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1.
Am Indian Alsk Native Ment Health Res ; 29(2): 63-84, 2022.
Article in English | MEDLINE | ID: covidwho-1964467

ABSTRACT

American Indian/Alaska Native (Native) youth face high rates of substance use, teen pregnancy and sexually transmitted infections. In response to the COVID-19 pandemic, Respecting the Circle of Life (RCL), a sexual reproductive health and teen pregnancy prevention program for Native youth and their trusted adult, was adapted and delivered in a virtual format with Native youth in a rural, reservation-based Native community. This manuscript describes the adaptation process, feasibility, and acceptability of virtual program implementation. The manuscript describes the process of rapidly shifting the RCL program into a virtual format. In addition, a mixed-methods process evaluation of implementation forms, program feedback forms, in-depth interviews with participants, and staff debriefing sessions was completed. Results show virtual implementation of RCL is both feasible and acceptable for Native youth and their trusted adults. A key benefit of virtual implementation is the flexibility in scheduling and ability to have smaller groups of youth, which offers greater privacy for youth participants compared to in-person implementation with larger groups. However, internet connectivity did present a challenge for virtual implementation. Ultimately, sexual and reproductive health programs seeking to reach Native youth and families should consider virtual implementation methods, both during and outside of pandemic situations.


Subject(s)
COVID-19 , Indians, North American , Pregnancy in Adolescence , Adolescent , Adult , COVID-19/prevention & control , Feasibility Studies , Female , Humans , Pandemics , Pregnancy , Pregnancy in Adolescence/prevention & control , Reproductive Health
2.
Front Public Health ; 10: 919668, 2022.
Article in English | MEDLINE | ID: covidwho-1963645

ABSTRACT

Objectives: Coronavirus disease 2019 was declared a global pandemic in March 2020 with correct and early detection of cases using laboratory testing central to the response. Hence, the establishment of quality management systems and monitoring their implementation are critical. This study describes the experience of implementing the COVID-19 Laboratory Testing and Certification Program (CoLTeP) in Africa. Methods: Private and public laboratories conducting SARS-CoV-2 testing using polymerase chain reaction were enrolled and assessed for quality and safety using the CoLTeP checklists. Results: A total of 84 laboratories from 7 countries were assessed between April 2021 to December 2021 with 52% of these from the private sector. Among them, 64% attained 5 stars and were certified. Section 4 had the highest average score of 92% and the lowest of 78% in Section 3. Also, 82% of non-conformities (NCs) were related to sample collection, transportation, and risk assessments. Non-availability, inconsistency in performing, recording, instituting corrective actions for failed internal and external quality controls were among major NCs reported. Conclusions: Laboratories identified for SARS-CoV-2 testing by public and private institutions mostly met the requirements for quality and safe testing as measured by the CoLTeP checklist.


Subject(s)
COVID-19 Testing , COVID-19 , Certification , Africa , COVID-19/diagnosis , COVID-19/epidemiology , Clinical Laboratory Techniques , Humans , Laboratories , SARS-CoV-2
3.
Revista Ibérica de Sistemas e Tecnologias de Informação ; - (45):48-63, 2022.
Article in Portuguese | ProQuest Central | ID: covidwho-1964810

ABSTRACT

: The purpose of higher education is to train students efficiently to meet the needs of today's society;however, during the COVID-19 pandemic, it was mandatory to implement a contingency plan so that the teaching-learning process was not affected. In this sense, it was necessary to train teachers in the face of the deficiencies detected in teacher training when changing from the face-to-face modality to the virtual one to face the current educational challenges to carry out their teaching practice successfully. The data collection is done with a pre and post-test to the teachers and an interview with the students. Después, se realizó la segunda sesión virtual donde se dialogó con los docentes acerca de que les había parecido el curso, cuales mejoras le harían, que temas les gustó y sirvió más, entre otras cosas, también se hizo entrega de reconocimientos a todos los que forman parte del grupo en línea y otro más a los que participaron de manera activa. 3.Evaluación del proyecto Para elaborar el análisis de evaluación del proyecto RPD se utilizó el programa estadístico SPSS V.23, el cual permite una descripción más detallada, permitiéndonos así elaborar tablas por categorías y gráficas de estudio.

