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2.
J Marital Fam Ther ; 47(3): 551-565, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1169822

ABSTRACT

As a response to the COVID-19 global crisis, many in the couple/marital and family therapy (CMFT) professional community quickly met the challenge of providing services to clients via telebehavioral health (TBH) services. As this public health emergency endures, family therapists must continue to engage in TBH practice professionally and ethically. The rapid adoption of TBH with minimal training and experience during this public health emergency can result in crises for both individual therapists as well as for the profession in implementing electronic record-keeping, conducting virtual sessions, and communicating online with various clinical populations. The risk of insufficient training and supervision create a challenge to new and experienced family therapists. This article summarizes the work done by the profession thus far to respond to this public health emergency and presents a roadmap of recommendations for navigating those challenges into the future and offers ideas about how to sustain quality TBH practice.


Subject(s)
Couples Therapy , Family Therapy , Guidelines as Topic , Health Personnel , Mental Health Services , Professional Practice , Telemedicine , Couples Therapy/organization & administration , Couples Therapy/standards , Family Therapy/organization & administration , Family Therapy/standards , Guidelines as Topic/standards , Health Personnel/education , Health Personnel/standards , Humans , Mental Health Services/organization & administration , Mental Health Services/standards , Professional Practice/organization & administration , Professional Practice/standards , Telemedicine/organization & administration , Telemedicine/standards
5.
Postgrad Med J ; 96(1141): 711-717, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-901414

ABSTRACT

Facing an investigation into performance concerns can be one of the most traumatic events in a doctor's career, and badly handled investigations can lead to severe distress. Yet there is no systematic way for National Health Service (NHS) Trusts to record the frequency of investigations, and extremely little data on the long-term outcomes of such action for the doctors. The document-Maintaining High Professional Standards in the Modern NHS (a framework for the initial investigation of concerns about doctors and dentists in the NHS)-should protect doctors from facing unfair or mismanaged performance management procedures, which include conduct, capability and health. Equally, it provides NHS Trusts with a framework that must be adhered to when managing performance concerns regarding doctors. Yet, very few doctors have even heard of it or know about the provisions it contains for their protection, and the implementation of the framework appears to be very variable across NHS Trusts. By empowering all doctors with the knowledge of what performance management procedures exist and how best practice should be implemented, we aim to ensure that they are informed participants in any investigation should it occur.


Subject(s)
Clinical Competence/standards , Physicians , Professional Practice , Professionalism , Work Performance/standards , Humans , Liability, Legal , Medical Errors/legislation & jurisprudence , Medical Errors/prevention & control , Personnel Management/methods , Physicians/psychology , Physicians/standards , Professional Practice/organization & administration , Professional Practice/standards , Professionalism/ethics , Professionalism/legislation & jurisprudence , Professionalism/standards , State Medicine/standards , United Kingdom , Workforce/organization & administration
8.
Ann Biol Clin (Paris) ; 78(3): 269-277, 2020 06 01.
Article in French | MEDLINE | ID: covidwho-608309

ABSTRACT

The SARS-CoV-2 virus is responsible for an epidemic disease called COVID-19, which was initially evidenced in Wuhan, China, and spread very rapidly in China and around the world. In France, the first isolated case seems now to be reported in December 2019, stage 3 of the COVID-19 epidemic was triggered on March 14th, the start of the planned containment exit from May 11th. Healthcare services have faced a large influx of patients who may be beyond their capacity to receive and care, particularly in the Large-East and Ile-de-France regions. Some patients show an evolution of the disease never observed before with other coronaviruses and develop in a few days a very important inflammatory reaction, which can lead to death of patients. A working group of the French Society of Clinical Biology (SFBC) was set up with the objective of providing updated information on the current status of the biological prescriptions (focusing on biochemistry ones) and their evolution during the epidemic, and of analyzing the biological parameters associated with comorbidities and patient evolution in order to link biological results with medical events. The expanded working group covers all sectors of medical biology in France and extends to the French-speaking world: hospital sectors (CHU and CH, Army Training Hospitals) and the private sector opening a field of view on the biological situation in establishments for dependent elderly, social establishments and clinical medical institutions. The purpose of this article is the presentation of this working group and its immediate and future actions.


