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1.
J Contin Educ Nurs ; 51(9): 402-411, 2020 Sep 01.
Article in English | MEDLINE | ID: covidwho-729674

ABSTRACT

This article provides the most current guidelines for nurse educators and nurses to use systems thinking to manage COVID-19 in health systems. A working definition of systems thinking is offered, with a review of basic knowledge and care in the context of the system awareness model (SAM). Seven key messages assist nurse educators and nurses in the management of COVID-19 patients culminating in leadership of complex health care systems using systems thinking. [J Contin Educ Nurs. 2020;51(9):402-411.].


Subject(s)
Coronavirus Infections/therapy , Critical Care Nursing/education , Critical Care Nursing/standards , Delivery of Health Care/organization & administration , Delivery of Health Care/statistics & numerical data , Health Personnel/education , Pneumonia, Viral/therapy , Practice Guidelines as Topic , Adult , Betacoronavirus , Curriculum , Education, Nursing, Continuing/organization & administration , Female , Humans , Male , Middle Aged , Pandemics , Systems Analysis
2.
J Contin Educ Nurs ; 51(9): 399-401, 2020 Sep 01.
Article in English | MEDLINE | ID: covidwho-729673

ABSTRACT

In light of the COVID-19 pandemic and uncertainties around risk of transmission, urgent hospital resuscitation (also known as "Code Blue") efforts are needed, pivoting to protect health care workers. This article provides teaching tips for "Protected Code Blues." [J Contin Educ Nurs. 2020;51(9):399-401.].


Subject(s)
Cardiopulmonary Resuscitation/education , Cardiopulmonary Resuscitation/nursing , Cardiopulmonary Resuscitation/standards , Coronavirus Infections/nursing , Health Personnel/education , Nursing Staff, Hospital/education , Pneumonia, Viral/nursing , Simulation Training/organization & administration , Adult , Betacoronavirus , Curriculum , Education, Nursing, Continuing/organization & administration , Female , Humans , Male , Middle Aged , Pandemics , Practice Guidelines as Topic
4.
Eur Rev Med Pharmacol Sci ; 24(15): 8202-8209, 2020 08.
Article in English | MEDLINE | ID: covidwho-696823

ABSTRACT

OBJECTIVE: The recent outbreak of SARS-CoV-2 infection in Italy has resulted in a sudden and massive flow of patients into emergency rooms, and a high number of hospitalizations with the need for respiratory isolation. Massive admission of patients to the Policlinico "Agostino Gemelli" Foundation of Rome, Italy, determined the need for reengineering the entire hospital. MATERIALS AND METHODS: In this article, we consider some of the structural and organizational changes that have been necessary to deal with the emergency, with particular reference to non-intensive medicine wards, and the preventive measures aimed at limiting the spread of SARS-CoV-2 infection among hospital staff and patients themselves. RESULTS: 577 staff members were subjected to molecular tests in 1-month period and 3.8% of the total were positive. 636 patients admitted to the COVID-19 pathway were included and analyzed: 45.4% were identified as SARS-CoV-2 positive. More SARS-CoV-2 negative patients were discharged in comparison to SARS-CoV-2 positive patients (59% vs. 41%, respectively). On the other hand, more SARS-CoV-2 positive patients were transferred to ICUs in comparison to SARS-CoV-2 negative patients (16% vs. 1%, respectively). Occurrence of death was similar between the two groups, 11% vs. 7%, for SARS-CoV-2 negative and positive patients, respectively. 25% of ≥80 years old SARS-CoV-2 positive patients died during the hospitalization, while death rate was lower in other age groups (5% in 70-79 years old patients and 0% in remaining age groups). CONCLUSIONS: Rapid hospital reengineering has probably had an impact on the management of patients with and without SARS-CoV-2 infection, and on in-hospital mortality rates over the reporting period.