4.
BMC Cardiovasc Disord ; 22(1): 270, 2022 06 16.
Article in English | MEDLINE | ID: covidwho-1962737

ABSTRACT

BACKGROUND: Cardiac rehabilitation for heart failure continues to be greatly underused worldwide despite being a Class I recommendation in international clinical guidelines and uptake is low in women and patients with mental health comorbidities. METHODS: Rehabilitation EnAblement in CHronic Heart Failure (REACH-HF) programme was implemented in four UK National Health Service early adopter sites ('Beacon Sites') between June 2019 and June 2020. Implementation and patient-reported outcome data were collected across sites as part of the National Audit of Cardiac Rehabilitation. The change in key outcomes before and after the supervised period of REACH-HF intervention across the Beacon Sites was assessed and compared to those of the intervention arm of the REACH-HF multicentre trial. RESULTS: Compared to the REACH-HF multicentre trial, patients treated at the Beacon Site were more likely to be female (33.8% vs 22.9%), older (75.6 vs 70.1), had a more severe classification of heart failure (26.5% vs 17.7%), had poorer baseline health-related quality of life (MLHFQ score 36.1 vs 31.4), were more depressed (HADS score 6.4 vs 4.1) and anxious (HADS score 7.2 vs 4.7), and had lower exercise capacity (ISWT distance 190 m vs 274.7 m). There appeared to be a substantial heterogeneity in the implementation process across the four Beacon Sites as evidenced by the variation in levels of patient recruitment, operationalisation of the REACH-HF intervention and patient outcomes. Overall lower improvements in patient-reported outcomes at the Beacon Sites compared to the trial may reflect differences in the population studied (having higher morbidity at baseline) as well as the marked challenges in intervention delivery during the COVID-19 pandemic. CONCLUSION: The results of this study illustrate the challenges in consistently implementing an intervention (shown to be clinically effective and cost-effective in a multicentre trial) into real-world practice, especially in the midst of a global pandemic. Further research is needed to establish the real-world effectiveness of the REACH-HF intervention in different populations.


Subject(s)
COVID-19 , Cardiac Rehabilitation , Heart Failure , Female , Heart Failure/rehabilitation , Heart Failure/therapy , Humans , Male , Pandemics , Quality of Life , State Medicine
5.
BMJ Open ; 12(7): e060576, 2022 07 26.
Article in English | MEDLINE | ID: covidwho-1962300

ABSTRACT

OBJECTIVES: This study explored the perceived barriers and facilitators regarding the implementation of policies and programmes aimed at reducing adolescent pregnancy among health and education professionals ('professionals'), grassroots workers and adolescent girls in Ghana. DESIGN AND SETTING: We employed an exploratory qualitative study design involving interviews with professionals, grassroots workers and adolescent girls in the Central Region of Ghana. PARTICIPANTS: This study involved 15 professionals employed in government or non-governmental organisations, 15 grassroots workers and 51 pregnant/parenting and non-pregnant adolescent girls. DATA ANALYSIS: Thematic analysis was conducted deductively using the ecological framework for understanding effective implementation. RESULTS: Eighteen themes mapped to the five domains of the ecological framework emerged. Perceived barriers included gender inequality, family poverty, stigma, community support for early childbearing and cohabitation, inadequate data systems, lack of collaboration between stakeholders and lack of political will. Effective implementation of community by-laws, youth involvement, use of available data, and collaboration and effective coordination between stakeholders were the perceived facilitators. CONCLUSION: Political leaders and community members should be actively engaged in the implementation of adolescent sexual and reproductive health policies and programmes. Gender empowerment programmes such as education and training of adolescent girls should be implemented and strengthened at both the community and national levels. Community members should be sensitised on the negative effects of norms that support child marriage, gender-based violence and early childbearing.


Subject(s)
Pregnancy in Adolescence , Adolescent , Child , Female , Ghana , Humans , Policy , Poverty , Pregnancy , Pregnancy in Adolescence/prevention & control , Qualitative Research
6.
J Technol Behav Sci ; 7(3): 351-357, 2022.
Article in English | MEDLINE | ID: covidwho-1959217

