Expanding Protection Motivation Theory to explain vaccine uptake among United Kingdom and Taiwan populations.

Vaccination can sufficiently ameliorate the coronavirus disease-2019 (COVID-19). Investigating what factors influence vaccine uptake may benefit ongoing vaccination efforts (e.g. booster injections, annual vaccination). The present study expanded Protection Motivation Theory with possible factors including perceived knowledge, adaptive responses, and maladaptive responses to develop a proposed model investigating vaccine uptake among United Kingdom (UK) and Taiwan (TW) populations. An online survey collected responses from UK (n = 751) and TW (n = 1052) participants (August to September, 2022). The results of structural equation modeling (SEM) showed that perceived knowledge was significantly associated with coping appraisal in both samples (standardized coefficient [ß] = 0.941 and 0.898; p < .001). Coping appraisal was correlated with vaccine uptake only in the TW sample (ß = 0.319, p < .05). Multigroup analysis showed there were significant differences between the path coefficients of perceived knowledge to coping and threat appraisals (p < .001), coping appraisal to adaptive and maladaptive responses (p < .001), as well as threat appraisal to adaptive response (p < .001). Such knowledge may improve vaccine uptake in Taiwan. The potential factors for the UK population require further investigation.

Adverse Patient Safety Events During the COVID Epidemic.

METHODS: A retrospective descriptive analysis of patient safety events related to COVID-19 was performed on data that were submitted in the Joint Patient Safety Event Reporting System and Root Cause Analysis databases to the VHA National Center for Patient Safety from March 2020 to February 2021. Events were coded for type of event, location, and cause of event. RESULTS: Delays in care and staff/patients exposed to COVID-19 were the most common types of patient safety events, followed by COVID-19-positive patients eloping, laboratory processing errors, and one wrong procedure. The most frequently cited locations where events took place were emergency departments, medical units, community living centers, and intensive care units. Confusion over procedures, care not provided because of COVID-19, and failure to identify COVID-positive patient before they exposed others to COVID were the most common causes for patient safety events. DISCUSSION: Our results are similar to other studies of patient safety during the first year of the COVID-19 pandemic. Based on these results, we recommend the following: (1) focus on patient safety culture, leadership, and governance; (2) proactively develop competency checklists, cognitive aids, and other tools for healthcare staff who are working in new or unfamiliar clinical settings; (3) augment or enhance communication efforts with patient safety huddles or briefings at all levels within a healthcare organization to proactively uncover risk and mitigate fear by explaining changes in policies and procedures; and (4) maximize the use of quality and patient safety experts who are knowledgeable in system and human factor theories as well as change management to assist in redesigning clinical workflows and processes.

Cultivating support during COVID-19 through clinical supervision: A discussion article.

AIM: This article aims to discuss how clinical supervision is an important approach in supporting frontline nurses and students during and post COVID-19 through the lens of the nursing metaparadigms. DESIGN: Discussion article. METHODS: Discourse of the literature considering the importance of working collaboratively with healthcare and educational organisations in operationalising clinical supervision. RESULTS: The evidence base supporting clinical supervision as an effective support strategy for nurses exists, however, its implementation and practice has become sporadic. A resurgence is required to support student's and nurse's during this pandemic. It is timely for nurse educators to creatively engage with clinical partners in supporting clinical supervision to enhance both nurses and students pandemic practice experiences. Clinical supervision is proposed as one strategy to support and guide both nurses and students to develop, strengthen and challenge the effectiveness of their care during COVID-19.

Impact of full personal protective equipment on alertness of healthcare workers: a prospective study.

The COVID-19 pandemic has resulted in healthcare workers (HCWs) having to wear full personal protective equipment (FPPE) even for routine patient care. When worn for prolonged periods, FPPE has the potential to adversely affect the ability of HCW to carry out their tasks. This study aimed to assess the impact of FPPE on the alertness levels of HCWs in the intensive care unit.Fifty HCWs were tested using psychomotor vigilance test (PVT) and serial sevens test (SST) on two occasions during their shift-once without FPPE and once after they had been in FPPE for at least 2 hours. The median time in FPPE was 2.5 hours. FPPE induced a significant increase in the average reaction time and the number of false responses in PVT. Subjects took longer to complete SST in FPPE compared with without it.This study demonstrates that being in FPPE for as little as 2.5 hours can adversely affect HCW alertness. The findings of this study are relevant in terms of workforce environment considerations as the use of FPPE in certain settings is likely to become a regular feature.

