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Revista Medica del IMSS ; 60(6):616-623, 2022.
Article in Spanish | Academic Search Complete | ID: covidwho-2125499
Neurología (English Edition) ; 2022.
Article in English | ScienceDirect | ID: covidwho-2082751
Politics & Policy ; : 1, 2022.
Article in English | Academic Search Complete | ID: covidwho-2063917
Emergencias ; 34(5): 369-376, 2022 10.
Article in English, Spanish | MEDLINE | ID: covidwho-2057979


OBJECTIVES: To define quality of care indicators and care process standards for treating patients with COVID-19 in hospital emergency departments (EDs), to determine the level of adherence to standards during the first wave in 2020, and to detect factors associated with different levels of adherence. MATERIAL AND METHODS: We selected care indicators and standards by applying the Delphi method. We then analyzed the level of adherence in the SIESTA cohort (registered by the Spanish Investigators in Emergency Situations Team). This cohort was comprised of patients with COVID-19 treated in 62 Spanish hospitals in March and April 2020. Adherence was compared according to pandemic-related ED caseload pressure, time periods during the wave (earlier and later), and age groups. RESULTS: Fourteen quality indicators were identified. Three were adhered to in less than 50% of the patients. Polymerase chain reaction testing for SARS-CoV-2 infection was the indicator most often disregarded, in 29% of patients when the caseload was high vs 40% at other times (P .001) and in 30% of patients in the later period vs 37% in the earlier period (P = .04). Adherence to the following indicators was better in the later part of the wave: monitoring of oxygen saturation (100% vs 99%, P = .035), electrocardiogram monitoring in patients treated with hydroxychloroquine (87% vs 65%, P .001), and avoiding of lopinavir/ritonavir treatment in patients with diarrhea (79% vs 53%, P .001). No differences related to age groups were found. CONCLUSION: Adherence to certain quality indicators deteriorated during ED treatment of patients with COVID-19 during the first wave of the pandemic. Pressure from high caseloads may have exacerbated this deterioration. A learning effect led to improvement. No differences related to patient age were detected.

OBJETIVO: Definir indicadores de calidad y sus estándares para el proceso asistencial del paciente con COVID-19 en servicios de urgencias hospitalarios (SUH), así como determinar su grado de cumplimiento durante el primer pico pandémico e investigar si existieron diferencias en relación con diferentes factores. METODO: Siguiendo la metodología del Delphi, los autores seleccionaron los indicadores y sus estándares. Posteriormente, se analizó el grado de cumplimiento en la cohorte SIESTA, formada por pacientes COVID-19 de 62 SUH españoles atendidos en marzo y abril de 2020. Se comparó el cumplimiento de los indicadores según la presión asistencial generada por la pandemia en el SUH, el periodo asistencial y el grupo etario. RESULTADOS: Se definieron 14 indicadores. Tres de ellos se cumplieron en 50% de los pacientes. La realización de la reacción en cadena de la polimerasa (PCR) para el SARS-CoV-2 tuvo peor cumplimiento en SUH con alta presión (29% frente a 40%, p 0,001) y durante el periodo tardío (30% frente a 37%, p = 0,04). Durante el periodo tardío, mejoró la medida de saturación de oxígeno (100% frente a 99%, p = 0,035), la realización de electrocardiograma en pacientes tratados con hidroxicloroquina (87% frente a 65%, p 0,001) y la no administración de lopinavir-ritonavir en pacientes con diarrea (79% frente a 53%, p 0,001). No hubo diferencias en relación con el grupo etario. CONCLUSIONES: Durante el primer pico pandémico, diversos aspectos de la calidad de la atención a pacientes COVID-19 en los SUH españoles se vieron deteriorados. La presión asistencial pudo incrementar este deterioro. Hubo un efecto de aprendizaje que condicionó una mejora, pero no se observaron diferencias según la edad de los pacientes.