ABSTRACT

Literature has reinforced the importance of telehealth-focused education to foster provider competence and optimal patient care. As clinical psychology evolves to meet field needs, many have suggested graduate school as an optimal time to offer comprehensive telehealth education. Despite the rapid expansion of telehealth post-COVID-19, the extent of telehealth-specific doctoral-level programming, as well as the foci of available trainings, has remained unclear. To address this gap and inform future work, the current study evaluated doctoral-level clinical psychology training programs throughout the USA. Fourteen doctoral-level training programs completed author-created REDCap-hosted demographic and telehealth training surveys. Pre-COVID-19, three of fourteen programs reported implementing some form of telehealth-focused education, with a majority of the information being viewed as optional targets for instructors. Contrastingly, thirteen programs indicated implementing telehealth-focused education post-COVID-19, with a majority of the information being indicated as mandatory educational targets. Despite increases in educational activities, a large number of programs endorsed a desire for additional telehealth-focused education for students as they transition into future roles. Educational foci, methods of training, and instructor preparation are discussed. While participation was limited, the current study demonstrated positive trends in the development of telehealth-focused education. Nevertheless, there remains an ongoing need for both specialized coursework and a wider range of educational topics. Ultimately, the current study is believed to have provided a preliminary evaluation of the types and foci of telehealth-focused education among doctoral-level clinical psychology training programs.

7.
Am J Community Psychol ; 2022 Jul 28.
Article in English | MEDLINE | ID: covidwho-1958675

ABSTRACT

Digital messaging programs have the potential to be a powerful, low-cost, technological tool to support multiple facets of caregivers' knowledge, and implementation of developmentally appropriate caregiver-child activities among diverse immigrant populations. However, involving caregivers and community stakeholders in the cultural and linguistic tailoring of interventions to optimize utilization and engagement may be critical to ensuring messaging programs' usability and acceptability. The purpose of this mixed-method study was to use the dynamic adaptation process (DAP) within an Exploration, Preparation, Implementation, Sustainment (EPIS) framework to examine the implementation of a digital messaging program, developed at the beginning of the COVID-19 pandemic, aimed at providing Spanish-, English-, and Mandarin-speaking immigrant caregivers with caregiver-child activities that supported children's development and caregivers' knowledge. Building upon the EPIS framework, using DAP, we assessed the feasibility and acceptability of a messaging program via short message service or multimedia message service, WeChat, and Remind and webinar program during the COVID-19 pandemic. The study illustrated how a digital messaging program is a feasible mechanism for sharing developmentally and culturally appropriate information with immigrant caregivers. In addition, the use of the DAP and the EPIS framework allowed us to continuously track the process of cultural adaptation, identify barriers and facilitators of the outreach program, and examine how implementation unfolded across all three groups of caregivers.

8.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-341759

ABSTRACT

Background: The National Health Service Diabetes Prevention Programme (NHS DPP) was commissioned by NHS England in 2016 and rolled out in three ‘waves’ across the whole of England. It aims to help people with raised blood glucose levels reduce their risk of developing type 2 diabetes through behaviour change techniques (e.g. weight loss, dietary changes and exercise). We report findings from interviews with designated local leads, responsible for the local commissioning and implementation of the programme, to explore how local implementation processes were enacted and adapted over time. Methods We conducted a telephone interview study across two time-points. We conducted 24 semi-structured interviews with local leads across 19 sampled case sites between October 2019 and January 2020. We conducted 13 interviews with local leads across 13 sampled case sites between July 2020 and August 2020. Interviews aimed to reflect on the experience of implementation and explore how things changed over time;this included how implementation plans changed in the light of the COVID-19 pandemic. Results We identified five overarching themes to show how implementation was locally enacted and adapted across the sampled case sites: 1. Adapting to provider change;2. Identification and referral;3. Enhancing uptake in underserved populations;4. Digital and remote service options and 5. Impact of COVID-19 pandemic on implementation. Conclusion This paper reports how designated local leads, responsible for local implementation of the NHS DPP, adapted implementation efforts over the course of a changing national diabetes prevention programme, including how implementation and delivery of the programme was impacted during the COVID-19 pandemic. This paper highlights three main factors that influence implementation: the importance of facilitation, the ability (or not) to tailor interventions to local needs and the role of context in implementation.

