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3.
Ann Biol Clin (Paris) ; 78(4): 363-382, 2020 Aug 01.
Article in English | MEDLINE | ID: covidwho-709296

ABSTRACT

The point-of-care tests (POCT) are subject to accreditation. A national inventory survey provides a synthesis of knowledge. The survey distributed 31 questions in 2019. 147 responses were received (75% biologists, 49% CHU, 42% CHG). Only 20.41% are accredited ISO22870, the majority for <50% of the medical departments; 70% say they are going there at the end of 2019 or in 2020. The maps are unknown for 32% (EBMD) and 82% (TROD). Visibility is poor with: medical establishment committee (40%), IT department (31%). Connection is necessary for 87-95% depending on the criterion (QC, authorizations, etc.) and 66% of answers highlight that less than 50% of connexion is effective. The major advantage is the delay of the result (62.5%), then the relationship with the health teams (33.3%). The disadvantages: difficulty of the quality approach (45%), cost of tests (34.3%). Human resource requirements are identified for technicians (82%) and biologists (76%). The multiplicity of sites, devices and operators means that it is difficult to set up and maintain. Biology outside the laboratories, under biological responsibility, must meet a rigorous imperative quality approach.


Subject(s)
Clinical Laboratory Techniques , Global Health , Laboratories/statistics & numerical data , Laboratories/standards , Point-of-Care Testing , Accreditation , Clinical Laboratory Services/standards , Clinical Laboratory Services/statistics & numerical data , Clinical Laboratory Techniques/standards , Clinical Laboratory Techniques/statistics & numerical data , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , France/epidemiology , Global Health/standards , Global Health/statistics & numerical data , History, 21st Century , Humans , Internationality , Laboratory Proficiency Testing/standards , Pandemics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Point-of-Care Systems/standards , Point-of-Care Systems/statistics & numerical data , Point-of-Care Testing/organization & administration , Point-of-Care Testing/standards , Point-of-Care Testing/statistics & numerical data , Quality Assurance, Health Care/organization & administration , Surveys and Questionnaires
4.
Curr Opin Infect Dis ; 33(4): 304-311, 2020 08.
Article in English | MEDLINE | ID: covidwho-643197

ABSTRACT

PURPOSE OF THE REVIEW: Laboratory-developed tests (LDTs) are essential for the clinical care of immunocompromised individuals. These patients often require specialized testing not available from commercial manufacturers and are therefore dependent on the laboratory to create, validate, and perform these assays. Recent paradigm-shifting legislation could alter the way that LDTs are operationalized and regulated. RECENT FINDINGS: On March 5th, 2020 the Verifying Accurate and Leading-Edge In-Vitro Clinical Tests Development Act (VALID) was introduced in the US Congress. This statute would overhaul existing regulatory framework by unifying the oversight of LDTs and commercial in-vitro diagnostic tests (IVDs) through the FDA. If enacted, LDTs would be subject to regulatory requirements like those found in commercial submissions for market review. Stakeholders continue to discuss the details and scope of the proposed legislation in the setting of the Severe Acute Respiratory Syndrome Coronavirus 2 pandemic, where LDTs are integral to the national COVID-19 response. SUMMARY: Congressional lawmakers have introduced legislation to alter the regulatory framework governing LDTs. Moving forward, a balance must be struck to ensure the availability of safe and accurate testing without delays or overregulation that could be harmful to patients. The downstream implications of how VALID and other legislation will impact laboratories, clinicians, and patients warrant close examination.


