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1.
New Zealand Medical Journal ; 133(1520):91-98, 2020.
Article in English | EMBASE | ID: covidwho-2207322

ABSTRACT

Coronavirus disease 2019 (COVID-19) has rapidly spread across the globe, driving radical transformation in the way patient care is delivered in primary and secondary care. As part of the response against COVID-19 across primary care in New Zealand, practices and medical centres have largely transitioned to telehealth over a short period of time while maintaining the traditional business model of in-person care on an as-required basis. To inform other primary care services and future practice, we describe our experience at one general practice and the challenges faced in the process of converting to telehealth in the midst of the COVID-19 pandemic. Copyright © NZMA.

2.
Loss and grief: Personal stories of doctors and other healthcare professionals ; : xv, 231, 2023.
Article in English | APA PsycInfo | ID: covidwho-2212838

ABSTRACT

This collection of personal narratives is just that: stories intended to chronicle the journeys of a small number of health clinicians and other professionals who have been struck by personal illness and/or loss. What these stories do not assume is that there are answers to the universal experiences of loss and grief, courage, and survival implicit in the telling. While the past is gone, the meaning of it, however, is forever in flux, forever being worked and reworked in our conscious and unconscious minds. Each memory is a redoing of what it represents and brings forth within our sense of ourselves and in our relationships with one another. Grief challenges us physically, emotionally, and psychologically to recast the loss again and again. And, in recasting the past and the passage of time, refashioning memory to meet the needs of the moment in which the lost object and our response to it either helps us to move forward in our life or keeps us stuck, unable to engage with a future that requires acceptance of giving up the life lived before. The COVID pandemic further highlighted the internalization of expectations. Drilled into us in training is the "prime directive", the ethical responsibility of patient care and that one should deal with personal things on one's one time. The stories written in this collection were a draft perhaps unending versions telling of the experience. Some stories were written in one setting, others over many weeks or months as the writer lost and regained footing along the tale's trail. The shame, the sadness and weeping, the anger and guilt, and the shame of feeling relief of the pain and suffering for ourselves or those we love(d) and the "weakness" of not being able to manage it all echo through these stories. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

3.
Journal of the American College of Cardiology ; 81(1):97-99, 2023.
Article in English | EMBASE | ID: covidwho-2210568
4.
BJGP Open ; 2022 Nov 29.
Article in English | MEDLINE | ID: covidwho-2201018

ABSTRACT

BACKGROUND: Changes in primary care provision during the COVID-19 pandemic could have affected patient experience of primary care both positively and negatively. AIM: To assess the experiences of patients in primary care during the COVID-19 pandemic. DESIGN & SETTING: A qualitative study of patients from regions with high and low COVID-19 prevalence in the Netherlands. METHOD: A qualitative study using a phenomenological framework was performed among purposively sampled patients. Individual semi-structured interviews were performed and transcribed. Data were thematically analysed by means of an inductive approach. RESULTS: Twenty-eight patients were interviewed (13 men and 15 women, aged 27-91 years). After thematic analysis, two main themes emerged: accessibility and continuity of primary care. Changes considered positive during the pandemic regarding accessibility and continuity of primary care included having a quieter practice, having more time for consultations, and the use of remote care for problems with low complexity. However, patients also experienced decreases in both care accessibility and continuity, such as feeling unwelcome, the GP postponing chronic care, seeing unfamiliar doctors, and care being segregated. CONCLUSION: Despite bringing several benefits, patients indicated that the changes to primary care provision during the COVID-19 pandemic could have threatened care accessibility and continuity, which are core values of primary care. These insights can guide primary care provision not only in this and future pandemics, but also when implementing permanent changes to care provision in primary care.

5.
Archives of Academic Emergency Medicine ; 11(1) (no pagination), 2023.
Article in English | EMBASE | ID: covidwho-2205014

