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1.
Telehealth and Medicine Today ; 6(2), 2021.
Article in English | ProQuest Central | ID: covidwho-2026473

ABSTRACT

Introduction: Recent advancements in information technology and access to smartphone have expanded the scope of healthcare delivery services across the globe. Telemedicine is making healthcare affordable and more accessible to the needy in situations like the present pandemic. Although telepsychiatry services were underutilised initially in India due to various barriers, its role in delivering healthcare services, has gained pace since the last few years. During the coronavirus disease (COVID-19) pandemic, India introduced telemedicine practice guidelines (March, 2020), and telepsychiatry operational guidelines (May, 2020), to remove barriers and promote equitable access. In the wake of COVID-19 pandemic various mental health institutes across India relied heavily upon telepsychiatry services to provide care. National Institute of Mental Health and Neuro Sciences, Bangalore being an Institute of National Importance has introduced different modules to provide clinical care to the mentally ill. Objectives: In this article, the authors provide an experiential account of various clinical services provided by our institute through telepsychiatry means across India during the COVID-19 pandemic. Conclusion: These clinical service modules have tremendous potential to increase the use of technology in providing quality care to the unreached population, bridging the treatment gap for psychiatric disorders globally and developing countries in particular.

2.
Telehealth and Medicine Today ; 6(2), 2021.
Article in English | ProQuest Central | ID: covidwho-2026468

ABSTRACT

The Telemedicine Practice Guidelines (TPG) released in 2020 provide legal framework for registered medical practitioners (RMPs) to consult with patients deploying Information and Communication Technology. Necessary compliance requirements have also been included. This article analyses the effectiveness of the ‘Train to Practice’ course designed by the Telemedicine Society of India to train doctors in India to follow ethical and safe standards of practice of telemedicine. The online course was taught by a faculty of 18 members, over a period of 6 months using four modules. The course comprised of a pre-course assessment, live lectures, and a post-course assessment to ascertain the level of preparedness and knowledge imparted to the RMPs by way of the course. The article highlights that the RMPs had a preliminary understanding of the concept of telemedicine prior to the course. Post-course assessment indicated improvement in knowledge levels. Pre- and post-course assessments were conducted using multiple choice Yes or No response-based questionnaires. Participating RMPs exhibited a real drive to understand the legalities and operational procedures of the practice of telemedicine as was evidenced by queries posed to the lecturers. While the course was rated generously by all the attendee RMPs, there were also evidences of a lack of seriousness from certain RMPs who did not have to pay for participating in the course. The researchers have also suggested that the presence of a TPG qualification paper online and the swift introduction of TPG aligned courses in medical schools would streamline implementation challenges in the future. The researchers have also recommended the amendment of the TPG and the Medical Council of India (MCI) Code of Ethics Regulations, 2002, to provide better protection to RMPs from possible litigation occurring during telemedicine practice.

3.
Practice Nursing ; 33(9):388-388, 2022.
Article in English | CINAHL | ID: covidwho-2025632

ABSTRACT

The article offers news briefs related to practice nursing in the United Kingdom as of September 2022 including the release of a guidance on type 1 diabetes in adults, the availability of resources for COVID-19 autumn booster, and the updated guide on eye care for non-ophthalmic nursing staff.

4.
Radiologic Technology ; 94(1):66-70, 2022.
Article in English | CINAHL | ID: covidwho-2011951

ABSTRACT

The article focuses on the consequences of evolving guidelines during the COVID-19 pandemic. Topics include the revisions made on healthcare guidelines brought by new data and limiting factors, the impact of spreading misinformation regarding COVID-19 through social media, and the challenge of building public confidence by presenting current guidelines.