Subject(s)
Betacoronavirus , Biochemistry/organization & administration , Biomarkers/analysis , Clinical Laboratory Services/organization & administration , Coronavirus Infections/diagnosis , Pneumonia, Viral/diagnosis , Societies, Scientific/organization & administration , Betacoronavirus/isolation & purification , Betacoronavirus/pathogenicity , Biochemistry/standards , Biomarkers/blood , COVID-19 , Clinical Laboratory Services/standards , Community Networks/organization & administration , Community Networks/standards , Community Networks/trends , Coronavirus Infections/blood , Coronavirus Infections/epidemiology , Disease Outbreaks , France/epidemiology , History, 21st Century , Humans , Intersectoral Collaboration , Pandemics , Pneumonia, Viral/blood , Pneumonia, Viral/epidemiology , Professional Practice/organization & administration , Professional Practice/standards , Professional Practice/trends , SARS-CoV-2 , Societies, Scientific/standards , Videoconferencing/organization & administration , Videoconferencing/standards
9.
World J Emerg Surg ; 15(1): 36, 2020 05 24.
Article in English | MEDLINE | ID: covidwho-342959

ABSTRACT

BACKGROUND: COVID-19 pandemic has rapidly spread in Italy in late February 2020. Almost all surgical services have been reorganized, with the aim of maintaining an adequate therapeutic path, especially for surgical emergencies. The knowledge of how surgeons dealing with emergency surgery have reacted to the epidemic in the real life can be useful while drafting clinical recommendations. METHODS: Surgeons from multiple Italian regions were invited answering to an online survey in order to make a snapshot of their current behaviors towards COVID-19-positive patients bearing urgent surgical diseases. Questions about institutional rules and personal approach for patient treatment and to limit epidemic spread were included in a 37-item questionnaire. RESULTS: Seventy-one questionnaires from institutions dealing with emergency surgery were accepted. Participating surgeons were equally subdivided from a geographical point of view, with a large proportion of public (97.2%) and non-academical (91.5%) centers. In 80.3% of cases, the hospitals treated COVID-19 patients; in 69.1% of centers, a change in work plan was necessary, and 33.8% of teams had almost a surgeon infected or in preventive quarantine. The vast majority of surgeons operated only on urgent cases (73.9%), but the number of interventions significantly dropped. Up to 40% of non-traumatic abdominal emergency cases had an unusual delayed treatment. The laparoscopic approach was used in 69.6% of interventions on COVID-19 patients. Strategies to protect health care workers against COVID-19 infection and to identify asymptomatic infected surgeons were suboptimal with respect to the WHO recommendations in 70.4% and 90.2% of centers, respectively. Advanced personal protective equipment for operating room workers was adopted for all surgeries in only 12.7% of centers. DISCUSSION: This survey confirms that the COVID-19 outbreak is dramatically changing the practice of emergency surgery centers in Italy. Despite the reduction in number, urgent cases were on average more challenging owing to diagnostic delay. Recommendations from the International Scientific Societies are frequently not complied concerning the use of laparoscopic approach, the availability of personal protective equipment in the operating rooms, and the testing of both asymptomatic physicians and patients scheduled for surgery. A further evaluation of the short-term results of these attitudes is warranted to modulate international recommendations.


