Italy. Patients and coordinators from Breast Units across the country highlighted many important aspects that should be considered when assessing the effects of the COVID-19 pandemic on the entire healthcare system in order to be better prepared for future pandemics.
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Aim/Background: COVID-19 pandemic has casted a new light over the capacity of telepharmacy to increase access to pharmaceutical care, providing more support to patients and allowing new opportunities for pharmacists. However, telepharmacy still hasn't been introduced as a standardised pharmaceutical service in the Republic of Serbia, therefore, the objective of this paper is to assess the potential for its local implementation by exploring the perspectives of community pharmacists. Materials and Methods: Semi-structured one-on-one interviews were conducted online from January to March 2021, with pharmacists working in community pharmacies across the country (n=23). The questions were developed to ensure the consistency and comprehensibility of the interviews, while keeping the questions flexible enough to allow each participant to share their understanding of telepharmacy, its application, benefits and risks, but also their motivating factors, ideas, and views on overall capacity to introduce such services. Interviews were transcribed ad verbatim, coded and thematically analysed. Results: The participants had a good theoretical understanding and were mostly open and ready for the introduction of new services, but due to the lack of regulatory, financial and organisational solutions, participants believed that this is still not possible, especially since remote healthcare services still aren't recognised by the national law of Serbia. Conclusion: Although many pharmacists were willing to support patients remotely and have done so on their own in the past, there is a need for further initiatives in order to introduce structured and standardised telepharmacy services in the Republic of Serbia. © 2023 Author(s). Distributed under Creative Commons CC-BY 4.0.
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Introduction: Community pharmacists were amongst the few healthcare professionals readily available for face-to-face consultation after the first COVID19 outbreak in Catalonia, Spain. A collaborative practice programme was created in September 2020 to ease the referral to and communication with Primary Care (PC) of those Community Pharmacy (CP) users who had COVID19-like symptoms. This programme, known as JoDIC, was created by the Epidemiological Surveillance Services (ESS) of Valles and Barcelones-Nord-Maresme Areas, the Catalan Healthcare Service (CatSalut) and Barcelona Pharmacists Association (COFB). After using a paper-based system at the beginning, a safe cloud-based software hosted in Farmaserveis, the Catalan pharmacy services platform, started running in February 2021, to facilitate patients' follow-up. In June 2021, referral for COVID19 vaccination was included to the platform. COVID19 antigenic tests were not available in Spanish CPs until July 2021. Objective(s): To enable an effective and safe referral and communication system from CPs to PC centers of patients needing COVID19-related healthcare interventions, within the JoDIC programme;and to describe the pharmaceutical interventions performed in the JoDIC programme framework. Method(s): COFB, ESS and CatSalut jointly designed JoDIC circuit, which was activated at the CP to detect users with COVID19-like symptoms, users who were a close contact to a COVID19 case or users who were not fully vaccinated. The initial paper-based circuit started in September 2020, involving Valles area only. Complete referral data was gathered from the 5th February 2021 to the 31st December 2020 period of study, when Farmaserveis specific module was launched. On the 23rd June 2021, JoDIC was expanded to the whole Northern Barcelona Metropolitan Area, comprising more than two million inhabitants who are serviced by 649 CP. By filling up a form on Farmaserveis, the patient's data was referred by a community pharmacist to the PC centre to evaluate each case and to provide further care needed. Result(s): 528 community pharmacists working in 372 CP were trained in the protocol. Community pharmacists performed interventions in 1303 CP users (496, paper-based;and 807, registered on Farmaserveis). 111 CP registered pharmaceutical interventions on Farmaserveis (7.4 patients per CP). 63.1% (n = 509) of CP users, received health education by the pharmacist, while 36.9% (n = 298) were referred to their PC centre. 71.6% of the referred patients were due to having COVID19-like symptoms;25.3%, were close contacts to COVID19-positive cases;and 3.1%, to be vaccinated. 68.8% of the referred patients eventually attended their appointments with their family physician. 63.4% of the visited patients needed some kind of diagnostic test. 30.8% tests were COVID19-positive. Conclusion(s): The current pandemic favoured the establishment of new COVID19 detection circuits and communication ways between ESS, CP and PC centers. Our data shows high efficacy to detect COVID19-positive cases (30.8% positivity) and good acceptability amongst referred citizens (68.8% successful referrals). JoDIC programme is a seminal project that will facilitate communication amongst PC and CP professionals in other contexts.
