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Background The coronavirus disease 2019 (COVID-19) pandemic has extensively affected the public physical and mental health, especially the medical staff working in the COVID-19 wards of hospitals. Objective This study aims to evaluate the relationship between post-traumatic stress disorder (PTSD), anxiety sensitivity (AS), and resilience among hospital medical staff in Rasht, during the COVID-19 pandemic. Methods This is an analytical cross-sectional study. The study population consists of all medical staff working in the COVID-19 wards of Poursina and Razi hospitals in Rasht, Iran. Of these, 94 participated who were selected using a convenience sampling method. Weathers et al.'s post-traumatic stress disorder checklist, Reiss et al.'s AS index, and Connor-Davidson resilience scale were used for data collection. The data were analyzed using Pearson correlation test and multiple linear regression analysis. Results There was a significant negative correlation between PTSD and resilience (r = -0.405, P = 0.001). and a significant positive correlation between PTSD and AS (r=0.633, P=0.001). The results of multiple analyses showed that resilience (B=-0.208, P=0.004) and AS (B=0.574, P=0.001) could significantly explain the PTSD in medical staff. Conclusion Resilience can be an important protective factor against PTSD in hospital medical staff during the COVID-19 pandemic. The medial staff with AS may experience the symptoms of PTSD more.
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A preliminary evaluation of a multicomponent youth development program for siblings in foster care was conducted prior to and during the COVID-19 pandemic. Pretest posttest measures of youth well-being were collected from sixteen youth, caregivers, and caseworkers over a six-month period. Caregivers reported increased internalizing and externalizing behaviors, sibling relationship difficulties, prosocial behavior, and resilience during the study period. Youth reported reduced school engagement, increased resilience, and prosocial behavior. In-person sibling programming was associated with increased prosocial behavior. Virtual sibling programming was associated with lower hyperactivity, increased prosocial behavior, and increased emotional problems. Implications for research and practice are discussed.
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Purpose: This study aimed to identify and understand challenges to inform new strategies to increase the COVID‐19 vaccination rate according to involved vaccinators' perspectives in Belitung, Indonesia. Design A qualitative descriptive study design was used. Methods: Online interviews and chatting were done among 11 vaccinators for data collection between August 2021 and January 2022. Data were analyzed using a content analysis model. Findings Four main themes emerged, including (1) communication strategies (evidence‐based, electronic‐based, and culturally based communication), (2) cross‐sectoral strategies (collaboration with police, religious leaders, customary leaders, heads of village divisions, and non‐governmental organizations), (3) "picking‐up the ball" system (home visits for elderly and people with disability and school visits for children), and (4) setting‐up priorities (between mandatory vaccines and boosters). Conclusion: Despite making vaccination mandatory, the roles of communication, cross‐sectoral innovations, "picking‐up the ball" system, and priority setting may have useful potential to improve vaccination rates. Clinical Relevance: The findings may serve as an input to overcome challenges and accelerate the vaccination coverage in Indonesia and beyond. However, further research is needed.
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BACKGROUND: Timely lab results are important to clinical decision-making and hospital flow. However, at our institution, unreliable blood sample collection for patients with central venous access jeopardised this outcome and created staff dissatisfaction. METHODS: A multidisciplinary team of nurses including a specialist clinical nurse leader (CNL), the hospital intravenous team and quality improvement (QI) consultants aimed to achieve >80% blood sample collection reliability among patients with central venous access by employing a simple signature/countersignature form coupled with audit-feedback and behavioural economics strategies. The form was piloted on one 25-bed unit. Data were collected for 60 weeks and interpreted per standard run chart rules. RESULTS: Blood sample collection reliability exceeded the 80% goal by week 22. The practice was sustained on the pilot unit and spread successfully to other wards despite significant operational threats including the COVID-19 pandemic. CONCLUSIONS: At our institution, a simple signature/countersignature form supplemented by audit-feedback and behavioural economics strategies led to sustained practice change among staff. The pairing of CNL to QI consultant enhanced change potency and durability.
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COVID-19 , Quality Improvement , Humans , Pandemics , Reproducibility of Results , Social ResponsibilityABSTRACT
Within the field of neurological disease, it seems that involvement of relatives is of utmost importance since the patients often are affected in several areas (physical, cognitive, and emotional) which impair their ability to participate in decision-making about their treatment and care. This study aimed to illuminate neuroscience nurses' comprehension of collaborating with and involvement of relatives. Semi-structured interviews were conducted with 19 neuroscience registered nurses. The qualitative data were analyzed utilizing inductive thematic analysis. The COREQ checklist was applied. The analysis identified how collaboration with, and involvement of relatives are perceived as a focus for nursing care and a resource for both patients and registered nurses. Registered nurses having personal experience as a relative find it easier to establish a relationship with relatives. This study emphasizes the importance of the establishment of a trusting relationship between registered nurses and relatives for a positive collaboration and thus involvement of relatives.