Subject(s)
Clinical Laboratory Services/legislation & jurisprudence , Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Immunocompromised Host , Laboratories, Hospital/legislation & jurisprudence , Pneumonia, Viral/diagnosis , Uncertainty , United States Food and Drug Administration/legislation & jurisprudence , Betacoronavirus/pathogenicity , Congresses as Topic , Health Services Research/legislation & jurisprudence , Humans , Pandemics , Quality Assurance, Health Care , United States
6.
Farm Hosp ; 44(7): 5-10, 2020 06 12.
Article in English | MEDLINE | ID: covidwho-599567

ABSTRACT

The WHO declared the SARS- CoV-2 outbreak a pandemic in March 11, 2020.  Spain has been the third country with the highest number of reported cases of  COVID-19. In the face of the pandemic, the authorities of the Autonomous  Community of Madrid led an unprecedented transformation of hospital services  by increasing the number of beds available, setting up temporary field hospitals  in fairgrounds, and transforming hotels into support centers for patients with  mild symptoms of COVID-19. In the light that this crisis will continue to be a real threat for the years to come, our hospital pharmacies need to be better prepared for similar outbreaks in the future. During the COVID-19 pandemic, the  Department of Hospital Pharmacy of Hospital General Universitario Gregorio  Marañón has faced four challenges: an exponential increase in the demand for  resources, constant changes to therapeutic protocols and approaches, regulatory changes, and a dramatic impact on hospital staff (strain on human resources  and psychological impact). This article is aimed at describing the main  organizational changes implemented to the Department of Hospital Pharmacy of  Hospital GU Gregorio Marañón and its relationship with other hospital  pharmacies of the Community of Madrid. An account is provided of the strategies to be adopted for reorganizing a Department of Hospital Pharmacy and achieve a safe and effective use of medications. Strategies range from the creation of  integral hospital task groups (COVID-crisis task group, protocolization task  group, research task group) to the adaptation of the internal organization of the  Department of Hospital Pharmacy, which encompasses aspects related to  management and leadership; a communication plan (internal and external);  staff management, and the reorganization and adaptation of processes. People,  patients and professionals are at the core of these strategies. This paper is a  reflection on key factors of "humanization in COVID times".


Subject(s)
Betacoronavirus , Coronavirus Infections , Pandemics , Pharmacy Service, Hospital , Pneumonia, Viral , Antiviral Agents/supply & distribution , Antiviral Agents/therapeutic use , Coronavirus Infections/drug therapy , Coronavirus Infections/prevention & control , Disaster Planning , Health Resources , Health Services Needs and Demand , Hospitals, General/organization & administration , Humans , Infection Control/organization & administration , Pandemics/prevention & control , Pharmacy Service, Hospital/organization & administration , Pneumonia, Viral/drug therapy , Pneumonia, Viral/prevention & control , Professional-Patient Relations , Protective Devices , Quality Assurance, Health Care , Spain , Telemedicine
7.
Farm Hosp ; 44(7): 5-10, 2020 06 12.
Article in English | MEDLINE | ID: covidwho-597187

ABSTRACT

The WHO declared the SARS- CoV-2 outbreak a pandemic in March 11, 2020.  Spain has been the third country with the highest number of reported cases of  COVID-19. In the face of the pandemic, the authorities of the Autonomous  Community of Madrid led an unprecedented transformation of hospital services  by increasing the number of beds available, setting up temporary field hospitals  in fairgrounds, and transforming hotels into support centers for patients with  mild symptoms of COVID-19. In the light that this crisis will continue to be a real threat for the years to come, our hospital pharmacies need to be better prepared for similar outbreaks in the future. During the COVID-19 pandemic, the  Department of Hospital Pharmacy of Hospital General Universitario Gregorio  Marañón has faced four challenges: an exponential increase in the demand for  resources, constant changes to therapeutic protocols and approaches, regulatory changes, and a dramatic impact on hospital staff (strain on human resources  and psychological impact). This article is aimed at describing the main  organizational changes implemented to the Department of Hospital Pharmacy of  Hospital GU Gregorio Marañón and its relationship with other hospital  pharmacies of the Community of Madrid. An account is provided of the strategies to be adopted for reorganizing a Department of Hospital Pharmacy and achieve a safe and effective use of medications. Strategies range from the creation of  integral hospital task groups (COVID-crisis task group, protocolization task  group, research task group) to the adaptation of the internal organization of the  Department of Hospital Pharmacy, which encompasses aspects related to  management and leadership; a communication plan (internal and external);  staff management, and the reorganization and adaptation of processes. People,  patients and professionals are at the core of these strategies. This paper is a  reflection on key factors of "humanization in COVID times".


