Nursing work environments during covid-19: contributions to develop a technological tool / Ambientes de trabalho de enfermagem durante a covid-19: contribuições para desenvolver uma ferramenta tecnológica / Ambientes de trabajo de enfermería durante covid-19: contribuciones para desarrollar una herramienta tecnológica

Objetivo: avaliar o impacto da COVID-19 nos ambientes de trabalho de enfermagem e desenvolver uma ferramenta tecnológica para avaliar sistematicamente a qualificação desses contextos. Método: pesquisa de método misto realizada em seis hospitais portugueses, com participação de 442 enfermeiros. Utilizou-se um questionário com caracterização sociodemográfica e profissional, a Scale for the Environments Evaluation of Professional Nursing Practice e questões abertas. Resultados: a COVID-19 teve impacto negativo nos componentes Estrutura (ƿ<0,001), Processo (ƿ<0,001) e Resultado (ƿ=0,009) dos ambientes de trabalho de enfermagem. A monitorização da qualidade dos ambientes de trabalho foi apontada como uma estratégia de melhoria. A ferramenta tecnológica desenvolvida permite identificar precocemente as dimensões mais fragilizadas e priorizar melhorias. Conclusão: a COVID-19 repercutiu negativamente nos ambientes de trabalho. A ferramenta tecnológica construída, que tornou mais dinâmica a avaliação dos ambientes de trabalho, além de garantir o envolvimento dos enfermeiros, constitui uma importante ferramenta de gestão.

Objetivo: evaluar el impacto de COVID-19 en los entornos de trabajo de enfermería y desarrollar una herramienta tecnológica para evaluar sistemáticamente la calificación de estos contextos. Método: investigación de método mixto realizada en seis hospitales portugueses, con participación de 442 enfermeros. Se utilizó un cuestionario con caracterización sociodemográfica y profesional, la Scale for the Environments Evaluation of Professional Nursing Practice y cuestiones abiertas. Resultados: La COVID-19 tuvo impacto negativo en los componentes Estructura (ƿ<0,001), Proceso (ƿ<0,001) y Resultado (ƿ=0,009) de los ambientes de trabajo de enfermería. La monitorización de la calidad de los entornos de trabajo fue apuntada como una estrategia de mejora. La herramienta tecnológica desarrollada permite identificar precozmente las dimensiones más fragilizadas y priorizar mejoras. Conclusión: COVID-19 tuvo un impacto negativo en los entornos de trabajo. La herramienta tecnológica construida, que hizo más dinámica la evaluación de los ambientes de trabajo, además de garantizar la participación de los enfermeros, constituye una importante herramienta de gestión.

Objective: to evaluate the impact of COVID-19 on nursing work environments and to develop a technological tool to assess systematically the qualification of these contexts. Method: mixed method research conducted in six Portuguese hospitals, with the participation of 442 nurses. The questionnaire used contained sociodemographic and professional characterization, which was the Scale for the Environments Evaluation of Professional Nursing Practice and open questions. Results: COVID-19 had a negative impact on the components Structure (ƿ<0,001), Process (ƿ<0,001) and Result (ƿ=0,009) of nursing work environments. The monitoring of the quality of the work environments was pointed out as an improvement strategy. The technological tool developed allows identifying the most fragile dimensions early and prioritizing improvements. Final considerations: COVID-19 had a negative impact on work environments. The technological tool built, which made the evaluation of work environments more dynamic, in addition to ensuring the involvement of nurses, is an important management tool.

Modeling of network based digital contact tracing and testing strategies, including the pre-exposure notification system, for the COVID-19 pandemic.