ABSTRACT

Introduction: Provision of pre-hospital care by emergency medical services (EMS) requires paying attention to self-care and patient care against possible infections. The present study was conducted with the aim of determining the level of self-care and patient care against COVID-19. Method(s): The present correlational, descriptive, analytical study was carried out on 301 EMS personnel in Iran. Data were collected using a demographic information form and questionnaires made by the researcher on the level of self-care and patient care against COVID-19. Result(s): The results showed that more than half of the participants (55%) were aged 27 to 34 years. Themajority of the participants had an experience of participating in self-care (88.7%) and patient care (83.7%) training courses against COVID-19. The overall score of self-care was 55.96 +/- 6.97 out of 72 and that of patient care was 26.86+/- 3.39 out of 32, both of which revealed a favorable level. However, in some questions, the mean score was lower than the optimal level. The lowest mean score among items related to self-care against COVID-19 was allocated to wearing protective clothing (1.77+/-1.19). Among items related to patient care against COVID-19, the lowest mean score was related to training the patient about hand hygine after touching contaminated equipment (2.83+/-1.08 out of 4). There was a positive (r=0.491) and significant correlation between self-care and patient care against COVID-19 (p=0.001) based on our findings. Conclusion(s): Although the general level of selfcare and patient care against COVID-19 was favorable, due to the undesired level of some domains, it seems necessary to implement corrective planning through periodical training and monitoring the performance of the personnel. Copyright © 2023,Archives of Academic Emergency Medicine.All Rights Reserved.

6.
British Journal of Neuroscience Nursing ; 18(6):274-276, 2022.
Article in English | CINAHL | ID: covidwho-2203780

ABSTRACT

As 2022 draws to a close, the NHS has never been in a more fragile condition. As a result of the COVID-19 pandemic and, more recently, inflation and the cost-of-living crisis, the NHS is under some of the most significant pressures in its history. But how do these pressures impact on neurology services? Sue Thomas explores the main issues causing the NHS crisis and delves into how neurology services need to respond.

7.
JNCCN Journal of the National Comprehensive Cancer Network ; 20(12):1279, 2022.
Article in English | EMBASE | ID: covidwho-2203002
8.
Journal of Turkish Sleep Medicine ; 8(1):1-6, 2021.
Article in Turkish | EMBASE | ID: covidwho-2202236

ABSTRACT

This meta-analysis study aimed to determine the sleep quality of medical staff during the Coronavirus disease-2019 (COVID-19) pandemic. A literature search without date limitation was conducted using databases of Science Direct, Google Scholar, PubMed, Clinical Key, Scopus and Web of Science. ''Coronavirus'', ''Pittsburgh sleep quality'', ''medical staff' and ''COVID-19'' were used as keywords. Subsequently, four articles published from 1 January 2020 to 14 June 2020 and meeting the inclusion criteria, were included in this study. The random effects model was used for meta-analysis of continuous and binary variables. The AXIS assessment tool was used for evaluating the quality of publication bias. The total sample size of the four studies was 2.030. Among the participants, 77.9% were women and 22.1% were men. The Pittsburgh Sleep Quality index total score of the medical staff working during the OVID-19 pandemic was 7.55 [(95% confidence interval (CI) 6.024-9.073), z=9.76, p<0.001]. The sleep quality of the medical staff who were in contact with patients with COVID-19 was 2.57 (odds ratio 2.57, 95% CI 1.58-4.18, z=3.82, p<0.001) times worse than those of medical staff without patient contact. This study found that the medical staff working during the COVID-19 pandemic had poor sleep quality. Specifically, medical staff giving treatment and taking care of patients with COVID-19 had lower sleep quality. We suggest providing psychological support to medical staff in charge of the treatment and care of patients with COVID-19. Copyright © Telif Hakki 2021 Turk Uyku Tibbi Dernegi/Turk Uyku Tibbi Dergisi, Galenos Yayinevi tarafindan yayinlanmistir

9.
International Journal of Environmental Research and Public Health ; 19(23) (no pagination), 2022.
Article in English | EMBASE | ID: covidwho-2200242
10.
Pharmaceutical Journal ; 309(7966), 2022.
Article in English | EMBASE | ID: covidwho-2196685
11.
Pharmaceutical Journal ; 309(7965), 2022.
Article in English | EMBASE | ID: covidwho-2196674
12.
Journal of Oncology Pharmacy Practice ; 2022.
Article in English | EMBASE | ID: covidwho-2195108

ABSTRACT

Objective: Off-protocol prescribing of systemic anti-cancer therapy (SACT) can lead to concerns about effectiveness of patient care. To identify variations in practice, a toolkit was developed for health services to address patient safety and the risk of sub-optimal outcomes for patients. Data sources: Following significant incidents with SACT in South Australia and New South Wales, the Department of Health and Human Services, Victoria (the department) conducted an assessment of Victorian public health services to understand current practice regarding SACT protocol governance. A literature review examining SACT auditing was also undertaken to guide improvements. A department supported Chemotherapy Audit Toolkit (CAT) was created for implementation at public hospitals in Victoria. A post-implementation survey was done on uptake and issue identification. Data summary: An initial assessment showed that 27% of Victorian public health services were undertaking retrospective review of SACT dosing, which was targeted for improvement. The literature review identified little guidance, however an audit of current sector practices found several audit methodologies. A process that involved audits by health services assessing their own practice was adopted. The toolkit was developed and piloted with health services. A post-implementation survey showed that 20% of services were using the toolkit, 35% were implementing the toolkit and 45% did not use the toolkit. Conclusion(s): The VicTAG CAT has been adopted by more than half of Victorian public health services and is being used to influence prescribing. Implementation of the toolkit has been affected by resource reallocation due to the COVID-19 pandemic. The CAT is available online. Copyright © The Author(s) 2022.