9.
Pediatr Pulmonol ; 57(1): 176-184, 2022 01.
Article in English | MEDLINE | ID: covidwho-1955933

ABSTRACT

BACKGROUND: Tracheostomy-related morbidity and mortality mainly occur due to decannulation, misplacement, or obstruction of the tube. A standardized training can improve the skills and confidence of the caregivers in tracheostomy care (TC). OBJECTIVE: Our primary aim was to evaluate the efficiency of standardized training program on the knowledge and skills (changing-suctioning the tracheostomy tube) of the participants regarding TC. MATERIALS AND METHODS: Sixty-five caregivers of children with tracheostomy were included. First, participants were evaluated with written test about TC and participated in the practical tests. Then, they were asked to participate in a standardized training session, including theoretical and practical parts. Baseline and postintervention assessments were compared through written and practical tests conducted on the same day. RESULTS: A significant improvement was observed in the written test score after the training. The median number of correct answers of the written test including 23 questions increased 26%, from 12 to 18 (p < .001). The median number of correct steps in tracheostomy tube change (from 9 to 16 correct steps out of 16 steps, 44% increase) and suctioning the tracheostomy tube (from 9 to 17 correct steps out of 18 steps, 44% increase) also improved significantly after the training (p < .001, for both). CONCLUSION: Theoretical courses and practical hands-on-training (HOT) courses are highly effective in improving the practices in TC. A standardized training program including HOT should be implemented before discharge from the hospital. Still there is a need to assess the impact of the program on tracheostomy-related complications, morbidity, and mortality in the long term.


Subject(s)
Caregivers , Tracheostomy , Child , Humans , Patient Discharge
10.
Education Policy Analysis Archives ; 30, 2022.
Article in Portuguese | Scopus | ID: covidwho-1955066

ABSTRACT

This paper assesses the users’ perception about the implementation of the Remote Education Program (Reanp) formulated by the government of the state of Minas Gerais. A total of 388 comments from teachers, students and guardians were monitored and analyzed in relation to 36 posts on the official Facebook page of the State Department of Education, published between May and October 2020. The data reveal that the implementation of the program and its complexity can contribute to the intensification of regional and social inequality, in addition to pointing to the exclusion of a significant number of users. Tensions are evident in relation to technologies, resources and artifacts, access asymmetries that compromise teaching work and student performance. The users’ perceptions about the implementation of Reanp indicates that the emergence of the policy led to vertical and improvised actions, increased levels of discretion, inducing different levels of commitment and motivation. © 2022, Arizona State University. All rights reserved.

11.
Clin Appl Thromb Hemost ; 28: 10760296221115112, 2022.
Article in English | MEDLINE | ID: covidwho-1950835

ABSTRACT

Pharmacovigilance plays a lifesaving role in the practice of medicine. In 2021, during the Coronavirus Infectious Disease 2019 (COVID-19) pandemic, Loyola University Chicago launched a graduate-level Pharmacovigilance Certificate Program (PV-CERT) and a pre-professional non-graduate Pharmacovigilance Certificate Course (EPEC-PV), to provide students a comprehensive and contemporary understanding of the principles and practices of pharmacovigilance. Formal training in pharmacovigilance through this course provided a structured understanding of how safety data are generated through clinical trials and from real-world evidence as well as the regulatory environment in which data are monitored and interpreted. Pharmacovigilance training is of critical importance, especially during the COVID-19 pandemic, during which several drugs were re-purposed for the management of various stages of COVID-19 without conventional safety data. Moreover, the safety of currently-used vaccines is of concern in some populations. Although anticoagulants and antithrombotic medications are crucial in the management of COVID-19, a clear pharmacovigilance program on their use in this indication is not established. As the century progresses, new diseases and infectious agents will require novel therapies for which the evaluation of benefits versus risks will be as essential as it has been for the current COVID-19 pandemic. As such, the Loyola course and accompanying programs on pharmacovigilance will play a key role in educating the next generation of professionals in pursuing careers in the development of therapies that ultimately improve patient outcomes while maintaining rigorous safety standards.


Subject(s)
COVID-19 , Communicable Diseases , Humans , Pandemics , Pharmacovigilance
12.
Front Public Health ; 10: 862388, 2022.
Article in English | MEDLINE | ID: covidwho-1952798