With more than 1.7 million COVID-19 deaths, identifying effective measures to prevent COVID-19 is a top priority. We developed a mathematical model to simulate the COVID-19 pandemic with digital contact tracing and testing strategies. The model uses a real-world social network generated from a high-resolution contact data set of 180 students. This model incorporates infectivity variations, test sensitivities, incubation period, and asymptomatic cases. We present a method to extend the weighted temporal social network and present simulations on a network of 5000 students. The purpose of this work is to investigate optimal quarantine rules and testing strategies with digital contact tracing. The results show that the traditional strategy of quarantining direct contacts reduces infections by less than 20% without sufficient testing. Periodic testing every 2 weeks without contact tracing reduces infections by less than 3%. A variety of strategies are discussed including testing second and third degree contacts and the pre-exposure notification system, which acts as a social radar warning users how far they are from COVID-19. The most effective strategy discussed in this work was combining the pre-exposure notification system with testing second and third degree contacts. This strategy reduces infections by 18.3% when 30% of the population uses the app, 45.2% when 50% of the population uses the app, 72.1% when 70% of the population uses the app, and 86.8% when 95% of the population uses the app. When simulating the model on an extended network of 5000 students, the results are similar with the contact tracing app reducing infections by up to 79%.

Consumer Informatics and COVID-19 Pandemics: Challenges and Opportunities for Research.

OBJECTIVE: To summarise the state of the art during the year 2020 in consumer health informatics and education, with a special emphasis on "Managing Pandemics with Health Informatics - Successes and Challenges". METHODS: We conducted a systematic search of articles published in PubMed using a predefined set of queries, which identified 147 potential articles for review. These articles were screened according to topic relevance and 15 were selected for consideration of best paper candidates, which were then presented to a panel of international experts for full paper review and scoring. The top five papers were discussed in a consensus meeting. Three papers received the highest score from the expert panel, and these papers were selected to be representative papers on consumer informatics for managing pandemics in the year 2020. RESULTS: Bibliometrics analysis conducted on words found in abstracts of the candidate papers revealed 4 clusters of articles, where the clustering outcomes explained 77.04% of the dispersion. The first cluster composed of articles related to the use of mobile apps for video consultation and telehealth during the pandemic. The second revealed studies reporting the lived experience of healthcare workers and patients during COVID-19. The third focused on ways people used the internet to seek for health information during the pandemic and the dissemination of fake news. The last cluster composed of articles reporting the use of social listening methods (e.g., via tweet hashtags) to explore the spread of the virus around the world. CONCLUSIONS: The pandemic outbreak of the novel coronavirus disease (COVID-19) constitutes a grave risk to the global community and sparks a significant increase in public interest and media coverage, especially on social media. Consumers are facing a new set of challenges that were not considered before COVID-19, often finding themselves in a world that is constantly changing-blended with facts and fake information-and unable to decide what to do next. Despite most people understanding the good will behind public health policies, one must not forget it is individuals we are supporting and that their personal circumstances may affect how they perceive and comply with these policies. Consumers more than ever need help to make sense of the uncertainty and their situation and we need to help them navigate the best option in a world that is constantly evolving.

Mapping the Role of Digital Health Technologies in Prevention and Control of COVID-19 Pandemic: Review of the Literature.

BACKGROUND: Coronavirus Disease (COVID-19) is currently spreading exponentially around the globe. Various digital health technologies are currently being used as weapons in the fight against the pandemic in different ways by countries. The main objective of this review is to explore the role of digital health technologies in the fight against the COVID-19 pandemic and address the gaps in the use of these technologies for tackling the pandemic. METHODS: We conducted a scoping review guided by the Joanna Briggs Institute guidelines. The articles were searched using electronic databases including MEDLINE (PubMed), Cochrane Library, and Hinari. In addition, Google and Google scholar were searched. Studies that focused on the application of digital health technologies on COVID-19 prevention and control were included in the review. We characterized the distribution of technological applications based on geographical locations, approaches to apply digital health technologies and main findings. The study findings from the existing literature were presented using thematic content analysis. RESULTS: A total of 2,601 potentially relevant studies were generated from the initial search and 22 studies were included in the final review. The review found that telemedicine was used most frequently, followed by electronic health records and other digital technologies such as artificial intelligence, big data, and the internet of things (IoT). Digital health technologies were used in multiple ways in response to the COVID-19 pandemic, including screening and management of patients, methods to minimize exposure, modelling of disease spread, and supporting overworked providers. CONCLUSION: Digital health technologies like telehealth, mHealth, electronic medical records, artificial intelligence, the internet of things, and big data/internet were used in different ways for the prevention and control of the COVID-19 pandemic in different settings using multiple approaches. For more effective deployment of digital health tools in times of pandemics, development of a guiding policy and standard on the development, deployment, and use of digital health tools in response to a pandemic is recommended.