Subject(s)
Coronavirus Infections/epidemiology , Hospital Units/organization & administration , Infection Control/organization & administration , Personnel Staffing and Scheduling/organization & administration , Pneumonia, Viral/epidemiology , Tertiary Care Centers/organization & administration , Aged , Aged, 80 and over , Betacoronavirus , Coronavirus Infections/therapy , Coronavirus Infections/transmission , Female , Health Personnel/education , Hospital Bed Capacity , Hospitals, Special , Humans , Infection Control/methods , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Intensive Care Units , Italy/epidemiology , Male , Middle Aged , Pandemics , Patient Isolation , Personal Protective Equipment , Pneumonia, Viral/therapy , Pneumonia, Viral/transmission
5.
Medicine (Baltimore) ; 99(29): e21081, 2020 Jul 17.
Article in English | MEDLINE | ID: covidwho-676465

ABSTRACT

The World Health Organization has declared coronavirus disease 2019 (COVID-19) a pandemic. Polymerase chain reaction testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the diagnostic gold standard of COVID-19. We have developed a simulation-based training program for mobile prehospital diagnostic teams in the province of Styria, Austria, and performed a prospective observational study on its applicability and effectivity.The 1-day curriculum uses theoretical instruction, technical skills training, and simulator-based algorithm training to teach and train prehospital patient identification and communication, donning the personal protective equipment, collection of naso-/oropharyngeal swabs for SARS-CoV-2 polymerase chain reaction testing, doffing the personal protective equipment, and sample logistics. Trainings were conducted at the SIM CAMPUS simulation hospital, Eisenerz, using high-fidelity patient simulation. To ensure achievement of predefined learning outcomes, participants had to undergo a final simulator-based objective structured clinical examination.In March 2020, 45 emergency medical assistants and 1 physician of the Austrian Red Cross participated on a voluntary basis. Forty-five of the 46 participants (97.8%) completed the curriculum successfully, with mean objective structured clinical examination ratings of 98.6%.Using several proven educational concepts, we have successfully drafted and implemented a training program for mobile prehospital SARS-CoV-2 diagnostic teams. Based on simulation-based objective structured examinations, it has prepared participants effectively for preclinical duties.


Subject(s)
Betacoronavirus/genetics , Coronavirus Infections/diagnosis , Pneumonia, Viral/diagnosis , Simulation Training/methods , Ambulances/statistics & numerical data , Austria/epidemiology , Betacoronavirus/isolation & purification , Body Fluids/virology , Coronavirus Infections/epidemiology , Curriculum , Female , Health Personnel/education , Humans , Male , Pandemics , Personal Protective Equipment , Pneumonia, Viral/epidemiology , Polymerase Chain Reaction/methods , Polymerase Chain Reaction/standards , Prospective Studies , Specimen Handling/methods
6.
Rev Bras Enferm ; 73Suppl 2(Suppl 2): e20200316, 2020.
Article in English, Portuguese | MEDLINE | ID: covidwho-624891

ABSTRACT

OBJECTIVE: to perform a situational diagnosis of the behavior of health professionals concerning hand hygiene practices in highly-complex sectors. METHODS: this quantitative and retrospective study was based on reports (2016 and 2017) of Adult and Pediatric ICUs of a Federal hospital in Rio de Janeiro. RESULTS: one thousand two hundred fifty-eight opportunities for hand hygiene were analysed. The chance of professionals sanitizing hands in Pediatric ICUs is 41.61% higher than in Adult ICUs. Concerning proper hand hygiene, the medical team had a 39.44% lower chance than the nursing team. Others had a 30.62% lower chance when compared to the nursing team. The moment "after contact with the patient" presented 4.5275 times the chance in relation "before contact with the patient". CONCLUSION: in front of hand hygiene recommendations to control COVID-19, diagnostic assessment and previous analysis of the behavior of professionals proved to be positive.