ABSTRACT

Early life adversity can significantly impact child development and health outcomes throughout the life course. With the COVID-19 pandemic exacerbating preexisting and introducing new sources of toxic stress, social programs that foster resilience are more necessary now than ever. The Helping Us Grow Stronger (HUGS/Abrazos) program fills a crucial need for protective buffers during the COVID-19 pandemic, which has escalated toxic stressors affecting pregnant women and families with young children. HUGS/Abrazos combines patient navigation, behavioral health support, and innovative tools to ameliorate these heightened toxic stressors. We used a mixed-methods approach, guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, to evaluate the implementation of the HUGS/Abrazos program at Massachusetts General Hospital from 6/30/2020-8/31/2021. Results of the quality improvement evaluation revealed that the program was widely adopted across the hospital and 392 unique families were referred to the program. The referred patients were representative of the communities in Massachusetts disproportionately affected by the COVID-19 pandemic. Furthermore, 79% of referred patients followed up with the initial referral, with sustained high participation rates throughout the program course; and they were provided with an average of four community resource referrals. Adoption and implementation of the key components in HUGS/Abrazos were found to be appropriate and acceptable. Furthermore, the implemented program remained consistent to the original design. Overall, HUGS/Abrazos was well adopted as an emergency relief program with strong post-COVID-19 applicability to ameliorate continuing toxic stressors while decreasing burden on the health system.


Subject(s)
COVID-19 , COVID-19/epidemiology , Child , Child, Preschool , Female , Humans , Massachusetts/epidemiology , Pandemics , Pregnancy , Quality Improvement
13.
Mil Med ; 2022 Jul 21.
Article in English | MEDLINE | ID: covidwho-1948382

ABSTRACT

INTRODUCTION: Influenza infection in the United States results in hundreds of thousands of hospitalizations and 12,000 to 60,000 yearly deaths. Influenza season sees a sharp increase in emergency department (ED) patients nationwide, as primary care offices become overwhelmed. Because the ED is unique in its reach of underserved communities, ED vaccination programs can help maximize the number of people protected by vaccination. Influenza vaccination is one of the only vaccines that occurs yearly; therefore, successes with ED distribution of the influenza vaccine can potentially be translated into efforts of vaccinating the U.S. population more efficiently against other viral illnesses, such COVID-19. There has also not been a previous description in the literature of a vaccination program being used in a military setting. The original purpose of this study was to measure the effect of an ED vaccination program on our vaccine penetration and ED length of stay as well as to analyze the impact of provider education on vaccine uptake on vaccine refusal. METHODS: This was an observational, quality improvement project in the Wright-Patterson Medical Center Emergency Department evaluating an influenza vaccination program set to last from October 1, 2020 to April 1, 2021. Patients were to be surveyed to assess prior vaccination status, identify those at high risk for influenza complications, and to measure the effects of point-of-care education on vaccine acceptance. Separate measurements included average ED length of stay and the study's impact on how quickly the base population could be vaccinated. RESULTS: The effort was determined no longer feasible on November 20, 2020 because of the significant barriers. Although no data were gathered, we were able to glean important information that is vital in future efforts to implement ED-based vaccination programs. Reasons for program failure were multi-factorial, but were mainly attributed to rapid implementation, issues with Pyxis ordering and vaccine shipments, and vaccine storage capacity. The program also lacked a multidisciplinary implementation team of nurses and technicians, which could have better anticipated critical barriers. CONCLUSION: Influenza has caused multiple worldwide pandemics, contributed to countless deaths, and continues to be a challenge. ED-based influenza vaccination programs have been trialed to augment the primary care system in their effort to prevent deaths from influenza. The literature has shown that these programs are cost-effective and efficacious, but significant barriers have stunted their widespread utilization. Examining the rapid implementation and failure of this program highlights the importance of implementation models, process and barrier mapping, and proper operationalization. It is also the first such program that has been trialed in a military treatment facility. In consideration of the recent pandemic, successful ED-based vaccination programs can also offer a model for additional dissemination of other vaccines, such as the COVID-19 vaccine.

14.
Am J Infect Control ; 2022 Jun 08.
Article in English | MEDLINE | ID: covidwho-1944006

ABSTRACT

The use of fit tested respirators in the workplace is required to protect health workers against airborne pathogens. The COVID-19 pandemic required rapid upscaling of fit testing which was achieved using the framework of a respiratory protection program. Implementing and sustaining such a program in the midst of a pandemic was challenging and required clear direction from a lead agency combined with stakeholder engagement.