Internet of Things and Robotics in Transforming Current-Day Healthcare Services.

Technology has become an integral part of everyday lives. Recent years have witnessed advancement in technology with a wide range of applications in healthcare. However, the use of the Internet of Things (IoT) and robotics are yet to see substantial growth in terms of its acceptability in healthcare applications. The current study has discussed the role of the aforesaid technology in transforming healthcare services. The study also presented various functionalities of the ideal IoT-aided robotic systems and their importance in healthcare applications. Furthermore, the study focused on the application of the IoT and robotics in providing healthcare services such as rehabilitation, assistive surgery, elderly care, and prosthetics. Recent developments, current status, limitations, and challenges in the aforesaid area have been presented in detail. The study also discusses the role and applications of the aforementioned technology in managing the current pandemic of COVID-19. A comprehensive knowledge has been provided on the prospect of the functionality, application, challenges, and future scope of the IoT-aided robotic system in healthcare services. This will help the future researcher to make an inclusive idea on the use of the said technology in improving the healthcare services in the future.

How to Improve Information Technology to Support Healthcare to Address the COVID-19 Pandemic: an International Survey with Health Informatics Experts.

OBJECTIVES: To identify the ways in which healthcare information and communication technologies can be improved to address the challenges raised by the COVID-19 pandemic. METHODS: The study population included health informatics experts who had been involved with the planning, development and deployment of healthcare information and communication technologies in healthcare settings in response to the challenges presented by the COVID-19 pandemic. Data were collected via an online survey. A non-probability convenience sampling strategy was employed. Data were analyzed with content analysis. RESULTS: A total of 65 participants from 16 countries responded to the conducted survey. The four major themes regarding recommended improvements identified from the content analysis included: improved technology availability, improved interoperability, intuitive user interfaces and adoption of standards of care. Respondents also identified several key healthcare information and communication technologies that can help to provide better healthcare to patients during the COVID-19 pandemic, including telehealth, advanced software, electronic health records, remote work technologies (e.g., remote desktop computer access), and clinical decision support tools. CONCLUSIONS: Our results help to identify several important healthcare information and communication technologies, recommended by health informatics experts, which can help to provide better care to patients during the COVID-19 pandemic. The results also highlight the need for improved interoperability, intuitive user interfaces and advocating the adoption of standards of care.

A Proteome-Wide Immunoinformatics Tool to Accelerate T-Cell Epitope Discovery and Vaccine Design in the Context of Emerging Infectious Diseases: An Ethnicity-Oriented Approach.