Subject(s)
Betacoronavirus , Coronavirus Infections/prevention & control , Guideline Adherence/statistics & numerical data , Hand Disinfection/standards , Health Personnel/education , Intensive Care Units/standards , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Practice Guidelines as Topic , Adult , Brazil , Female , Humans , Male , Middle Aged , Retrospective Studies
8.
Rev Bras Enferm ; 73Suppl 2(Suppl 2): e20200303, 2020.
Article in English, Portuguese | MEDLINE | ID: covidwho-626845

ABSTRACT

OBJECTIVE: to discuss the application of Rapid Cycle Deliberate Practice for attire and unattire training in the context of COVID-19 and structure a practical guide to the application at this juncture. METHODS: this methodological study described theoretical and practical aspects of the application of a simulation strategy as a technological training tool. An application guide was constructed from the search for evidence from the main health authority bodies in Brazil. RESULTS: maximizing time in Deliberate Practice, feedback with evidence and psychological security are the principles of this strategy. The dynamic involves repetition and feedback. The application guide presents the sequence of actions for attire and unattire. FINAL CONSIDERATIONS: coping with this pandemic requires appropriate use of personal protective equipment. The authors suggest the Rapid Cycle Deliberate Practice as a technological educational tool for attire/unattire, since it encourages mastery performance.


Subject(s)
Coronavirus Infections/prevention & control , Health Personnel/education , Pandemics/prevention & control , Personal Protective Equipment/standards , Pneumonia, Viral/prevention & control , Practice Guidelines as Topic , Preventive Health Services/standards , Adult , Betacoronavirus , Brazil , Female , Humans , Male , Middle Aged
9.
J Card Surg ; 35(6): 1174-1175, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-614022

ABSTRACT

With the ongoing coronavirus, journals and the media have extensively covered the impacts on doctors, nurses, physician assistants, and other healthcare workers. However, one group that has rarely been mentioned despite being significantly impacted is medical students and medical education overall. This piece, prepared by both a medical student and a cardiothoracic surgeon with a long career in academic medicine, discusses the recent history of medical education and how it has led to issues now with distance-based learning due to COVID-19. It concludes with a call to action for the medical education system to adapt so it can meet the needs of healthcare learners during COVID-19 and even beyond.


Subject(s)
Coronavirus Infections/epidemiology , Education, Distance/methods , Education, Medical, Undergraduate/trends , Educational Measurement , Health Personnel/education , Pneumonia, Viral/epidemiology , Clinical Competence , Curriculum , Education, Medical, Undergraduate/methods , Female , Humans , Male , Pandemics , Students, Medical/statistics & numerical data , United States
10.
J Contin Educ Nurs ; 51(7): 297-299, 2020 Jul 01.
Article in English | MEDLINE | ID: covidwho-612620

ABSTRACT

The COVID-19 pandemic has created the need for rapid development and implementation of nursing continuing professional development (NCPD) to scale up nurses and other health care providers to meet a surge in critically ill patients. Through retooling and upskilling nurses and other health care providers, professional development is more important now than ever before. A heightened need for flexible professional development activity planning that is fully integrated into the professional environment is integral to prepare nurses to meet the challenges posed by this pandemic. This article addresses strategies to facilitate delivery of quality NCPD educational activities in real time. [J Contin Educ Nurs. 2020;51(7):297-299.].


Subject(s)
Betacoronavirus , Coronavirus Infections/diagnosis , Coronavirus Infections/nursing , Curriculum , Education, Nursing, Continuing/organization & administration , Health Personnel/education , Nursing Staff, Hospital/education , Pneumonia, Viral/diagnosis , Pneumonia, Viral/nursing , Adult , Female , Humans , Male , Middle Aged , Pandemics
11.
Farm Hosp ; 44(7): 28-31, 2020 06 12.
Article in English | MEDLINE | ID: covidwho-599562