Subject(s)
Betacoronavirus , Coronavirus Infections , Pandemics , Pharmacy Service, Hospital , Pneumonia, Viral , Antiviral Agents/supply & distribution , Antiviral Agents/therapeutic use , Coronavirus Infections/drug therapy , Coronavirus Infections/prevention & control , Disaster Planning , Health Resources , Health Services Needs and Demand , Hospitals, General/organization & administration , Humans , Infection Control/organization & administration , Pandemics/prevention & control , Pharmacy Service, Hospital/organization & administration , Pneumonia, Viral/drug therapy , Pneumonia, Viral/prevention & control , Professional-Patient Relations , Protective Devices , Quality Assurance, Health Care , Spain , Telemedicine
8.
Farm Hosp ; 44(7): 57-60, 2020 06 13.
Article in English | MEDLINE | ID: covidwho-595560

ABSTRACT

On the 20th of March 2020, triggered by the public health emergency declared,  the Health Authorities in Madrid reported a legal instruction (Orden 371/2020)  indicating the organization of a provisional hospital to admit patients with  COVID-19 at the Trade Fair Institution (IFEMA). Several pharmacists working in  the Pharmacy and Medical Devices Department of the Madrid Regional Health  Service were called to manage the Pharmacy Department of the  abovementioned hospital. Required permissions to set up a PD were here  authorized urgently. Tackling human and material resources, and computer  systems for drug purchase and electronic prescription, were some of the initial  issues that hindered the pharmaceutical provision required for patients from the  very day one. Once the purchase was assured, mainly by direct purchase from suppliers, drug dispensing up to 1,250 hospitalized patients (25 nursing units) and 8 ICU patients was taken on. Dispensing was carried out  through either drug stocks in the nursing units or individual patient dispensing  for certain drugs. Moreover, safety issues related to prescription were  considered, and as the electronic prescription was implemented we attained  100% prescriptions review and validation. The constitution of a multidisciplinary  Pharmacy and Therapeutics Committee let agree to a pharmacotherapy guide,  pres cription protocols, therapeutic equivalences, interactions, and drug  dispensing circuits. The Pharmacy Department strategy was to ensure a very  quick response to basic tasks keeping the aim to offer a pharmaceutical care of  the highest quality whenever possible. Working under a health emergency  situation, with many uncertainties and continuous pressure was a plight.  However, the spirit of collaboration in and out of the Pharmacy Department was  aligned with the whole hospital motivation to offer the highest quality of  healthcare. These were possibly the keys to allow caring for almost 4,000  patients during the 42 days that the hospital lasted.


Subject(s)
Coronavirus Infections , Delivery of Health Care/organization & administration , Hospitals, Urban/organization & administration , Models, Theoretical , Pandemics , Pharmacy Service, Hospital/organization & administration , Pneumonia, Viral , Betacoronavirus , Delivery of Health Care/legislation & jurisprudence , Delivery of Health Care/methods , Electronic Prescribing/standards , Facility Regulation and Control/legislation & jurisprudence , Forecasting , Health Facility Planning , Health Services Needs and Demand , Hospitalization , Hospitals, Urban/legislation & jurisprudence , Humans , Interdisciplinary Communication , Patient Safety , Pharmacy Service, Hospital/legislation & jurisprudence , Pharmacy and Therapeutics Committee/organization & administration , Quality Assurance, Health Care , Spain
9.
Indian J Public Health ; 64(Supplement): S91-S93, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-552173

ABSTRACT

Some nations in the world and some states in India have had more success in containing this pandemic. Recent efforts in strengthening the health sector have focused largely on reforms in modes of financing, but as the pandemic brings home to us, the main challenge in India remains the challenge of the organization of public services using a health systems understanding. A close to community comprehensive primary health care, quality assurance, and planned excess capacity in public health systems, a more robust disease surveillance systems that can integrate data on new outbreaks and the indigenous technological capacity to scale up innovation and manufacture of essential health commodities are some of our most important requirements for both epidemic preparedness and response.