Emerging infectious diseases (EIDs) caused by viruses are increasing in frequency, causing a high disease burden and mortality world-wide. The COVID-19 pandemic caused by the novel SARS-like coronavirus (SARS-CoV-2) underscores the need to innovate and accelerate the development of effective vaccination strategies against EIDs. Human leukocyte antigen (HLA) molecules play a central role in the immune system by determining the peptide repertoire displayed to the T-cell compartment. Genetic polymorphisms of the HLA system thus confer a strong variability in vaccine-induced immune responses and may complicate the selection of vaccine candidates, because the distribution and frequencies of HLA alleles are highly variable among different ethnic groups. Herein, we build on the emerging paradigm of rational epitope-based vaccine design, by describing an immunoinformatics tool (Predivac-3.0) for proteome-wide T-cell epitope discovery that accounts for ethnic-level variations in immune responsiveness. Predivac-3.0 implements both CD8+ and CD4+ T-cell epitope predictions based on HLA allele frequencies retrieved from the Allele Frequency Net Database. The tool was thoroughly assessed, proving comparable performances (AUC ~0.9) against four state-of-the-art pan-specific immunoinformatics methods capable of population-level analysis (NetMHCPan-4.0, Pickpocket, PSSMHCPan and SMM), as well as a strong accuracy on proteome-wide T-cell epitope predictions for HIV-specific immune responses in the Japanese population. The utility of the method was investigated for the COVID-19 pandemic, by performing in silico T-cell epitope mapping of the SARS-CoV-2 spike glycoprotein according to the ethnic context of the countries where the ChAdOx1 vaccine is currently initiating phase III clinical trials. Potentially immunodominant CD8+ and CD4+ T-cell epitopes and population coverages were predicted for each population (the Epitope Discovery mode), along with optimized sets of broadly recognized (promiscuous) T-cell epitopes maximizing coverage in the target populations (the Epitope Optimization mode). Population-specific epitope-rich regions (T-cell epitope clusters) were further predicted in protein antigens based on combined criteria of epitope density and population coverage. Overall, we conclude that Predivac-3.0 holds potential to contribute in the understanding of ethnic-level variations of vaccine-induced immune responsiveness and to guide the development of epitope-based next-generation vaccines against emerging pathogens, whose geographic distributions and populations in need of vaccinations are often well-defined for regional epidemics.

How hospitals in mainland China responded to the outbreak of COVID-19 using information technology-enabled services: An analysis of hospital news webpages.

OBJECTIVE: Many countries have implemented quarantine rules during the global outbreak of coronavirus disease 2019 (COVID-19). Understanding how hospitals can continue providing services in an effective manner under these circumstances is thus important. In this study, we investigate how information technology (IT) helped hospitals in mainland China better respond to the outbreak of the pandemic. MATERIALS AND METHODS: We conducted a content analysis of pages published on the websites of the top 50 hospitals in mainland China between January 22 and February 21, 2020. In total, we analyzed 368 pages that the hospitals published during the initial days of the COVID-19 pandemic. The purpose was to identify common themes related to the utilization of IT by these hospitals in response to the pandemic's outbreak. RESULTS: We identified 5 focal themes across the webpages published by the hospitals during our study period, including (1) popular medical science education, (2) digitalized hospital processes, (3) knowledge management for medical professionals, (4) telemedicine, and (5) new IT initiatives for healthcare services. Our analysis revealed that Chinese hospitals spent greater effort in promoting popular medical science education in the initial stages of our study period and more on telemedicine in the latter stages. DISCUSSION: We propose a configurational approach for hospitals to design response strategies to pandemic outbreaks based on their available resources. CONCLUSIONS: Our study provides rich insights for hospitals to better utilize their IT resources and some recommendations for policymaker to better support hospitals in the future.

User reactions to COVID-19 screening chatbots from reputable providers.

OBJECTIVES: The objective was to understand how people respond to coronavirus disease 2019 (COVID-19) screening chatbots. MATERIALS AND METHODS: We conducted an online experiment with 371 participants who viewed a COVID-19 screening session between a hotline agent (chatbot or human) and a user with mild or severe symptoms. RESULTS: The primary factor driving user response to screening hotlines (human or chatbot) is perceptions of the agent's ability. When ability is the same, users view chatbots no differently or more positively than human agents. The primary factor driving perceptions of ability is the user's trust in the hotline provider, with a slight negative bias against chatbots' ability. Asian individuals perceived higher ability and benevolence than did White individuals. CONCLUSIONS: Ensuring that COVID-19 screening chatbots provide high-quality service is critical but not sufficient for widespread adoption. The key is to emphasize the chatbot's ability and assure users that it delivers the same quality as human agents.

Real-time, interactive website for US-county-level COVID-19 event risk assessment.