15.
J Am Pharm Assoc (2003) ; 2021 Nov 03.
Article in English | MEDLINE | ID: covidwho-1936708

ABSTRACT

BACKGROUND: Hypertension is a leading cause of cardiovascular disease in the United States and is costing the health care system billions of dollars annually. A health program that combines education, empowerment, and monitoring has shown to improve clinical outcomes and decrease overall health care costs. OBJECTIVE: To describe the implementation and effectiveness of a self-measured blood pressure (SMBP) program in a community pharmacy. PRACTICE DESCRIPTION: An independent community pharmacy located within rural Southeast Missouri. On-site community pharmacists provide medication therapy management, adherence monitoring, immunizations, and reimbursed clinical services. PRACTICE INNOVATION: Patients were eligible if they were older than 18 years of age and fell into one of the following categories: self-reported a new hypertension diagnosis, self-reported a desire to SMBP, were referred by a provider, or had a medication change within the 3 months before enrollment. The program consisted of 4 patient sessions. The first session obtained an initial blood pressure and provided patient education and behavior counseling. Follow-up sessions obtained average SMBP readings and reinforced previously learned concepts. EVALUATION METHODS: Implementation was evaluated using time and patient satisfaction. Effectiveness was evaluated using number and type of clinical problems identified, BP measurements, and test scores. RESULTS: A total of 20 patients enrolled and completed the study. The program took 63 minutes (SD ± 18) of staff time per patient for recruitment, sessions, reminder calls, and documentation. All patients received education and monitoring and 11 additional clinical problems were documented. Systolic BP decreased an average of 17 mm Hg (P = 0.002), and diastolic BP decreased an average of 12 mm Hg (P < 0.001). Patient confidence scores increased by 14%, and 7 more patients correctly answered the post-test knowledge question. All patients reported overall satisfaction with the program as "satisfied" or "very satisfied." CONCLUSION: This standardized SMBP program effectively improved hypertension control and patient confidence in managing BP.

16.
World Sustainability Series ; : 301-313, 2022.
Article in English | Scopus | ID: covidwho-1941423

ABSTRACT

Teaching and research activities in specific fields, such as technology and natural sciences, continuously produce chemical waste in their daily activities. Concerning the environmental impact and risk to human health in teaching and research activities, Brazilian universities have gradually started to draw up their Chemical Waste Management Program (PGRQ) in order to cope with potentially hazardous activities. In this context, the Federal University of Paraiba (UFPB), which has 130 graduate courses, 80 master’s/doctoral programs distributed on 5 campuses in the state of Paraiba/Brazil, is going through a process of implementing a chemical management program for such waste. Therefore, the objective of this article is to describe, through a quantitative and qualitative approach, the initiatives and activities adopted to implement the Chemical Waste Management Plan at UFPB. The study was conducted using data on regular collection from university campuses. Initially, proper chemical containers were distributed to collect and store liquid solutions from research activities and practical lab classes. In the first collection alone, 17,595 kg of environmental liabilities were collected. All collected chemical had their proper final treatment in industrial landfills or incinerated by the contracted company. In 2020, 21,132 kg of hazardous waste from classes A, B and E were collected. In comparison with the previous year, where 11,363 kg of waste were collected, there was an increase of 9769 kg of chemical waste. Due to the COVID-19 pandemic during the year 2021, a large part of the laboratories stopped or decreased their activities and there was a reduction in the amount of hazardous waste produced. UFPB currently has 59 registered points for storage of chemical waste and 21 points for voluntary delivery among its 04 campuses, serving more sloth’s 9000 people, including professors, technicians and graduate students. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