5.
Antibiotics (Basel) ; 11(7)2022 Jul 06.
Article in English | MEDLINE | ID: covidwho-1963670

ABSTRACT

A quasi-experimental study was conducted on the implementation of locally developed clinical practice guidelines (CPGs) for empirical antibiotic (ATB) therapy of common infections (bacteremia, urinary tract infection (UTI), pneumonia) in the hospitals from January 2019 to December 2020. The CPGs were developed using data from patients with these infections at individual hospitals. Relevant CPG data pre- and post-implementation were collected and compared. Of the 1644 patients enrolled in the study, 808 and 836 were in the pre- and post-implementation periods, respectively, and patient outcomes were compared. Significant reductions in the mean durations of intensive care unit stay (3.44 ± 9.08 vs. 2.55 ± 7.89 days; p = 0.035), ventilator use (5.73 ± 12.14 vs. 4.22 ± 10.23 days; p = 0.007), piperacillin/tazobactam administration (0.954 ± 3.159 vs. 0.660 ± 2.217 days, p = 0.029), and cefoperazone/sulbactam administration (0.058 ± 0.737 vs. 0.331 ± 1.803 days, p = 0.0001) occurred. Multivariate analysis demonstrated that CPG-implementation was associated with favorable clinical outcomes (adjusted odds ratio 1.286, 95% confidence interval: 1.004-1.647, p = 0.046). Among patients who provided follow-up cultures (n = 284), favorable microbiological responses were significantly less frequent during the pre-implementation period than the post-implementation period (80.35% vs. 91.89%; p = 0.01). In conclusion, the locally developed CPG implementation is feasible and effective in improving patient outcomes and reducing ATB consumption. Hospital antimicrobial stewardship teams should be able to facilitate CPG development and implementation for antimicrobial therapy for common infections.

6.
Am J Health Syst Pharm ; 2022 Jul 15.
Article in English | MEDLINE | ID: covidwho-1948156

ABSTRACT

DISCLAIMER: In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. PURPOSE: To assess the quality of critical care clinical practice guidelines (CPGs) involving pharmacotherapy recommendations. METHODS: A systematic electronic search was performed using PubMed, MEDLINE, and Embase for critical care CPGs published between 2012 and 2022 and involving pharmacotherapy recommendations. The Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument was employed to appraise CPG quality through independent assessment by 2 appraisers. RESULTS: Twenty-one CPGs were evaluated. The number of recommendations in each guideline ranged from 2 to 250, with a total of 1,604 recommendations. The number of strong (vs weak) recommendations in each guideline ranged from 0 to 31, with a total of 116 strong recommendations, or 7.23% of the total number of recommendations. There was at least 1 pharmacist author for 9 (43%) of the guidelines. The AGREE II domains for which mean quality scores of evaluated guidelines were highest were scope and purpose (0.88; 95% CI, 0.85-0.92), rigor of development (0.80; 95% CI, 0.77-0.83), clarity of presentation (0.84; 95% CI, 0.81-0.87), and editorial independence (0.86; 95% CI, 0.79-0.94), while those for which mean scores were lowest were stakeholder involvement (0.69; 95% CI, 0.63-0.75) and applicability (0.49; 95% CI, 0.43-0.55). Involvement of a pharmacist in CPG development was associated with significantly higher scoring for stakeholder involvement (P = 0.0356). CONCLUSION: Strong recommendations accounted for less than 10% of the recommendations in the evaluated CPGs. Moreover, there are concerns related to guideline applicability (ie, advice or tools for putting recommendations into practice) and stakeholder involvement (ie, inclusion of individuals from all relevant groups). It is important to involve pharmacists in CPGs with pharmacotherapy recommendations.

7.
Hospital Employee Health ; 41(7):1-4, 2022.
Article in English | CINAHL | ID: covidwho-1929171

ABSTRACT

The healthcare community is pushing back against OSHA adopting a more flexible final COVID-19 rule that could change with public health guidelines. The agency is finalizing its Emergency Temporary Standard to protect healthcare workers from COVID-19.

8.
Dental Nursing ; 18(6):266-269, 2022.
Article in English | CINAHL | ID: covidwho-1912185

ABSTRACT

The article presents the discussion on world news briefs. Topics include Royal College of Surgeons of England welcoming the plans for expanding water fluoridation schemes across England for improving children's oral health;and reduction in the number of children undergoing dental treatment under general anaesthesia.