Large events and gatherings, particularly those taking place indoors, have been linked to multitransmission events that have accelerated the pandemic spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To provide real-time, geolocalized risk information, we developed an interactive online dashboard that estimates the risk that at least one individual with SARS-CoV-2 is present in gatherings of different sizes in the United States. The website combines documented case reports at the county level with ascertainment bias information obtained via population-wide serological surveys to estimate real-time circulating, per-capita infection rates. These rates are updated daily as a means to visualize the risk associated with gatherings, including county maps and state-level plots. The website provides data-driven information to help individuals and policy makers make prudent decisions (for example, increasing mask-wearing compliance and avoiding larger gatherings) that could help control the spread of SARS-CoV-2, particularly in hard-hit regions.

The emerging role of clinical informatics fellows in service learning during the COVID-19 pandemic.

OBJECTIVE: The study sought to describe the contributions of clinical informatics (CI) fellows to their institutions' coronavirus disease 2019 (COVID-19) response. MATERIALS AND METHODS: We designed a survey to capture key domains of health informatics and perceptions regarding fellows' application of their CI skills. We also conducted detailed interviews with select fellows and described their specific projects in a brief case series. RESULTS: Forty-one of the 99 CI fellows responded to our survey. Seventy-five percent agreed that they were "able to apply clinical informatics training and interest to the COVID-19 response." The most common project types were telemedicine (63%), reporting and analytics (49%), and electronic health record builds and governance (32%). Telehealth projects included training providers on existing telehealth tools, building entirely new virtual clinics for video triage of COVID-19 patients, and pioneering workflows and implementation of brand-new emergency department and inpatient video visit types. Analytics projects included reports and dashboards for institutional leadership, as well as developing digital contact tracing tools. For electronic health record builds, fellows directly contributed to note templates with embedded screening and testing guidance, adding COVID-19 tests to order sets, and validating clinical triage workflows. DISCUSSION: Fellows were engaged in projects that span the breadth of the CI specialty and were able to make system-wide contributions in line with their educational milestones. CONCLUSIONS: CI fellows contributed meaningfully and rapidly to their institutions' response to the COVID-19 pandemic.

Unveiling the silent threat among us: leveraging health information technology in the search for asymptomatic COVID 19 healthcare workers.

Assuring the safety of both patients and healthcare workers (HCWs) in hospitals has been the primary focus of every healthcare organization during the COVID 19 pandemic. This article discusses the NIH Clinical Center's interdisciplinary approach to deploying an organizational Asymptomatic Staff Testing System.

Coronavirus disease 2019 (COVID-19) outcomes in HIV/AIDS patients: a systematic review.

OBJECTIVES: The aim of the study was to systematically review current studies reporting on clinical outcomes in people living with HIV (PLHIV) infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS: We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. A comprehensive literature search was conducted in Global Health, SCOPUS, Medline and EMBASE using pertinent key words and Medical Subject Headings (MeSH) terms relating to coronavirus disease 2019 (COVID-19) and HIV. A narrative synthesis was undertaken. Articles are summarized in relevant sections. RESULTS: Two hundred and eighty-five articles were identified after duplicates had been removed. After screening, eight studies were analysed, totalling 70 HIV-infected patients (57 without AIDS and 13 with AIDS). Three themes were identified: (1) controlled HIV infection does not appear to result in poorer COVID-19 outcomes, (2) more data are needed to determine COVID-19 outcomes in patients with AIDS and (3) HIV-infected patients presenting with COVID-19 symptoms should be investigated for superinfections. CONCLUSIONS: Our findings suggest that PLHIV with well-controlled disease are not at risk of poorer COVID-19 disease outcomes than the general population. It is not clear whether those with poorly controlled HIV disease and AIDS have poorer outcomes. Superimposed bacterial pneumonia may be a risk factor for more severe COVID-19 but further research is urgently needed to elucidate whether PLHIV are more at risk than the general population.

Supporting health care workers during the COVID-19 pandemic: Mental health support initiatives and lessons learned from an academic medical center.

The unprecedented COVID-19 pandemic has put a great strain on the physical and mental health of health care workers across the globe. This commentary provides an overview of mental health initiatives implemented at an academic medical center to support health care workers during this challenging time and highlights lessons learned. (PsycInfo Database Record (c) 2020 APA, all rights reserved).