Subject(s)
Coronavirus Infections/prevention & control , Disease Transmission, Infectious/prevention & control , General Surgery/organization & administration , Infection Control/standards , Intensive Care Units/organization & administration , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Professional Practice/standards , Betacoronavirus , COVID-19 , Coronavirus Infections/complications , Coronavirus Infections/epidemiology , Emergencies , Hospitals/statistics & numerical data , Humans , Italy/epidemiology , Laparoscopy/methods , Pneumonia, Viral/complications , Pneumonia, Viral/epidemiology , SARS-CoV-2 , Surveys and Questionnaires
10.
J Vasc Surg ; 73(2): 372-380, 2021 02.
Article in English | MEDLINE | ID: covidwho-343534

ABSTRACT

OBJECTIVE: The COVID-19 pandemic has had major implications for the United States health care system. This survey study sought to identify practice changes, to understand current personal protective equipment (PPE) use, and to determine how caring for patients with COVID-19 differs for vascular surgeons practicing in states with high COVID-19 case numbers vs in states with low case numbers. METHODS: A 14-question online survey regarding the effect of the COVID-19 pandemic on vascular surgeons' current practice was sent to 365 vascular surgeons across the country through REDCap from April 14 to April 21, 2020, with responses closed on April 23, 2020. The survey response was analyzed with descriptive statistics. Further analyses were performed to evaluate whether responses from states with the highest number of COVID-19 cases (New York, New Jersey, Massachusetts, Pennsylvania, and California) differed from those with lower case numbers (all other states). RESULTS: A total of 121 vascular surgeons responded (30.6%) to the survey. All high-volume states were represented. The majority of vascular surgeons are reusing PPE. The majority of respondents worked in an academic setting (81.5%) and were performing only urgent and emergent cases (80.5%) during preparation for the surge. This did not differ between states with high and low COVID-19 case volumes (P = .285). States with high case volume were less likely to perform a lower extremity intervention for critical limb ischemia (60.8% vs 77.5%; P = .046), but otherwise case types did not differ. Most attending vascular surgeons worked with residents (90.8%) and limited their exposure to procedures on suspected or confirmed COVID-19 cases (56.0%). Thirty-eight percent of attending vascular surgeons have been redeployed within the hospital to a vascular access service or other service outside of vascular surgery. This was more frequent in states with high case volume compared with low case volume (P = .039). The majority of vascular surgeons are reusing PPE (71.4%) and N95 masks (86.4%), and 21% of vascular surgeons think that they do not have adequate PPE to perform their clinical duties. CONCLUSIONS: The initial response to the COVID-19 pandemic has resulted in reduced elective cases, with primarily only urgent and emergent cases being performed. A minority of vascular surgeons have been redeployed outside of their specialty; however, this is more common among states with high case numbers. Adequate PPE remains an issue for almost a quarter of vascular surgeons who responded to this survey.


Subject(s)
COVID-19/epidemiology , Pandemics/statistics & numerical data , Patient Care/statistics & numerical data , Personal Protective Equipment/statistics & numerical data , Professional Practice/statistics & numerical data , Vascular Surgical Procedures/statistics & numerical data , COVID-19/diagnosis , Elective Surgical Procedures/standards , Elective Surgical Procedures/statistics & numerical data , Health Care Surveys , Humans , Internet , Patient Care/standards , Practice Patterns, Physicians'/standards , Practice Patterns, Physicians'/statistics & numerical data , Professional Practice/standards , SARS-CoV-2 , Thoracic Surgery/standards , Thoracic Surgery/statistics & numerical data , United States/epidemiology , Vascular Surgical Procedures/standards
12.
Hand Surg Rehabil ; 39(3): 159-166, 2020 05.
Article in English | MEDLINE | ID: covidwho-47793

ABSTRACT

The emergence of the COVID-19 pandemic has severely affected medical treatment protocols throughout the world. While the pandemic does not affect hand surgeons at first glance, they have a role to play. The purpose of this study was to describe the different measures that have been put in place in response to the COVID-19 pandemic by hand surgeons throughout the world. The survey comprised 47 surgeons working in 34 countries who responded to an online questionnaire. We found that the protocols varied in terms of visitors, health professionals in the operating room, patient waiting areas, wards and emergency rooms. Based on these preliminary findings, an international consensus on hand surgery practices for the current viral pandemic, and future ones, needs to be built rapidly.