ABSTRACT

During the pandemic caused by the SARS-CoV-2 virus, pharmacy services have  had to adapt their service portfolio, and yet ensure efficient, equitable and  quality pharmaceutical care. Given the limited scientific evidence available, most drugs have been used off-label or in the context of clinical trials, which should be the preferred option in order to create new evidence. Among kind different  situations we have faced are the increase in workload, the expansion of  coverage to new wards and ICUs and shortages, which have caused the use of  alternative drugs and even other routes of administration. Given that covid-19  affects elderly population with greater severity and many of them are  polymedicated, great effort have been focused on monitoring interactions, both  pharmacokinetic and pharmacodynamic (specially prolongation of the QT  interval), monitoring correct concentrations of electrolytes, nutritional support,  adaptation of chemotherapy treatment protocols and anticoagulant  management, among others. The use of personal protective equipment added  difficulty for nursing work and some measures had been taken to minimize the  number of entries into the rooms. Eventually, team's split to guarantee care, the challenge of teleworking, remote validation, telemedicine and telepharmacy for  communication between professionals and patients, as well as training in this pandemic situation have been a challenge for our profession. These  difficulties have risen up new learning opportunities we hope will be useful to us  in the event we have to face similar situations in the future.


Subject(s)
Betacoronavirus , Coronavirus Infections/drug therapy , Inpatients , Pandemics , Pharmacy Service, Hospital/organization & administration , Pneumonia, Viral/drug therapy , Aftercare , Communication , Comorbidity , Cross Infection/prevention & control , Drug Administration Routes , Drug Interactions , Drug Monitoring , Forecasting , Health Personnel/education , Health Services Needs and Demand , Humans , Infection Control/methods , Infection Control/organization & administration , Off-Label Use , Patient Education as Topic , Patient Safety , Personal Protective Equipment , Pharmacovigilance , Professional-Patient Relations , Telemedicine
12.
J Hosp Infect ; 105(4): 604-607, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-597579

ABSTRACT

In response to coronavirus disease 2019 (COVID-19), a rapid-cycle in-situ simulation (ISS) programme was developed to facilitate identification and resolution of systems-based latent safety threats. The simulation involved a possible COVID-19 case in respiratory failure, using a mannequin modified to aerosolize phosphorescent secretions. Thirty-six individuals participated in five ISS sessions over 6 weeks, and a further 20 individuals observed these sessions. Debriefing identified latent safety threats from four domains: personnel, personal protective equipment, supply/environment and communication. These threats were addressed and resolved in later iterations. Ninety-four percent of participants felt more prepared to care for a potential case of COVID-19 after the ISS.


Subject(s)
Coronavirus Infections/prevention & control , Disaster Planning/organization & administration , Epidemics/prevention & control , Health Personnel/education , Pandemics/prevention & control , Patient Safety/standards , Personal Protective Equipment/standards , Pneumonia, Viral/prevention & control , Simulation Training/organization & administration , Adult , Betacoronavirus , Female , Humans , Male , Middle Aged , Pregnancy
13.
Infez Med ; 28(suppl 1): 111-117, 2020 Jun 01.
Article in English | MEDLINE | ID: covidwho-596614

ABSTRACT

INTRODUCTION: The Personal Protective Equipment (PPE) is essential to avoid the COVID-19 spread to health care workers. Its use can be difficult, posing a high risk of contamination, mainly during doffing, then with the risk of becoming infected. METHODS: We conducted a prospective before-and-after design that used clinical simulation as a research methodology in a clinical simulation center of Colombia. A simulation-based educational intervention with two cases related to COVID-19 was proposed in the emergency room and the intensive care unit. We conducted A workshop for donning and doffing of personal protective equipment (PPE) and a debriefing after the first case. RESULTS: In the pre-test, 100% of participants failed donning and doffing PPE, 98.4% were contaminated, only one-person did not contaminate out of. The mean cognitive load was high (7.43±0.9 points). In the post-test, 100% were successful in donning the PPE and 94.8% in doffing; only 9.8% were contaminated. The mean of the cognitive load was low (4.1±1.4 points), and the performance was high (7.9±1.1). Of the total, 73.8% of participants reported overload in the doffing. The most difficulties were in gown/overall, and N95 mask removal. DISCUSSION: The PPE donning and doffing is critical and may be changed significantly by active training. In responding to the current COVID-19 pandemic in 2020, activities of training in donning and doffing PPE would provide a means of training personnel, reducing the cognitive load and maybe the risk of contamination and infection of health care workers.