17.
JAMIA open ; 2022.
Article in English | EuropePMC | ID: covidwho-1940075

ABSTRACT

Objective In order to manage COVID-19 patient population and bed capacity issues, remote patient monitoring (RPM) is a strategy used to transition patients from inpatients to home. We describe our RPM implementation process for post-acute care COVID-19 pneumonia patients. We also evaluate the impact of RPM on patient outcomes, including hospital length of stay (LOS), post-discharge Emergency Department (ED) visits, and hospital readmission. >Materials and Methods We utilized a cloud-based RPM platform (Vivify Health) and a nurse-monitoring service (Global Medical Response) to enroll COVID-19 patients who required oxygen supplementation after hospital discharge. We evaluated patient participation, biometric alerts, and provider communication. We also assessed the program’s impact by comparing RPM patient outcomes with a retrospective cohort of Control patients who similarly required oxygen supplementation after discharge but were not referred to the RPM program. Statistical analyses were performed to evaluate the two groups’ demographic characteristics, hospital LOS, and readmission rates. Results The RPM program enrolled 75 patients with respondents of a post-participation survey reporting high satisfaction with the program. Compared to the Control group (n = 150), which had similar demographics and baseline characteristics, the RPM group was associated with shorter hospital LOS (median 4.8 vs 6.1 days;P =.03) without adversely impacting return to the ED or readmission. Conclusion We implemented a RPM program for post-acute discharged COVID-19 patients requiring oxygen supplementation. Our RPM program resulted in a shorter hospital LOS without adversely impacting quality outcomes for readmission rates and improved healthcare utilization by reducing the average LOS. LAY SUMMARY To improve hospital operations and bed utilization during the COVID-19 pandemic, we rapidly developed a remote patient monitoring (RPM) program as a strategy to facilitate the discharge of stable COVID-19 patients requiring supplemental oxygen and support their transition from the inpatient setting to home. We share our RPM implementation process and show that enrolled RPM patients were associated with shorter hospital length of stay (LOS) without any adverse impact on quality outcomes, such as return to the Emergency Department or readmission, compared to a cohort of control patients who were not enrolled in RPM. We also show that our RPM program had a high patient engagement rate and positive patient satisfaction. Our results demonstrate that RPM can be an essential part of the healthcare delivery model, as it could positively impact outcomes, healthcare utilization, and patient satisfaction.

18.
INTERNET JOURNAL OF ALLIED HEALTH SCIENCES AND PRACTICE ; 20(2), 2022.
Article in English | Web of Science | ID: covidwho-1935303

ABSTRACT

Purpose: There is limited evidence describing burnout among graduate health professions students, including pharmacy students, and there is a need for educational institutions to mitigate burnout and promote future healthcare provider wellness. Methods: A burnout prevention elective course was developed within an accelerated Doctor of Pharmacy program. Course faculty transitioned from live to fully remote instruction in April 2020. The modified course format combined discussion-based lectures, burnout self-assessments, reflective writing assignments, and applications-based presentations. Results: Twentyone second-year pharmacy students completed the elective, and 13 completed post-course evaluations (61.9% response rate). Evaluations indicated substantial student support, with 92.3% "strongly agree" and 7.7% "agree" responses for all questions. Students suggested incorporating this course into the core didactic curriculum rather than offering it as an elective. Conclusion: Pharmacy programs considering piloting similar courses may effectively implement them even under the modified learning conditions imposed by COVID-19.

20.
JMIR Form Res ; 6(8): e38247, 2022 Aug 05.
Article in English | MEDLINE | ID: covidwho-1933487

ABSTRACT

BACKGROUND: In-person directly observed therapy (DOT) is standard of care for tuberculosis (TB) treatment adherence monitoring in the US, with increasing use of video-DOT (vDOT). In Minneapolis, vDOT became available in 2019. OBJECTIVE: In this paper, we aimed to evaluate the use and effectiveness of vDOT in a program setting, including comparison of verified adherence among those receiving vDOT and in-person DOT. We also sought to understand the impact of COVID-19 on TB treatment adherence and technology adoption. METHODS: We abstracted routinely collected data on individuals receiving therapy for TB in Minneapolis, MN, between September 2019 and June 2021. Our primary outcomes were to assess vDOT use and treatment adherence, defined as the proportion of prescribed doses (7 days per week) verified by observation (in person versus video-DOT), and to compare individuals receiving therapy in the pre-COVID-19 (before March 2020), and post-COVID-19 (after March 2020) periods; within the post-COVID-19 period, we evaluated early COVID-19 (March-August 2020), and intra-COVID-19 (after August 2020) periods. RESULTS: Among 49 patients with TB (mean age 41, SD 19; n=27, 55% female and n=47, 96% non-US born), 18 (36.7%) received treatment during the post-COVID-19 period. Overall, verified adherence (proportion of observed doses) was significantly higher when using vDOT (mean 81%, SD 17.4) compared to in-person DOT (mean 54.5%, SD 10.9; P=.001). The adoption of vDOT increased significantly from 35% (11/31) of patients with TB in the pre-COVID-19 period to 67% (12/18) in the post-COVID-19 period (P=.04). Consequently, overall verified (ie, observed) adherence among all patients with TB in the clinic improved across the study periods (56%, 67%, and 79%, P=.001 for the pre-, early, and intra-COVID-19 periods, respectively). CONCLUSIONS: vDOT use increased after the COVID-19 period, was more effective than in-person DOT at verifying ingestion of prescribed treatment, and led to overall increased verified adherence in the clinic despite the onset of the COVID-19 pandemic.

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