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BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has spread globally and caused a major worldwide health crisis. Patients who are affected more seriously by COVID-19 usually deteriorate rapidly and need further intensive care. AIMS AND OBJECTIVES: We aimed to assess the performance of the National Early Warning Score 2 (NEWS2) as a risk stratification tool to discriminate newly admitted patients with COVID-19 at risk of serious events. DESIGN: We conducted a retrospective single-centre case-control study on 200 unselected patients consecutively admitted in March 2020 in a public general hospital in Wuhan, China. METHODS: The following serious events were considered: mortality, unplanned intensive care unit (ICU) admission, and non-invasive ventilation treatment. Receiver operating characteristic (ROC) analysis and logistic regression analysis were used to quantify the association between outcomes and NEWS2. RESULTS: There were 12 patients (6.0%) who had serious events, where 7 patients (3.5%) experienced unplanned ICU admissions. The area under the ROC curve (AUROC) and cut-off of NEWS2 for the composite outcome were 0.83 and 3, respectively. For patients with NEWS2 ≥ 4, the odds of being at risk for serious events was 16.4 (AUROC = 0.74), while for patients with NEWS2 ≥ 7, the odds of being at risk for serious events was 18.2 (AUROC = 0.71). CONCLUSIONS: NEWS2 has an appropriate ability to triage newly admitted patients with COVID-19 into three levels of risk: low risk (NEWS2 = 0-3), medium risk (NEWS2 = 4-6), and high risk (NEWS2 ≥ 7). RELEVANCE TO CLINICAL PRACTICE: Using NEWS2 may help nurses in early identification of at-risk COVID-19 patients and clinical nursing decision-making. Using NEWS2 to triage new patients with COVID-19 may help nurses provide more appropriate level of care and medical resources allocation for patients safety.
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The person-artifact-task model provided us with a method to consider the practical performance anxiety (PPA) of technical college students who were working on a computer-related task via online learning. This study investigated 474 technical college students’ PPA in online courses without hands-on demonstration (PPAOC-without-HD) and with hands-on demonstration (PPAOC-with-HD), and it explored whether their PPA varied according to gender and average time spent on online learning. The results indicated that the students’ two types of PPA (PPAOC-without-HD and PPAOC-with-HD) varied significantly by gender and across the different online learning time groups. The average levels of participants’ two types of PPA were both high, and their PPAOC-without-HD was higher than their PPAOC-with-HD. Both types of PPA for females were significantly higher than those for males. Participants’ PPAOC-with-HD showed a significant difference for the average time of online learning. The findings of this study will be of value to educators who need to design and carry out online learning courses for technical college students.
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OBJECTIVES: To discuss the demands and countermeasures for outpatients and emergency patients during the outbreak of coronavirus disease 2019 (COVID-19) in large general hospital. METHODS: By analyzing patients' demands, outpatient service system and emergency system complemented each other with the help of "internet medical" to provide online medical treatment, self-diagnosed pneumonia program, online pharmacies, outpatient appointment and online pre-examination services, open green channels for special patients, and to provide referral services for critical patients. The COVID-19 suspected patients and other common fever patients were separated from other patients. RESULTS: From January 28 to March 1, we have received 26 000 patients online, 1 856 special patients, 2 929 suspected patients and common fever patients including 31 confirmed patients, 0 case of misdiagnosis and cross-infection. CONCLUSIONS: Targeting patient's demands and taking appropriate measures are effective on meeting the needs of outpatients' and emergency patients' medical services.