13.
Pediatric Critical Care Medicine Conference: 11th Congress of the World Federation of Pediatric Intensive and Critical Care Societies, WFPICCS ; 23(11 Supplement 1), 2022.
Article in English | EMBASE | ID: covidwho-2190779

ABSTRACT

BACKGROUND AND AIM: Tell me and I will forget, show me and I may remember;involve me and I will understand Confucius Simulation training is well established in improving patient care by learning from mistakes in a safe environment. During COVID pandemic, lot of junior doctor workforce were redeployed and having not worked in paediatrics was a cause of concern and need of the hour. METHOD(S): We formulated a team of enthusiastic, passionate and dedicated registrars and identified the barriers to setting up simulation for the first time in Leicester children hospital targeting specifically junior doctors. 1. Social distancing whilst working in a team. 2. Accessibility for time out from busy workload on the wards. 3. Being put on spot fear when already stressed with workload. RESULT(S): We took the support of college tutors, Senior Consultant and Nursing team to developed robust structured pathway for simulation scenarios and how to conduct them so that learning needs are achieved. This enabled registrars let the junior doctors to attend and adapt into existing teaching rota as a simulation session. We rotated to different wards and different day of the week to cover wide range of junior doctors and kept the scenarios specific for their workplace which in turn made them more relaxed and interested. CONCLUSION(S): Simulation is a great learning tool and be able to share experience and knowledge in difficult time of pandemic was a challenging but achievable. We learned and adapted changes from each simulation as coordinators which helped in running the subsequent sessions better.

14.
Open Forum Infectious Diseases ; 9(Supplement 2):S919, 2022.
Article in English | EMBASE | ID: covidwho-2190034

ABSTRACT

Background. Antibiotic treatment of asymptomatic bacteriuria (ASB) is unnecessary except in pregnant women or those undergoing invasive urologic procedures. Unnecessary treatment of ASB is an important driver of inappropriate antimicrobial use (IAU), leading to antimicrobial resistance, Clostridioides difficile infection, adverse drug events, and increased costs. Because ASB requires detection to be treated, unnecessary urine cultures (UC) are a key cause of IAU. Strong evidence supports not obtaining a UC from asymptomatic patients. Methods. To reduce unnecessary UC orders at the Minneapolis Veterans Affairs Health Care System (MVAHCS), UC orders within the electronic health record (EHR) were redirected to a UC clinical decision support (CDS) menu (Figure 1). Selection of an indication from the defined list is required to place a UC order and provides tracking. UC order data was obtained from the Corporate Data Warehouse (CDW), the VA's data program. Patient bed days were collected from a CDW dashboard developed by the Iowa City Veteran's Affairs Health Care System. Data was visualized using Microsoft Power BITM platform. Results. The UC CDS menu was implemented at the MVAHCS in September 2020. UC orders from 16 months prior to implementation (9/1/2018 - 12/31/2019) was compared to orders 16 months after implementation (9/1/2020 - 12/31/2021). Data from 1/1/2020 - 8/31/2020 was not included due to atypical patient care patterns during the COVID-19 pandemic.4 The monthly number of UC orders after implementation significantly decreased from an average of 765 to 564, a 26.3% reduction (P < .001;2-sided t-test) (Figure 2). The average patient bed days prior to and following implementation was not significantly different (Figure 3). Most UC orders came from the UC CDS menu (8103, 89.8%) compared to orders placed from other order menus or directly from the drug file (920, 10.2%). The most common indication selected was dysuria, frequency, and urgency (4050, 44.9%) followed by fever or sepsis (1230, 13.6%) then pre-operative urologic screening (1056, 11.7%) (Figure 4). Conclusion. Implementation of a UC CDS menu within the MVAHCS EHR resulted in significantly fewer UC orders. Most UC orders had an appropriate indication suggesting the decrease was primarily due to preventing unnecessary UC orders. (Figure Presented).