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The interest in wearable wireless monitoring systems has accelerated secondary to the ongoing COVID-19 pandemic. Moreover, the alarmingly high number of infections in the pediatric population underscores a gap in monitoring these vulnerable populations, particularly in the home setting. This systematic review aims to identify and assess currently available wearables used to monitor cardiopulmonary function in infants and neonates. The study, prospectively registered on PROSPERO (CRD42020200642), completed a search of PubMed 1946-, Embase 1947-, Cochrane Library, Scopus 1823-, and IEEE Explore 1872-in June 2020. A total of 2324 unique citations were identified, with 16 studies describing 17 unique devices meeting inclusion criteria. Types of devices included smart clothing, belts, and mechanical adhesives, each with unique battery designs, data collection, and transmission hardware. Only four of the 17 devices underwent rigorous comparative testing, and three demonstrated correlation with the standard of care monitoring systems. Low sensitivity and specificity were reported in two commercially available consumer devices compared to the standard of care monitoring systems. The risk of bias in the entire cohort was highly based on a modified ROBINS-I scale. Further development and rigorous wearable device testing are necessary for neonatal and infant deployment.
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Introduction Advance care planning (ACP) is a vital part of holistic and person-centred care. It allows formalising of an individual’s wishes and best interests, and avoids unnecessary or unwanted interventions including, potentially, hospital admissions. It is crucial that any decisions or recommendations are communicated to all relevant healthcare professionals to ensure peoples’ wishes are upheld. We developed this project to review and improve documentation and communication on discharge when a decision had been made to limit care to the community and avoid admission. Method A checklist was developed comprising 11 criteria to be documented in the discharge letter and actions to disseminate information including;updating the ReSPECT form and alerting the hospital frailty and community out of hours teams. We carried out a closed loop audit of patients where admission should be avoided and reviewed discharge letters against the criteria. Where patients were readmitted we reviewed the notes to determine whether the admission was appropriate. Results We compared patients discharged between February 2020–February 2021 and then from March–September 2021. 161 and 27 patients were identified respectively. Average age was 84.6 and 87.3 years respectively. In cohort 2 48.1% of patients were readmitted, up from 8.7% during the previous cycle. 33% of admissions in cohort 2 and 38.9% of readmissions in cohort 1 were deemed appropriate. Documentation improved in 10 of the 11 criteria. Average length of stay for readmissions was reduced from 16.7 to 5.7 days. Conclusion As evidenced by our study utilising a checklist has improved documentation and dissemination of ACPs to the Community. This did not lead to a reduction in hospital admissions but this may have been skewed by factors relating to the Covid-19 pandemic. We did find a significant reduction in length of stay for those subsequently readmitted.
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The new global situation of COVID-19 affects the whole world in all aspects of life including mental health. The study's goal is to detect the relationship between post-traumatic stress disorder (PTSD) and Emotion Regulation (ER) difficulties under the COVID-19 condition. Methods: University students were asked to complete: 1) Emotion Regulation Difficulties Questionnaire (DERS) 2) PTSD Checklist (PCL- 5). 3) Life Events Checklist for DSM-5 (LEC-5). Results: There were 441 students with suspected COVID-19 symptoms out of 1195 students. When compared to students who did not have suspected COVID-19 symptoms, those who did had a greater prevalence of PTSD symptoms (18.2% vs. 4.7%) and DERS (34.5% vs. 23.3%). Additionally, correlation studies demonstrated a significant positive link (Ps< .01) between the PCL, the overall DERS, and all six categories of emotion regulation difficulties. Conclusion: Students with suspected COVID-19 symptoms have more difficulty with emotion regulation and post-traumatic stress disorder than students without such symptoms. This research recommends that during the pandemic, health professionals should implement a suitable psychological intervention for students who exhibit COVID-19 symptoms.