9.
Gastrointestinal Nursing ; 20(5):6-8, 2022.
Article in English | CINAHL | ID: covidwho-1903910

ABSTRACT

The article provides an overview of the work undertaken by the Association of Coloproctology of Great Britain and Ireland (ACPGBI) Colonoscopy Clinical Sub-Committee in colonoscopy and endoscopy training, service delivery and governance across the United Kingdom (UK) over the past two years since the coronavirus pandemic.

10.
Asian American Journal of Psychology ; : No Pagination Specified, 2022.
Article in English | APA PsycInfo | ID: covidwho-1900434

ABSTRACT

This article offers guidelines for psychological practitioners on ways to best support the well-being of Asian American/Pacific Islanders (AAPIs) through the COVID-19 global pandemic. The article argues that strengthening the connection with their intersecting identities is essential to the well-being of diverse AAPIs, especially given three interconnected and added strains: anti-Asian rhetoric and ensuing violence, invisible and intensified structural inequalities, and exacerbated mental health disparity. To facilitate AAPIs ongoing development and connection with their intersecting identities, three complementary theoretical approaches are introduced as the foundation of practice guidelines offered. The approaches include a culturally affirming developmental approach that fosters growth and resilience consistent with AAPIs identities;a multicultural feminist approach that promotes, empowers, and advocates for AAPIs by acknowledging structural power differentials within multiple interlocking systems of oppression;and a social justice-oriented psychoanalytic approach that recognizes structural impacts and offers attentive listening to the voices of AAPIs whose experiences are otherwise unheard. To support AAPIs through and beyond the pandemic, psychological practitioners must familiarize themselves with identity development theories relevant to AAPIs, participate in social advocacy by acknowledging and affirming differences within and external to AAPI communities, and expand on one's ability to listen for the diverse experiences that are unspoken, unheard, or uncomfortable to digest embedded in the oppressive structure. (PsycInfo Database Record (c) 2022 APA, all rights reserved) Impact Statement Strengthening Asian American/Pacific Islanders (AAPIs') connection with intersecting identities is key to AAPIs collective well-being given the three added and interconnected strains (i.e., intensified anti-Asian rhetoric, structural inequality, and mental health disparity) during the COVID-19 pandemic. Practitioners should incorporate advocacy, recognize power differentials, and engage in depthful listening when helping AAPIs develop toward an increasingly mature and nuanced connection with their intersecting identities, which contribute to resilience and healing. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

12.
AORN Journal ; 115(5):P2-P3, 2022.
Article in English | CINAHL | ID: covidwho-1825862
13.
Am J Obstet Gynecol MFM ; 4(5): 100654, 2022 May 02.
Article in English | MEDLINE | ID: covidwho-1814040

