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Luo WY, Sun JW, Zhang WL, Li Q, Ni P, Zhao LB, Tian JH, Zhang YQ, Lu H. Management in the paediatric wards facing novel coronavirus infection: a rapid review of guidelines and consensuses. BMJ Open 2020; 10:e039897. [PMID: 32788192 PMCID: PMC7422658 DOI: 10.1136/bmjopen-2020-039897] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/27/2020] [Accepted: 07/30/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Relevant guidelines and consensuses for COVID-19 contain recommendations aimed at optimising the management in paediatric wards. The goal of this study was to determine the quality of those recommendations and provide suggestions to hospital managers for the adjustment of existing hospital prevention and control strategies, and also to offer recommendations for further research. DESIGN A rapid review of the guidelines and consensuses for the management in paediatric wards facing COVID-19. METHODS PubMed, EMBASE, the Cochrane Library, UpToDate, China National Knowledge Infrastructure, the Wanfang database and relevant websites such as medlive.cn, dxy.cn, the National Health and Health Commission and the China Center for Disease Control and Prevention were systematically searched through late May 2020. The Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool was then used to assess the quality of the selected articles and summarise the relevant evidence concerning management in paediatric wards. RESULTS A total of 35 articles were included, composed of 3 consensus guidelines, 25 expert consensuses and 7 expert opinions. Of the 35 papers, 24 were from China, 2 from the USA, 1 from Spain, 1 from Brazil, 1 from Saudi Arabia and 6 from multinational cooperative studies. Scores for the six domains of the AGREE II tool (scope and purpose, stakeholder involvement, rigour of development, clarity of presentation, applicability and editorial independence) were 98.57%, 53.57%, 17.92%, 69.62%, 26.96% and 50.35%, respectively. Recommendations for nosocomial infection and control, human resource management as well as management of paediatric patients and their families were summarised. CONCLUSIONS Due to the outbreak of COVID-19, the quality of rapid guidelines and consensuses for the management in paediatric wards affected by COVID-19 is unsatisfactory. In the future, it will be necessary to develop more high-quality guidelines or consensuses for the management in paediatric wards to deal with nosocomial outbreaks in order to fully prepare for emergency medical and health problems.
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Affiliation(s)
- Wen-Yi Luo
- Department of Nursing, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Ji-Wen Sun
- Department of Nursing, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wen-Lan Zhang
- Pediatric Intensive Care Unit, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qian Li
- Department of General Surgical, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ping Ni
- Department of Nursing, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lie-Bin Zhao
- Dean's Office, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jin-Hui Tian
- Evidence-Based Medicine Center, Lanzhou University School of Basic Medical Sciences, Lanzhou, Gansu, China
| | - Ya-Qing Zhang
- Editorial Department of Journal of Shanghai Jiao Tong University (Medical Science), Shanghai Jiao Tong University, Shanghai, China
| | - Hong Lu
- Department of Nursing, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Kogutt BK, Sheffield JS, Whyne D, Maragakis LL, Andonian J, Flinn J, Sulmonte C, Dodson A, Romig M, Sauer L, Maloney R, Ferrell J, Vaught AJ, Golden WC, Garibaldi BT. Simulation of a Spontaneous Vaginal Delivery and Neonatal Resuscitation in a Biocontainment Unit. Health Secur 2019; 17:18-26. [PMID: 30779606 DOI: 10.1089/hs.2018.0090] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This article describes a large-scale scenario designed to test the capabilities of a US biocontainment unit to manage a pregnant woman infected with a high-consequence pathogen, and to care for a newborn following labor and spontaneous vaginal delivery. We created and executed a multidisciplinary functional exercise with simulation to test the ability of the Johns Hopkins Hospital biocontainment unit (BCU) to manage a pregnant patient in labor with an unknown respiratory illness and to deliver and stabilize her neonate. The BCU Exercise and Drill Committee established drill objectives and executed the exercise in partnership with the Johns Hopkins Simulation Center in accordance with Homeland Security and Exercise Program guidelines. Exercise objectives were assessed by after-action reporting and objective measurements to detect contamination, using a fluorescent marker to simulate biohazardous fluids that would be encountered in a typical labor scenario. The immediate objectives of the drill were accomplished, with stabilization of the mother and successful delivery and resuscitation of her newborn. There was no evidence of contamination when drill participants were inspected under ultraviolet light at the end of the exercise. Simulation optimizes teamwork, communication, and safety, which are integral to the multidisciplinary care of the maternal-fetal unit infected, or at risk of infection, with a high-consequence pathogen. Lessons learned from this drill regarding patient transportation, safety, and obstetric and neonatal considerations will inform future exercises and protocols and will assist other centers in preparing to care for pregnant patients under containment conditions.
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Affiliation(s)
- Benjamin K Kogutt
- Benjamin K. Kogutt, MD, is a Clinical Fellow, Department of Gynecology and Obstetrics, Division of Maternal-Fetal Medicine, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jeanne S Sheffield
- Jeanne S. Sheffield, MD, is Division Director, Department of Gynecology and Obstetrics, Division of Maternal-Fetal Medicine, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Dianne Whyne
- Dianne Whyne, RN, MS, is Director of Operations, Office of Critical Event Preparedness and Response, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Lisa L Maragakis
- Lisa L. Maragakis, MD, MPH, is Associate Professor of Medicine, Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, and Senior Director of Infection Prevention, Johns Hopkins Health System, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jennifer Andonian
- Jennifer Andonian, MPH, is Program Manager, Johns Hopkins Biocontainment Unit, Department of Medicine, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jade Flinn
- Jade Flinn, RN, is a Nurse Educator, Johns Hopkins Biocontainment Unit, Office of Critical Event Preparedness and Response, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Chris Sulmonte
- Chris Sulmonte, MHA, is Administrative Manager, Johns Hopkins Biocontainment Unit, Department of Medicine, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Adam Dodson
- Adam Dodson, NRP, NCEE, is Lead Simulation Specialist, Johns Hopkins Simulation Center, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Mark Romig
- Mark Romig, MD, is Assistant Professor, Division of Pulmonary and Critical Care Medicine, and Johns Hopkins Armstrong Institute for Patient Safety and Quality, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Lauren Sauer
- Lauren Sauer, MS, is Research Director, Johns Hopkins Biocontainment Unit, Department of Medicine, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Robert Maloney
- Robert Maloney, MS, is Senior Director, Office of Emergency Management for Johns Hopkins Health System, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Janis Ferrell
- Janis Ferrell, CT, is Perinatal/Perioperative Clinical Operations Supervisor, Department of Gynecology and Obstetrics, Division of Maternal-Fetal Medicine, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Arthur J Vaught
- Arthur J. Vaught, MD, is Assistant Professor, Department of Gynecology and Obstetrics, Division of Maternal-Fetal Medicine, and Department of Surgery, Division of Surgical Critical Care, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, MD
| | - W Christopher Golden
- W. Christopher Golden, MD, is Medical Director, Johns Hopkins Hospital Newborn Nursery, Department of Pediatrics, Division of Neonatology, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Brian T Garibaldi
- Brian T. Garibaldi, MD, is Director, Johns Hopkins Biocontainment Unit, Department of Medicine, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, MD
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