Subject(s)
Coronavirus Infections/epidemiology , Disaster Planning/organization & administration , Pandemics , Pneumonia, Viral/epidemiology , Betacoronavirus , Capacity Building , Community Health Services/organization & administration , Humans , India/epidemiology , Primary Health Care/organization & administration , Public Health Administration , Public Health Surveillance , Quality Assurance, Health Care/organization & administration , Social Determinants of Health
10.
Ann Palliat Med ; 9(3): 1198-1205, 2020 May.
Article in English | MEDLINE | ID: covidwho-530660

ABSTRACT

BACKGROUND: Nursing quality is an integral part of health care quality and one of key performance indicators (KPIs) for health care management. The Plan-Do-Check-Act (PDCA) cycle is a management tool for continuous improvement of a business's products or processes. It can be applied to standardize nursing management and thus improve the nursing quality and increase the survival rate of patients. This study assessed the value of the PDCA cycle in standardizing nursing management in an intensive care unit (ICU) for patients with severe coronavirus disease 2019 (COVID-19). METHODS: The status quo of the ICU was analyzed, and the relevant issues and countermeasures were proposed. The PDCA cycle was applied to standardize the nursing management in the ICU. RESULTS: Nine measures were proposed and applied to improve the management of the COVID-19 ICU: defining the clean or contaminated areas, use of self-designed shoe storage cabinets, defining staff roles and responsibilities, establishing the staffing structure, staff training, placing items at fixed locations, improving shift handover, use of bulletin boards for listing key points, and use of reserved drugs cabinets. The virus contamination awareness, professional skills, awareness of duties and responsibilities, and quality and performance of nursing were remarkably improved 2 weeks after the implementation of the above countermeasures. CONCLUSIONS: The PDCA cycle helps to standardize nursing management in COVID-19 ICU by developing and applying effective nursing management approaches.


Subject(s)
Coronavirus Infections/nursing , Critical Care Nursing/organization & administration , Critical Care Nursing/standards , Intensive Care Units/organization & administration , Pneumonia, Viral/nursing , Quality Assurance, Health Care/methods , China/epidemiology , Coronavirus Infections/epidemiology , Humans , Nursing Administration Research , Nursing Evaluation Research , Pandemics , Pneumonia, Viral/epidemiology
11.
J Aging Soc Policy ; 32(4-5): 316-322, 2020.
Article in English | MEDLINE | ID: covidwho-526492

ABSTRACT

As of May 2020, nursing home residents account for a staggering one-third of the more than 80,000 deaths due to COVID-19 in the U.S. This pandemic has resulted in unprecedented threats to achieving and sustaining care quality even in the best nursing homes, requiring active engagement of nursing home leaders in developing solutions responsive to the unprecedented threats to quality standards of care delivery during the pandemic. This perspective offers a framework, designed with the input of nursing home leaders, to facilitate internal and external decision-making and collective action to address these threats. Policy options focus on assuring a shared understanding among nursing home leaders and government agencies of changes in the operational status of nursing homes throughout the crisis, improving access to additional essential resources needed to mitigate the crisis' impact, and promoting shared accountability for consistently achieving accepted standards in core quality domains.


