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1.
Nurs Leadersh (Tor Ont) ; 34(1): 30-37, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1175768

ABSTRACT

In the field of digital health research, nurse leaders have an opportunity to be integral to the design, implementation and evaluation of virtual care interventions. This case study details the experiences of two emerging nurse leaders during the COVID-19 pandemic in providing research and clinical leadership for a national virtual health trial. These nurse leaders trained and led a national team of 70 nurses across eight participating centres delivering the virtual care and remote monitoring intervention, using the normalization process theory. This case study presents a theoretically informed approach to training and leadership and discusses the experiences and lessons learned.


Subject(s)
Aftercare/trends , Leadership , Monitoring, Ambulatory/methods , Nurse-Patient Relations , Patient Discharge/standards , Remote Consultation/instrumentation , COVID-19/epidemiology , Canada/epidemiology , Computers, Handheld/supply & distribution , Humans , Pandemics , Randomized Controlled Trials as Topic , SARS-CoV-2 , Surgical Procedures, Operative
2.
CMAJ Open ; 9(1): E142-E148, 2021.
Article in English | MEDLINE | ID: covidwho-1115548

ABSTRACT

BACKGROUND: After nonelective (i.e., semiurgent, urgent and emergent) surgeries, patients discharged from hospitals are at risk of readmissions, emergency department visits or death. During the coronavirus disease 2019 (COVID-19) pandemic, we are undertaking the Post Discharge after Surgery Virtual Care with Remote Automated Monitoring Technology (PVC-RAM) trial to determine if virtual care with remote automated monitoring (RAM) compared with standard care will increase the number of days adult patients remain alive at home after being discharged following nonelective surgery. METHODS: We are conducting a randomized controlled trial in which 900 adults who are being discharged after nonelective surgery from 8 Canadian hospitals are randomly assigned to receive virtual care with RAM or standard care. Outcome adjudicators are masked to group allocations. Patients in the experimental group learn how to use the study's tablet computer and RAM technology, which will measure their vital signs. For 30 days, patients take daily biophysical measurements and complete a recovery survey. Patients interact with nurses via the cellular modem-enabled tablet, who escalate care to preassigned and available physicians if RAM measurements exceed predetermined thresholds, patients report symptoms, a medication error is identified or the nurses have concerns they cannot resolve. The primary outcome is number of days alive at home during the 30 days after randomization. INTERPRETATION: This trial will inform management of patients after discharge following surgery in the COVID-19 pandemic and offer insights for management of patients who undergo nonelective surgery in a nonpandemic setting. Knowledge dissemination will be supported through an online multimedia resource centre, policy briefs, presentations, peer-reviewed journal publications and media engagement. TRIAL REGISTRATION: ClinicalTrials.gov, no. NCT04344665.


Subject(s)
Aftercare/trends , Monitoring, Ambulatory/methods , Patient Discharge/standards , Remote Consultation/instrumentation , Adult , COVID-19/diagnosis , COVID-19/epidemiology , Canada/epidemiology , Computers, Handheld/supply & distribution , Humans , Middle Aged , Postoperative Period , SARS-CoV-2/genetics , User-Computer Interface
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