Subject(s)
Coronavirus Infections/prevention & control , Health Personnel/psychology , Memory, Short-Term , Occupational Diseases/prevention & control , Pandemics/prevention & control , Personal Protective Equipment , Pneumonia, Viral/prevention & control , Simulation Training , Adult , Containment of Biohazards , Emergency Service, Hospital , Equipment Contamination , Eye Protective Devices , Female , Gloves, Protective , Hand Hygiene , Health Personnel/education , Humans , Infection Control/methods , Intensive Care Units , Male , Masks , Prospective Studies , Protective Clothing , Task Performance and Analysis
14.
Farm Hosp ; 44(7): 28-31, 2020 06 12.
Article in English | MEDLINE | ID: covidwho-595356

ABSTRACT

During the pandemic caused by the SARS-CoV-2 virus, pharmacy services have  had to adapt their service portfolio, and yet ensure efficient, equitable and  quality pharmaceutical care. Given the limited scientific evidence available, most drugs have been used off-label or in the context of clinical trials, which should be the preferred option in order to create new evidence. Among kind different  situations we have faced are the increase in workload, the expansion of  coverage to new wards and ICUs and shortages, which have caused the use of  alternative drugs and even other routes of administration. Given that covid-19  affects elderly population with greater severity and many of them are  polymedicated, great effort have been focused on monitoring interactions, both  pharmacokinetic and pharmacodynamic (specially prolongation of the QT  interval), monitoring correct concentrations of electrolytes, nutritional support,  adaptation of chemotherapy treatment protocols and anticoagulant  management, among others. The use of personal protective equipment added  difficulty for nursing work and some measures had been taken to minimize the  number of entries into the rooms. Eventually, team's split to guarantee care, the challenge of teleworking, remote validation, telemedicine and telepharmacy for  communication between professionals and patients, as well as training in this pandemic situation have been a challenge for our profession. These  difficulties have risen up new learning opportunities we hope will be useful to us  in the event we have to face similar situations in the future.


Subject(s)
Betacoronavirus , Coronavirus Infections/drug therapy , Inpatients , Pandemics , Pharmacy Service, Hospital/organization & administration , Pneumonia, Viral/drug therapy , Aftercare , Communication , Comorbidity , Cross Infection/prevention & control , Drug Administration Routes , Drug Interactions , Drug Monitoring , Forecasting , Health Personnel/education , Health Services Needs and Demand , Humans , Infection Control/methods , Infection Control/organization & administration , Off-Label Use , Patient Education as Topic , Patient Safety , Personal Protective Equipment , Pharmacovigilance , Professional-Patient Relations , Telemedicine
15.
PLoS Negl Trop Dis ; 14(6): e0008305, 2020 06.
Article in English | MEDLINE | ID: covidwho-592006