Subject(s)
Coronavirus Infections/epidemiology , Homes for the Aged/organization & administration , Nursing Homes/organization & administration , Pandemics , Pneumonia, Viral/epidemiology , Quality of Health Care/organization & administration , Betacoronavirus , Disaster Planning/organization & administration , Homes for the Aged/standards , Humans , Leadership , Nursing Homes/standards , Policy , Protective Clothing/supply & distribution , Quality Assurance, Health Care/standards , Quality of Health Care/standards
12.
J Appl Clin Med Phys ; 21(7): 187-195, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-324503

ABSTRACT

PURPOSE: The COVID-19 pandemic has led to disorder in work and livelihood of a majority of the modern world. In this work, we review its major impacts on procedures and workflow of clinical physics tasks, and suggest alternate pathways to avoid major disruption or discontinuity of physics tasks in the context of small, medium, and large radiation oncology clinics. We also evaluate scalability of medical physics under the stress of "social distancing". METHODS: Three models of facilities characterized by the number of clinical physicists, daily patient throughput, and equipment were identified for this purpose. For identical objectives of continuity of clinical operations, with constraints such as social distancing and unavailability of staff due to system strain, however with the possibility of remote operations, the performance of these models was investigated. General clinical tasks requiring on-site personnel presence or otherwise were evaluated to determine the scalability of the three models at this point in the course of disease spread within their surroundings. RESULTS: The clinical physics tasks within three models could be divided into two categories. The former, which requires individual presence, include safety-sensitive radiation delivery, high dose per fraction treatments, brachytherapy procedures, fulfilling state and nuclear regulatory commission's requirements, etc. The latter, which can be handled through remote means, include dose planning, physics plan review and supervision of quality assurance, general troubleshooting, etc. CONCLUSION: At the current level of disease in the United States, all three models have sustained major system stress in continuing reduced operation. However, the small clinic model may not perform if either the current level of infections is maintained for long or staff becomes unavailable due to health issues. With abundance, and diversity of innovative resources, medium and large clinic models can sustain further for physics-related radiotherapy services.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Health Physics , Pandemics , Pneumonia, Viral/epidemiology , Radiation Oncology , Health Facilities/standards , Health Personnel , Health Physics/organization & administration , Health Physics/standards , Humans , Practice Guidelines as Topic/standards , Quality Assurance, Health Care , Radiation Oncology/organization & administration , Radiation Oncology/standards , Social Distance , United States/epidemiology
13.
Head Neck ; 42(7): 1668-1673, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-291449

ABSTRACT

The 2019 Coronavirus Pandemic challenges the delivery of care for patients with head and neck cancer. An important aspect of this care has been the evolution of enhanced survivorship services, which include surveillance for recurring cancer and prevention of second primaries. The application of evidence-based approaches to the identification and management of treatment and tumor-related toxicities has embraced the use of validated patient-reported outcomes instruments, health promotion, and care coordination. In this manuscript, we describe how our multidisciplinary team of survivorship providers has accommodated to the need to provide patients with social distancing while acknowledging the importance of continued care during treatment and through the spectrum of survivorship.


Subject(s)
Betacoronavirus , Continuity of Patient Care/organization & administration , Coronavirus Infections/epidemiology , Head and Neck Neoplasms/therapy , Patient Care Team , Pneumonia, Viral/epidemiology , Survivorship , Chemoradiotherapy , Deglutition Disorders/etiology , Deglutition Disorders/rehabilitation , Dental Care , Diagnostic Imaging , Humans , Infection Control , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Nutrition Assessment , Occupational Exposure/prevention & control , Pandemics , Patient Reported Outcome Measures , Pennsylvania/epidemiology , Personal Protective Equipment , Physical Examination , Physical Therapy Modalities , Quality Assurance, Health Care , Quality of Life , Speech Therapy , Surveys and Questionnaires , Symptom Assessment , Telemedicine
15.
Br J Nurs ; 29(8): 484-485, 2020 Apr 23.
Article in English | MEDLINE | ID: covidwho-122306

ABSTRACT

Professor Alan Glasper, from the University of Southampton, discusses how the Care Quality Commission and the Nursing and Midwifery Council are working during the COVID-19 pandemic.


Subject(s)
Advisory Committees , Coronavirus Infections/epidemiology , Pandemics , Pneumonia, Viral/epidemiology , Quality Assurance, Health Care/organization & administration , Coronavirus Infections/nursing , Critical Care Nursing , Humans , Pneumonia, Viral/nursing , State Medicine , United Kingdom/epidemiology
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