ABSTRACT

OBJECTIVE: To systematically identify and critically assess the quality of clinical practice guidelines for the management of SARS-CoV-2 infection in pregnancy. DATA SOURCES: Medline, Scopus, and ISI Web of Science databases were searched until February 15, 2022. STUDY ELIGIBILITY CRITERIA: Inclusion criteria were clinical practice guidelines on the management of SARS-CoV-2 infection in pregnancy. The risk of bias and quality assessments of the included clinical practice guidelines were performed using the Appraisal of Guidelines for REsearch and Evaluation II tool, which is considered the gold standard for quality assessment of clinical practice guidelines. To define a clinical practice guideline as of good quality, we adopted the cutoff score proposed by Amer et al: if the overall clinical practice guideline score was >60%, it was recommended. METHODS: The following clinical points related to the management of pregnant women with SARS-CoV-2 infection were addressed: criteria for maternal hospitalization, recommendations for follow-up fetal growth scan, specific recommendations against invasive procedures, management of labor, timing of delivery, postpartum care, and vaccination strategy. RESULTS: A total of 28 clinical practice guidelines were included. All recommended hospitalization only for severe disease; 46.1% (6/13) suggested a fetal growth scan after SARS-CoV-2 infection, whereas 23.1% (3/13) did not support this practice. Thromboprophylaxis with low-molecular-weight heparin was recommended in symptomatic women by 77.1% (7/9) of the clinical practice guidelines. None of the guidelines recommended administering corticosteroids only for the presence of SARS-CoV-2 infection in preterm gestation, unless specific obstetrical indication exists. Elective induction of labor from 39 weeks of gestation was suggested by 18.1% (2/11) of the clinical practice guidelines included in the present review, whereas 45.4% (5/11) did not recommend elective induction unless other obstetrical indications coexisted. There were 27% (3/11) of clinical practice guidelines that suggested shortening of the second stage of labor, and active pushing was supported by 18.1% (2/11). There was general agreement among the clinical practice guidelines in not recommending cesarean delivery only for the presence of maternal infection and in recommending vaccine boosters at least 6 months after the primary series of vaccination. The Appraisal of Guidelines for REsearch and Evaluation II standardized domain scores for the first overall assessment of clinical practice guidelines had a mean of 50% (standard deviation±21.82%), and 9 clinical practice guidelines scored >60%. CONCLUSION: A significant heterogeneity was found in some of the main aspects of the management of SARS-CoV-2 infection in pregnancy, as reported by the published clinical practice guidelines.

14.
Practice Nursing ; 33(4):168-168, 2022.
Article in English | CINAHL | ID: covidwho-1789691

ABSTRACT

The article reports on the tools, guidelines and major events for general practice nurses in United Kingdom (UK), including the updated duty of candour guidance from the Nursing and Midwifery Council and the scheduled Royal College of Nursing (RCN) Congress 2022 in Glasgow, Scotland.

15.
Practice Nurse ; 52(3):4-4, 2022.
Article in English | CINAHL | ID: covidwho-1766850

ABSTRACT

An introduction is presented which discusses article on several topics including National Health Service England/Accelerated Access Collaborative severe asthma project, e National Institute for Health and Care Excellence guideline and the war in Ukraine.

16.
British Journal of Nursing ; 31(5):280-288, 2022.
Article in English | CINAHL | ID: covidwho-1766711

ABSTRACT

Critical assessment of blood results is pivotal to a patient’s management. Advanced practice involves autonomous consultation and diagnostic reasoning. The field of haematology is often an area that colleagues find daunting. But with a systematic review and analysis of results, differential diagnosis and plans for treatment or referral can be made. This is the second article in a two-part series. The first article in this two-part series examined history taking in patients with suspected haematological disease. This article will discuss common derangement in blood results and the significance relating to patient management, considering latest evidence and guidelines.

17.
Br J Anaesth ; 128(6): 903-908, 2022 06.
Article in English | MEDLINE | ID: covidwho-1748196

ABSTRACT

Clinical practice guidelines are increasingly important to guide clinical care. However, they can vary widely in quality, and many recommendations are based on low-level evidence. The COVID-19 pandemic highlighted the need for new flexible formats for rigorously developed guidelines. Future guideline development should be standardised, graded, registered, and updated to ensure that they are 'living' works in progress.


Subject(s)
Anesthesia , COVID-19 , Humans , Pandemics/prevention & control
18.
Arch Bronconeumol ; 58(2): T150-T158, 2022 Feb.
Article in English, Spanish | MEDLINE | ID: covidwho-1729542

ABSTRACT

In this fifth phase of development, the contents of the Spanish Asthma Management Guidelines (GEMA), which include versions 5.0 and 5.1, have undergone a thorough review. The aim here is to set the main changes in context. These could be summarized as follows: DIAGNOSIS: new FENO cut-off and severity classification based on treatment needed to maintain control; INTERMITTENT ASTHMA: a more restrictive concept and treatment extended to include a glucocorticoid/adrenergic combination as needed; MILD ASTHMA: glucocorticoid/adrenergic therapy as needed as an alternative in case of low therapeutic adherence to conventional fixed-dose steroids; SEVERE ASTHMA: readjustment of phenotypes, incorporation of triple therapy in a single inhaler, and criteria for selection of a biologic in severe uncontrolled asthma; OTHERS: specific scoring in childhood asthma, incorporation of certain organizational aspects (care circuits, asthma units, telemedicine), new sections on COVID-19 and nasal polyposis.