COVID-19 , COVID-19/epidemiology , COVID-19/therapy , Emergency Service, Hospital , Hospitals , Humans , Hydroxychloroquine , Lopinavir , Ritonavir , SARS-CoV-2
Clínica e Investigación en Arteriosclerosis (English Edition) ; 2022.
Article in English | ScienceDirect | ID: covidwho-2003875
Enfermería Intensiva ; 2022.
Article in Spanish | ScienceDirect | ID: covidwho-1956136
Salud Pública de México ; 64(4):357-366, 2022.
Article in Spanish | Academic Search Complete | ID: covidwho-1934831
Ingeniería y Competitividad ; 24(2):1-14, 2022.
Article in Spanish | Academic Search Complete | ID: covidwho-1924911
Article in English | Academic Search Complete | ID: covidwho-1904035
Revista Internacional del Trabajo ; n/a(n/a), 2022.
Article in Spanish | Wiley | ID: covidwho-1883203
Biomedica ; 42(2):1-23, 2022.
Article in English, Spanish | Scopus | ID: covidwho-1791915
International Social Security Review ; 75(1):31-50, 2022.
Article in English | ProQuest Central | ID: covidwho-1741411
Cirugía Española (English Edition) ; 2022.
Article in English | ScienceDirect | ID: covidwho-1703329
Revista UNISCI ; (56)2021.
Article in English | ProQuest Central | ID: covidwho-1567683
Revista UNISCI ; (56)2021.
Article in English | ProQuest Central | ID: covidwho-1567675
Revista UNISCI ; (56)2021.
Article in English | ProQuest Central | ID: covidwho-1567669
Revista UNISCI ; (56)2021.
Article in English | ProQuest Central | ID: covidwho-1567585
Revista UNISCI ; (56)2021.
Article in English | ProQuest Central | ID: covidwho-1567562
Gac Sanit ; 36(2): 184-187, 2022.
Article in English | MEDLINE | ID: covidwho-1085557


The invariable governmental approach to the impact of the COVID-19 pandemic has been to effect the White Knight stance of Don Quixote, defending the population from the "Virus Dragon" and dedicating its knight-errantry to the damsel Dulcinea. Though essential, new therapeutics, vaccines, physical distancing, rigorous hygiene standards and efficient health systems are not sufficient to counter the effects of the virus. Individual compliance to public health guidelines also matters, while remaining similarly insufficient to diminish the threat. Earthier, citizen-led, community participation strategies, however, lead to innovative, tailored solutions that better fulfil the needs of diverse neighbourhoods and assures greater virus resistance and increase in population health compared to a top-down, knightly approach or isolated individual efforts. The challenge of COVID-19 offers communities a moment to build more resilient, antifragile communities that not only survive the current crisis, but that thrive after it, and that are better equipped for the next challenge. This is not the time for the singular heroics of the White Knight, or the antics of Don Quixote, tilting at windmills. It is the time of Sancho Panza, which is to say of regular non-credentialed citizens, and their collective efforts, who up to now have largely been considered pawns in this contest. Asset-based community development (ABCD) rejects both the individual as an island and the institutional, knightly emphasis on assessing needs and deficits within communities. It favours identifying and mobilising available and latent assets within a community to forge closer connections among all people, the better to collectivise problem-solving efforts. Community-driven initiatives are assisted in this by localised not-for-profit agencies that practice subsidiarity.

COVID-19 , Pandemics , COVID-19/epidemiology , COVID-19/prevention & control , Community Participation , Government Programs , Humans , Pandemics/prevention & control , Public Health
Reumatol Clin (Engl Ed) ; 17(5): 284-289, 2021 May.
Article in English, Spanish | MEDLINE | ID: covidwho-997480


Ultrasound is a widely implemented imaging modality in rheumatology practice that implies a great interaction between patient and professional. The COVID-19 pandemic requires a change in our clinical practice, through the adoption of new strategies that allow comprehensive care for our patients, guaranteeing the safety of both patients and healthcare professionals. OBJETIVE: Our objective was to develop practical recommendations, agreed among a panel of experts, on the use and safety of rheumatological ultrasound during the COVID-19 pandemic. METHODS: We performed a narrative review of the available literature. Based on the literature review, we produced preliminary recommendations that were subsequently agreed among a panel of experts using the Delphi methodology with a 1-5 Likert scale. Agreement for each recommendation was considered if 75% of the panel members scored the item ≥4 on the Likert scale. RESULTS: 5 overarching principles and 28 recommendations were issued and agreed among the panel. Group consensus was achieved in 100% of items. CONCLUSIONS: The document provides useful information about preventive measures in the practice of ultrasound in rheumatology in times of a COVID-19 pandemic based on the experience and literature available to date.

COVID-19/prevention & control , Infection Control/standards , Pandemics , Rheumatology/methods , Ultrasonography , COVID-19/transmission , Disinfection/methods , Disinfection/standards , Equipment Contamination/prevention & control , Gels , Humans , Infection Control/methods , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Microscopic Angioscopy/instrumentation , Microscopic Angioscopy/methods , Oils , Personal Protective Equipment , Rheumatic Diseases/diagnostic imaging , SARS-CoV-2 , Ultrasonography/instrumentation , Ultrasonography/methods