Subject(s)
Coronavirus Infections/prevention & control , Hand/surgery , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Practice Patterns, Physicians'/organization & administration , Professional Practice/organization & administration , COVID-19 , Coronavirus Infections/transmission , Health Care Surveys , Humans , Internationality , Internet , Pneumonia, Viral/transmission , Practice Patterns, Physicians'/standards , Professional Practice/standards
13.
Zhonghua Wai Ke Za Zhi ; 58(6): 404-407, 2020 Jun 01.
Article in Chinese | MEDLINE | ID: covidwho-38530

ABSTRACT

As a newly epidemic, 2019 coronavirus disease (COVID-19) with a concentrated outbreak poses a great challenge to medical treatment. The severe and critical patients are complex complicatied with the psychological problems, and the medical staff are overworked and under tremendous psychological pressure. The surgeon participated in emergency medical rescue could provide professional treatment for the patients combined with surgical diseases, as well as specialized training for the non-surgeon crew, to reduce surgical-related mortality. With the advantages of good team consciousness, strong aseptic concept and good psychological quality, the surgeons can quickly adapt to and carry out rescue work under the premise of good self-protection. Surgeons need to develop critical care management concepts and focus on the critical care support equipment. Some suggestions are put forward for the standardized training of resident surgeons to cultivate compound talents. It is hoped that this article can lead to the thinking of how to participate in the emergency medical rescue of infectious diseases among surgeons and provide some enlightenment for future surgical education.


Subject(s)
Coronavirus Infections/therapy , Critical Care/standards , Delivery of Health Care/standards , Patient Care Management/standards , Pneumonia, Viral/therapy , Professional Practice/standards , Surgeons/standards , Betacoronavirus , COVID-19 , Clinical Competence , Critical Care/psychology , Emergencies , Humans , Internship and Residency/standards , Occupational Stress/prevention & control , Pandemics , SARS-CoV-2 , Surgeons/education , Surgeons/psychology
14.
Cont Lens Anterior Eye ; 43(3): 196-203, 2020 06.
Article in English | MEDLINE | ID: covidwho-30733

ABSTRACT

A novel coronavirus (CoV), the Severe Acute Respiratory Syndrome Coronavirus - 2 (SARS-CoV-2), results in the coronavirus disease 2019 (COVID-19). As information concerning the COVID-19 disease continues to evolve, patients look to their eye care practitioners for accurate eye health guidance. There is currently no evidence to suggest an increased risk of contracting COVID-19 through contact lens (CL) wear compared to spectacle lens wear and no scientific evidence that wearing standard prescription spectacles provides protection against COVID-19 or other viral transmissions. During the pandemic there will potentially be significant changes in access to local eyecare. Thus, it is imperative CL wearers are reminded of the steps they should follow to minimise their risk of complications, to reduce their need to leave isolation and seek care. Management of adverse events should be retained within optometric systems if possible, to minimise the impact on the wider healthcare service, which will be stretched. Optimal CL care behaviours should be the same as those under normal circumstances, which include appropriate hand washing (thoroughly with soap and water) and drying (with paper towels) before both CL application and removal. Daily CL cleaning and correct case care for reusable CL should be followed according to appropriate guidelines, and CL exposure to water must be avoided. Where the availability of local clinical care is restricted, practitioners could consider advising patients to reduce or eliminate sleeping in their CL (where patients have the appropriate knowledge about correct daily care and access to suitable lens-care products) or consider the option of moving patients to daily disposable lenses (where patients have appropriate lens supplies available). Patients should also avoid touching their face, including their eyes, nose and mouth, with unwashed hands and avoid CL wear altogether if unwell (particularly with any cold or flu-like symptoms).


Subject(s)
Betacoronavirus , Contact Lenses/trends , Coronavirus Infections/epidemiology , Cross Infection/prevention & control , Disease Transmission, Infectious/prevention & control , Infection Control/methods , Pandemics , Pneumonia, Viral/epidemiology , Professional Practice/trends , COVID-19 , Contact Lens Solutions , Contact Lenses/standards , Hand Hygiene , Humans , Professional Practice/standards , SARS-CoV-2
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