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Purpose: The Royal Darwin Hospital's Department of Ophthalmology provide a regular outreach service to the remote communities of the Top End of the Northern Territory throughout the year. COVID-19 travel restrictions and community lockdowns has impacted the provision of scheduled outreach services typically provided to those patients residing in remote Top End communities. Method(s): A two-year retrospective analysis of patients booked into the Royal Darwin Hospital Department of Ophthalmology outreach clinics for consultations and procedures, over 2020 to 2021, were included. Records were used to identify outreach trips (number and location), patient demographics, waitlists, clinic attendance, intravitreal injections, and surgical procedures. Result(s): The Royal Darwin Hospital Department of Ophthalmology continued to provide outreach services to the remote Top End over 2020 and 2021. 6 remote communities were serviced in 2020, where 140 patients were reviewed. Eight communities were serviced in 2021, 113 patients were reviewed. Outreach services to Katherine Hospital and Gove District hospitals increased due to reduced community services. Two hundred and thirteen and 214 intravitreal injections were administered in 2020, and 2021 respectively. Total surgical procedures in 2020 and 2021 were similar, 68 and 70 respectively. Conclusion(s): The COVID-19 pandemic reduced the provision of regular outreach services provided by the Royal Darwin Hospital Ophthalmology Department, to the remote population of the Top End. Clinic reviews, intravitreal injections and surgical procedures continued at a reduced rate to the remote population of the top end.
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Aim: To evaluate the pattern of surgical emergencies and surgical care provided during COIVD 19 pandemic. Study design: Cross-sectional Study Place and duration of study: Department of Surgery, CMH, Lahore from 15th March - 15 June 2020. Methodology: Data was collected retrospectively, of all the patients who were admitted in department of surgery over the duration of 3 months. Demographic variables, diagnosis, work up related to COVID-19, specialty of admission and surgical vs conservative management was recorded. Results: A total of 312 patients were included. Majority were male 216(69.2%). Most of the patients 191(61.2%) were admitted via clinic, predominantly in month of May 148(41%). COVID-19 PCR was done on 210 patients (67.3%), chest x-ray was done on 271(87.9%), HRCT chest was done on 113 patients (29.20%). Although general surgery was the busiest service line with a total patient admission of 89(43.1%), Orthopedic surgery top the operative interventions list with 85.1% of admissions underwent operative management. Conclusion: The current local guidelines about patient flow and management of patients in COVID crisis are practical and can be implemented. In the wake of the later waves of COVID 19 hospitals should prepare to divert their resources to high volume specialties like General and orthopedic surgery. Simple, but important procedures like arteriovenous fistula creation should only be stopped it there is shortage of manpower.
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Background and objectives: The Royal College of Paediatrics and Child Health's (RCPCH) "Facing the Future: Standards for children in Emergency Care Settings" recommend full integration of pediatric emergency care, facilitating correct and timely assessment and treatment of children in the emergency care setting. This study focused on the "Management of the sick or injured child": "All children attending emergency care settings are visually assessed by a doctor or nurse immediately upon arrival with clinical assessment undertaken within 15 minutes to determine priority category, supplemented by a pain score and a full record of vital signs." The primary aim was to determine the baseline compliance rates against the national standards of pediatric care. This study is timely, with current increased waiting times and delays to emergency treatment causing UK government concern and implementation of emergency action due to patient safety concerns during the current Coronavirus-19 pandemic. Methods: In all, 61 pediatric patients admitted from May to June 2021 were reviewed using data from a NHS Trust Hospital Accident and Emergency system against the national standards. Children up to the age of 16 were included in the study. Clinical assessment times, vital sign completion, and staff review were all data collected and analyzed to determine the baseline. Results: National standards for assessment and observation were not met over the 2months analyzed. No children were immediately assessed by a doctor or a nurse upon arrival in either month. The average time to undertake a clinical assessment in June was 28 min, almost double the recommended time;65% of children were clinically assessed within 15 min in May and 23% in June. The recommendation for clinical assessment to be supplemented, by a full set of vital signs and a pain score, was achieved in 32% and 10% of patients in May and June, respectively. Discussions with the multidisciplinary team suggested a lack of infrastructure, staff shortages, and lack of training causing shortfall in meeting standards. Conclusion: These data support hospital departments to implement quality improvement schemes to enhance pediatric treatment and safe patient movement through emergency departments.
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Background: The administration of an accurate and effective point-of-care ultrasound (POCUS) course is a crucial tool in improving health education and thus the healthcare system in low-to middle-income countries. The development of the ultrasound curriculum in these countries during the pandemic era is a major challenge for medical educators. Objective: This study aims to survey the learner experience after implementing the POCUS curriculum for first-year emergency medicine residents. Method: A cross-sectional 10-question survey study was conducted at Srinagarind Hospital, Department of Emergency Medicine, Thailand, from July 2019 to July 2021 to determine the experience of POCUS learning by using the 5-point Likert-type scale after first-year emergency residents finishing the ultrasound rotation. Results: All learners responded to the survey. Our results demonstrated that the ultrasound rotation and our ultrasound learning materials were useful tools that showed a positive impact on POCUS knowledge for our learners. However, some obstacles of POCUS learning were identified to assist in closing faculty development gaps: the availability of handheld devices as well as the remodeling of the ultrasound rotation course should be managed according to the feedback we received. This study demonstrated a clear need for constant updates in higher education, medical program development, the accuracy of local learning materials, and the explosion of virtual and online learning platforms during this decade. Conclusion: Our results demonstrated that all academic activities employed and the ultrasound learning materials were useful in improving POCUS knowledge. However, we found some obstacles of POCUS learning that needed to be improved, mainly the length of time of training.