Understanding and Accommodating Patient and Staff Choice When Implementing Video Consultations in Mental Health Services.

During the COVID-19 pandemic, some mental healthcare in the United Kingdom has moved online, with more likely to follow. The current evidence base for video consultations is modest; hence, this study seeks to aid decision-makers by reporting on one large National Health Service mental health trust's video-consultation pilot project. Patients' choices/preferences were gathered via online forms; and staff's views, through a focus group. The typical patient was female, 26 years old, living in a deprived locality. Consultations typically lasted 37 minutes, saving patients 0-30 minutes of travel and £0-£3.00. Satisfaction was high, and the software was intuitive. Audio quality varied, but patients felt able to disclose "as if in person," were willing to use video consultation again, and found them more preferable than home visits and clinic attendance. Staff could foresee benefits but were concerned for their therapeutic relationships and were avoidant without familiarization, training, clinical coaching, and managerial reassurances especially regarding high-risk patients/situations. They argued video consultation would not suit all patients and should be used according to individual need. We found COVID-19 is necessitating staff to adopt video consultation and that patients are satisfied. However, unless staff's concerns are resolved, enabling them to use their full repertoire of interpersonal skills, therapeutic relationships will trump efficiency and video consultations may not remain their treatment modality of choice.

If There's Something Strange in Your Neighbourhood, Who You Gonna Call? Perceived Mental Health Service User Suitability for Video Consultations.

COVID-19 has placed additional challenges on mental health services. Video consultations (VCs) have provided a short-term solution to lockdown restrictions but could also increase long-term capacity to meet the anticipated rising demand. A total of 7752 VCs were conducted over six weeks. Thematic analysis of 474 online survey responses identified twenty patient attributes that influenced staffs' decisions to offer VCs. Their opinions were diverse, at times contradictory, and not always evidence based. There was reasonable consensus (and published evidence to support) of the probable suitability of VC for patients who: are IT savvy and suitably equipped; are teenagers; live in remote/rural locations; have caring responsibilities; have anxiety disorders or express a preference. No consensus was reached regarding eight attributes and there was a corresponding paucity of evidence, indicating the need for further research. Conversely, old age; paranoia, sensory impairment/communication difficulties; high risk and trauma/PTSD (posttraumatic stress disorder) were generally seen as contraindicated by staff, despite published evidence of success elsewhere. It may be possible to overcome staff's reticence to offer these groups VCs. As staff are effectively the gatekeepers to VC interventions, it is important to understand and support them to overcome reservations that are contrary to the empirical evidence base. This will ensure that their initial anxieties do not become unnecessary barriers to services for those most in need. As with all mental healthcare, such decisions should be made collaboratively, and on an individual basis.

Immunological Implications of Physical Inactivity among Older Adults during the COVID-19 Pandemic.

Social distancing has been adopted worldwide to control severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. Social isolation is likely to lead to a decline in physical activity, which could result in immune system dysfunction, thereby increasing infection susceptibility and exacerbating the pathophysiology of conditions that are common among older adults, including cardiovascular disease, cancer, and inflammatory disorders. Older adults and people living with these comorbidities are at a greater risk for complications during coronavirus disease 2019 (COVID-19). In this review, we discuss the negative impact of physical inactivity on immune function and showcase evidence that regular physical activity may be an effective strategy to counter some of the deleterious effects of social isolation. Furthermore, we briefly highlight key research questions in exercise immunology, with a focus on older adults in the context of COVID-19. Although it is worth emphasizing that there is no direct evidence that physical activity can prevent or treat -COVID-19, promoting an active lifestyle is a key intervention to counteract the effects of social isolation, especially in older adults and other at-risk individuals, such as those living with chronic diseases associated with ageing and lifestyle.