15.
British Journal of Surgery ; 109(Supplement 9):ix35-ix36, 2022.
Article in English | EMBASE | ID: covidwho-2188331

ABSTRACT

Background: Good quality of operation notes are essential for good post-operative care, patient safety and medico-legal issues. RCSEng have guidelines on items that should be included in all operation notes. RCSEng Guidelines state: Ensure that there are clear (preferably typed) operative notes for every procedure. The notes should accompany the patient into recovery and to the ward and should give sufficient detail to enable continuity of care by another doctor. We re-audited the quality of operation notes in general surgery. Method(s): We re-audited and compared the results with the first cycle. Four months (1st August to 30th November 2021) period of consecutive operation notes were reviewed. Operation notes for endoscopy were excluded. Operations notes were analysed for documentation of the items as per RCSEng guidelines. There were less operations post COVID-19, hence longer study period. After first cycle, departmental presentation given for education and posters displayed in theatres as reminder. Initial plan for 2nd cycle in 2020 but it was not possible due to COVID-19. Problems/complications, extra procedures and prosthesis used were not included. Additional criteria reviewed was: Type of anaesthetic, patient position, indication for procedure and ASA grade. Result(s): A total of 239 operation notes were identified. 169 emergency and 70 elective cases. 193 were handwritten and 46 were typed.The results were compared to the first cycle: Conclusion(s): Higher proportion was ofemergency procedures during the 2nd cycle. Also, higher proportion of handwritten notes during 2nd cycle. There was improvement in documenting elective/emergency, time, type of anaesthesia, indication, position, operative findings/diagnosis, details of tissue removed/added/altered, blood loss, antibiotics, DVT prophylaxis. However, there was poorer documentation of date, name of assistant, incision, closure, signature remains. Ongoing education of the surgeons is vital to improve the quality of the operation notes. We suggest addition of further headings on the current op-note as aid-memoire and introduction of digital operation notes.

16.
Seminars in Interventional Radiology ; 39(5):523-525, 2022.
Article in English | EMBASE | ID: covidwho-2186428

ABSTRACT

The SARS-COV-2/ COVID-19 pandemic created unique, once in a lifetime challenges for healthcare workers across the globe. One of the challenges specific to interventional radiology was the increased incidence of vascular thrombosis leading to urgent and emergent clinical patient management issues. Limited healthcare resources and complex clinical presentations required innovative solutions, and workflows to manage the increased burden on the healthcare providers. Copyright © 2022 Thieme Medical Publishers, Inc.. All rights reserved.

17.
Gesundheitsokonomie und Qualitatsmanagement ; 27(6):326-330, 2022.
Article in German | EMBASE | ID: covidwho-2186316

ABSTRACT

Guidelines are a key tool in the dissemination of new research findings for patient treatment. They are structured to support the best possible evidence-based care. For the management of a new disease such as COVID-19, for which there was initially no established care practice, the rapid development of up-to-date guidelines was essential. In view of intensive worldwide research, a great deal of new knowledge has been generated in a short time. At the same time, a large number of patients required acute care. The wealth of new knowledge thus had to be transferred very quickly into practice at a time when medical staff were already heavily burdened by the high demand for care. Furthermore, the preparation of guidelines is time-consuming and costly. For this reason, the Network University Medicine (NUM), a research association of 36 German university hospitals, has developed approaches in the CEOsys project to significantly accelerate the transfer of new findings from COVID-19 research into patient treatment. The platforms required for this must now be consolidated in order to permanently improve pandemic preparedness in Germany. Copyright © 2022 Georg Thieme Verlag. All rights reserved.

18.
The Lancet ; 400(10353):654-655, 2022.
Article in English | EMBASE | ID: covidwho-2184631
19.
Neuromodulation ; 25(7 Supplement):S364, 2022.
Article in English | EMBASE | ID: covidwho-2181842