Subject(s)
Asthma , COVID-19 , Adrenergic Agents/therapeutic use , Asthma/drug therapy , Glucocorticoids/therapeutic use , Humans
19.
BMC Health Serv Res ; 22(1): 272, 2022 Mar 01.
Article in English | MEDLINE | ID: covidwho-1717953

ABSTRACT

BACKGROUND: Events such as the COVID-19 pandemic remind us of the heightened risk that healthcare workers (HCWs) have from acquiring infectious diseases at work. Reducing the risk requires a multimodal approach, ensuring that staff have the opportunity to undertake occupational infection prevention and control (OIPC) training. While studies have been done within countries to look at availability and delivery of OIPC training opportunities for HCWs, there has been less focus given to whether their infection prevention and control (IPC) guidelines adhere to recommended best practices. OBJECTIVES: To examine national IPC guidelines for the inclusion of key recommendations on OIPC training for HCWs to protect them from infectious diseases at work and to report on areas of inconsistencies and gaps. METHODS: We applied a scoping review method and reviewed guidelines published in the last twenty years (2000-2020) including the IPC guidelines of World Health Organization and the United States Centers for Disease Control and Prevention. These two guidelines were used as a baseline to compare the inclusion of key elements related to OIPC training with IPC guidelines of four high-income countries /regions i.e., Gulf Cooperation Council, Australia, Canada, United Kingdom and four low-, and middle-income countries (LMIC) i.e. India, Indonesia, Pakistan and, Philippines. RESULTS: Except for the Filipino IPC guideline, all the other guidelines were developed in the last five years. Only two guidelines discussed the need for delivery of OIPC training at undergraduate and/or post graduate level and at workplace induction. Only two acknowledged that training should be based on adult learning principles. None of the LMIC guidelines included recommendations about evaluating training programs. Lastly the mode of delivery and curriculum differed across the guidelines. CONCLUSIONS: Developing a culture of learning in healthcare organizations by incorporating and evaluating OIPC training at different stages of HCWs career path, along with incorporating adult learning principles into national IPC guidelines may help standardize guidance for the development of OIPC training programs. Sustainability of this discourse could be achieved by first updating the national IPC guidelines. Further work is needed to ensure that all relevant healthcare organisations are delivering a package of OIPC training that includes the identified best practice elements.


Subject(s)
COVID-19 , Communicable Diseases , Adult , COVID-19/prevention & control , Health Personnel , Humans , Infection Control/methods , Pandemics/prevention & control , SARS-CoV-2
20.
World Med Health Policy ; 2022 Feb 21.
Article in English | MEDLINE | ID: covidwho-1700060

ABSTRACT

Telemedicine is the delivery of healthcare services from a distance, by use of information and communication technology. There have been no statutory regulations or official guidelines in India specific for telemedicine practice and allied matters so far. For the first time, the government of India released telemedicine practice guidelines for Registered Medical Practitioners on March 25, 2020, amid the COVID-19 outbreak. This review would initiate the discussion on the features of the guidelines, their limitations, and their significance in times of the COVID-19 pandemic. The guidelines are with a restricted scope for providing medical consultation to patients, excluding other aspects of telemedicine such as research and evaluation and the continuing education of healthcare workers. The guidelines have elaborated on the eligibility for practicing Telemedicine in India, the modes and types of teleconsultations, delved into the doctor-patient relationship, consent, and management protocols, and touched upon the data security and privacy aspects of Teleconsultation. After releasing the guidelines, the telescreening of the public for COVID-19 symptoms is being advocated by the government of India. COVID-19 National Teleconsultation Centre (CoNTeC) has been initiated, which connects the doctors across India to All India Institute of Medical Sciences (AIIMS) in real-time for accessing expert guidance on the treatment of the COVID-19 patients.

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