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Background-Covid-19 Pandemic has proved the Nurse's crucial role in health care delivery system and providing nursing care to critically ill patients. It is a challenge for nurses as they need to be astute, competent, compassionate and critical thinker when they have to take care of patients on mechanical ventilator. Aim-To assess knowledge and practices regarding care of patients on mechanical ventilator among nursing personnel before and after administration ofNursing Care Bundle (NCB) in experimental and comparison group. Material and method. A Quasi Experimental non Equivalent comparison group pretest post test design used in thus study. 65 nursing personnels (30 experimental and 35 comparison groups) were selected from hospitals of North India using convenience sampling technique. NCB was administered in experimental group. Structured knowledge questionairre, Structured Observation Checklist for practices was used to collect data before and after intervention. Results-The mean post test knowledge and practices scores of nursing personnel in experimental and comparison groups were (21.6 ± 3.84, 30.83 ± 4.51) and (17.54 ± 2.76, 19.54 ± 4.17) respectively. There was significant difference between mean pre test and post test knowledge and practices scores (p=0.00).There was statistically no significant correlation between post test knowledge and practices score [r=0.16 (0.39)] among nursing personnel in experimental group at the level of significance 0.05.There was significant association of selected variable in area of gender (0.02) in experimental and education (0.02) in comparison group with pre test knowledge scores , also there was a significant association of selected variable in area of gender in experimental (0.03) and present area of working (0.03) in comparison group with pre test practices score. Conclusion-Nursing Care Bundle was effective in improving knowledge and practices of nursing personnel.
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Hepatitis A , Hepatitis A/prevention & control , Humans , Learning , Liver Cirrhosis/complications , Quality Improvement , VaccinationABSTRACT
The literature has highlighted psychological disorders during the Covid-19 lockdown. A research was conducted with 49 students who contacted the Psychological Counseling Center of the University of Salerno between March and May 2020. The objectives were: a) to investigate the psychological disorders and in particular of PTSD;b) evaluate the effectiveness of a short course with online EMDR protocol for those students with PTSD linked to the reactivation of previous trauma following pandemic stress and lockdown. The data collected in the pre and post treatment phase (with psychological interview and the SCL-90-R Scale scoring) show: PTSD (25%), anxiety and stress (100%), depression (88%). In post-EMDR treatment, a reduction in cut-offs from clinical to regulatory range was highlighted on the IES-R Scale and at SCL-90-R scale a shift from clinically significant scores on the syndromic scale to normative scores. In particular, on the SCL-90-R Scale, the score on the Global Severity Index-GSI, a global indicator of the current intensity of psychic distress perceived by the subject, confirms, in the post-test, the achievement of a regulatory clinical framework. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (Italian) La letteratura ha evidenziato problemi psicologici durante il lockdown da Covid-19. E stata condotta una ricerca con 49 studenti che si sono rivolti al Centro di Counseling psicologico dell'Universita di Salerno tra marzo e maggio 2020. Gli obiettivi sono stati: a) indagare l'eventuale presenza di disturbi psicologici e in particolare di PTSD;b) valutare l'efficacia di un percorso breve con protocollo EMDR online per quegli studenti con PTSD legato alla riattivazione di traumi pregressi in seguito allo stress da pandemia e lockdown. I dati raccolti in fase di pre e post trattamento (dai colloqui psicologici e dallo scoring della Scala SCL-90- R) mostrano: PTSD (25%), ansia e stress (100%), depressione (88%). Nel post-trattamento EMDR si e evidenziata, alla Scala IES-R, una riduzione dei cut-off da range clinico a range normativo e alla SCL-90-R un passaggio da punteggi clinicamente significativi nelle scale sindromiche a punteggi normativi. In particolare, alla SCL-90, il punteggio all'indice Global Severity Index - GSI, indicatore globale dell'intensita attuale del disagio psichico percepito dal soggetto conferma, nel post trattamento, il raggiungimento di un assetto normativo. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
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INTRODUCTION: Effective implementation of standard precautions specific to COVID-19 is a challenge for hospitals within the existing constraints of time and resources. AIM: To rapidly design and operationalise personal protective equipment (PPE) donning and doffing areas required for a COVID-19 care facility. METHODS: Literature review was done to identify all issues pertaining to donning and doffing in terms of Donabedian's structure, process and outcome. Training on donning and doffing was given to hospital staff. Donning and doffing mock drills were held. 5S was used as a tool to set up donning and doffing areas. Instances of donning and doffing were observed for protocol deviations and errors. Plan-do-study-act cycles were conducted every alternate day for 4 weeks. The initiative was reported using Standards for QUality Improvement Reporting Excellence (SQUIRE) guidelines. RESULTS: Best practices in donning and doffing were described. Our study recommends a minimum area of 16 m2 each for donning and doffing rooms. Verbally assisted doffing was found most useful than visual prompts. DISCUSSION: Challenges included sustaining the structure and process of donning and doffing, varied supplies of PPE which altered sequencing of donning and/or doffing, and training non-healthcare workers such as plumbers, electricians and drivers who were required during emergencies in the facility. CONCLUSION: Our study used evidence-based literature and quality improvement (QI) tools to design and operationalise donning and doffing areas with focus on people, task and environment. Our QI will enable healthcare facilities to rapidly prototype donning and doffing areas in a systematic way.