ABSTRACT

Introduction: About 20.4% of US adults suffer from chronic pain and need consistent management plans which were disrupted in 2020 with the COVID-19 pandemic.1,2,3 Patients who use programmable neuromodulation devices to treat chronic pain typically require follow-up visits to address changes in symptoms. An FDA-approved teleprogramming platform enables real-time remote programming via mobile devices for movement disorder and chronic pain patients who use neuromodulation devices. The platform eases the burden travel imposed on many patients, allowing physicians to quickly resolve patient symptoms. The Remote Optimization, Adjustment, and Measurement for Chronic Pain Therapy (ROAM-CPT) study is a post-market, prospective, non-randomized, multi-center investigation to determine that the telehealth system meets patients' therapeutic needs safely and effectively. Materials / Methods: 62 consented subjects across 4 sites, with an implanted neuromodulation device, participating in the REALITY study (NCT03876054) were enrolled in ROAM-CPT and were provided access to the telehealth software. A questionnaire designed for both patient and physician was available after each remote session. The primary success rate was determined by the ability to establish an audio-video connection, complete remote programming or device check, and provide patient clinical care similar to an in-patient session. Additionally, the physicians' and patients' preferences, satisfaction, and reduction in the burden of care compared to in-person sessions were determined. Result(s): 15 patients initiated and completed an audio-video session. All physicians' confirmed services are akin to in-person sessions. During the study, 53.3% of the sessions were complex programming (change in three or more parameters), 26.7% simple programming (change in 1-2 parameter), and 20.0% device interrogation. Overall, all surveyed providers preferred remote care and 93.3% (14/15) of subjects did not require additional clinical care services. Of the 15 subjects across 4 sites, all but 1 reported rapid resolution (reduction in pain), preferred remote care to in-patient, and would recommend a remote session. Patients also reported getting faster appointment time as well as saving travel time and resources typically spent towards an in-person session. Discussion(s): The remote neuromodulation technology provides secure audio-video chat connectivity, programming changes such as amplitude, systems check, and session reports. Physicians easily provide patients care using this platform while patients' therapeutic needs were quickly resolved from the comfort of their homes using their mobile devices. Conclusion(s): Teleprogramming provides real-time programming capabilities and optimizes therapy for patients with neurostimulation devices. Learning Objectives: 1. Teleprogramming provides real-time, safe programming that equals an in-person session. No safety concerns were recorded for all 15 session 2. Virtual clinic affords clinicians the ability to provide quick patient care, does not increase the need for additional follow-up. All 15 participating patients reported resolved therapy needs. 14/15 did not require additional follow-up. 3. Physicians and patients both prefer Virtual clinic 4/4 surveyed physicians and 14/15 surveyed patients preferred virtual clinic. Keywords: Teleprogramming, Neuromodulation, Neurosphere, Virtual clinic, Remote programming, Telehealth Copyright © 2022

20.
Journal of Medical Imaging and Radiation Sciences ; 53(2 Supplement 1):S15-S16, 2022.
Article in English | EMBASE | ID: covidwho-2180793

ABSTRACT

Purpose: Obesity is generally reported as having a significant impact on healthcare practice and systems, although there is also growing recognition that pervasive weight stigma can affect access to healthcare and/or cause negative health effects. Imaging and treating patients with a larger body habitus is one of the many practice considerations for medical radiation science professionals (MRSPs). There are known technical and patient care considerations including size and weight equipment limitations in medical imaging and radiation therapy departments as well as considerations of imaging dose and treatment reproducibility for patients of a larger size. Communication and patient care also needs to be tailored to this patient population. This scoping review sought to answer the question: How has imaging and treating patients with a larger body habitus been defined, classified, and understood in the Medical Radiation Sciences literature? Methods A scoping study is typically carried out to examine the extent, range, and nature of research activity for a specific topic or question. For this study, a scoping review of English language peer-reviewed papers published from 2011 to 2021 was performed using the PRISMA framework. Four independent reviewers with content and methodological expertise selected papers with the initial inclusion criteria: english language, human subjects, obese, bariatric, fat, medical imaging, medical radiation technology, radiation therapy and radiography. An iterative process was utilized that included searching the literature, refining the search strategy, and reviewing articles for study inclusion. Result(s): The initial search identified 8809 articles. The review was carried out with the literature review and screening software 'Covidience'. Of the articles included, preliminary qualitative content analysis revealed three major themes. The majority of papers looked at imaging and/or dose (e.g. radiation exposure, image quality, artifacts and treatment position considerations) as well as equipment and environment (e.g. table load limits, aperture sizes, immobilization devices and positioning). Fewer papers discussed patient care (e.g. communication, perception and attitudes, practitioner bias and the need for appropriate education). Many of the radiography and radiation therapy specific papers were reviews and commentaries rather than research studies and lacked robust evidence. Data analysis is ongoing with a projected completion time of April 2022. Result(s): A growing number of studies about patients with a larger body habitus have been published in the last few years with both practical and patient care implications. Preliminary qualitative content analysis revealed the major themes in the MRSP literature consist of equipment and technical considerations. In addition, it seems likely that further investigation from the patient care perspective would reveal practice insights to inform future research, practice and policy and improve care for this patient population. Copyright © 2022

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