ABSTRACT

BACKGROUND: The dengue virus is endemic in many low- and middle-income countries. In Burkina Faso, the proportion of fevers that could be due to dengue is growing. In 2013, a dengue epidemic spread there, followed by other seasonal outbreaks. Dengue is often confused with malaria, and health workers are not trained to distinguish between them. Three training videos using different narrative genres were tested with nursing students from two institutions in Ouagadougou: journalistic, dramatic and animated video. The study aimed to determine if video is an effective knowledge transfer tool, if narrative genre plays a role in knowledge acquisition, and which narrative elements are the most appreciated. METHODOLOGY: A mixed method research design was used. The relative effectiveness of the videos was verified through a quasi-experimental quantitative component with a comparison group and post-test measurements. A qualitative component identified participants' perceptions regarding the three videos. Data were drawn from a knowledge test (n = 482), three focus groups with health professionals' students (n = 46), and individual interviews with health professionals (n = 10). Descriptive statistics and single-factor variance analysis were produced. A thematic analysis was used to analyse qualitative data. PRINCIPAL FINDINGS: Results showed that all three videos led to significant rates of knowledge improvement when compared with the comparison group (p <0.05): 12.31% for the journalistic video, 20.58% for the dramatic video, and 18.91% for the animated video. The dramatic and animated videos produced a significantly higher increase in knowledge than did the journalistic video (with respectively 8.27% (p = 0.003) and 6.59% (p = 0.029) and can be considered equivalent with a difference of 1.68% (p = 0.895). Thematic analysis also revealed that these two videos were considered to be better knowledge transfer tools. Four key aspects are important to consider for a video to be effective: 1) transmitting information in a narrative form, 2) choosing good communicators, 3) creating a visual instrument that reinforces the message and 4) adapting the message to the local context. CONCLUSIONS: Video has proven to be an effective and appreciated knowledge transfer and training tool for health professionals, but the narrative genre of the videos can influence knowledge acquisition. The production of other videos should be considered for training or updating health professionals and their narrative genre taken into consideration. The actual context of constant circulation of new diseases, such as COVID-19, reaffirms the need to train health professionals.


Subject(s)
Audiovisual Aids , Health Personnel/education , Narration , Burkina Faso , Dengue/diagnosis , Diagnostic Errors/prevention & control , Focus Groups , Humans , Information Dissemination/methods , Inservice Training , Knowledge
16.
In Vivo ; 34(3 Suppl): 1675-1680, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-542896

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) is now a global pandemic. It is unclear to radiotherapy practitioners how to carry out radiotherapy during the epidemic. PATIENTS AND METHODS: After the outbreak of COVID-19, our Institute established measures for the prevention and control of COVID-19, and continues to treat patients according to these measures. The Radiotherapy Department has been divided into a clean zone and a semi-contaminated zone, and corresponding personal protective equipment is used in these zones. The temperature of patients and their escorts, and history of fever are assessed daily. Special procedures are performed during radiotherapy setup and intracavitary brachytherapy. RESULTS: Over a period of 2 months, 655 patients were treated in the Department. Sixteen patients with fever were identified and no patient undergoing radiotherapy or medical staff have been infected with COVID-19. CONCLUSION: Our protective measures were found to be effective and can be used as a reference in places where COVID-19 situations are not markedly serious.


Subject(s)
Coronavirus Infections/prevention & control , Infection Control/methods , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Radiology Department, Hospital/organization & administration , Radiotherapy/methods , Adult , Beijing , Child , Clinical Laboratory Techniques/methods , Containment of Biohazards/methods , Coronavirus Infections/diagnosis , Coronavirus Infections/transmission , Disinfection , Equipment Contamination/prevention & control , Fever/etiology , Health Personnel/education , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Neoplasms/radiotherapy , Pneumonia, Viral/diagnosis , Pneumonia, Viral/transmission , Procedures and Techniques Utilization , Protective Devices , Symptom Assessment , Thermometry
20.
J Contin Educ Nurs ; 51(6): 250-252, 2020 Jun 01.
Article in English | MEDLINE | ID: covidwho-401601

ABSTRACT

Crisis breeds innovation and creativity. The COVID-19 pandemic shows where policy-related gaps exist. Three policy exemplars linked to COVID-related changes faced by professional development educators and leaders are presented: broadband Internet availability for training and development, information technology infrastructure, and scope of practice expansion. [J Contin Educ Nurs. 2020;51(6):250-252.].


Subject(s)
Betacoronavirus , Coronavirus Infections , Education, Nursing, Continuing/organization & administration , Health Personnel/education , Pandemics , Pneumonia, Viral , Public Policy , Staff Development/organization & administration , Adult , Curriculum , Female , Humans , Leadership , Male , Middle Aged
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