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Shennan S, Coyle N, Lockwood B, DiDiodato G. Visitor Restrictions During the COVID-19 Pandemic and Increased Falls With Harm at a Canadian Hospital: An Exploratory Study. J Patient Saf 2024; 20:434-439. [PMID: 38917342 DOI: 10.1097/pts.0000000000001237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
BACKGROUND Falls with harms (FWH) in hospitalized patients increase costs and lengths of stay. The COVID-19 pandemic has resulted in more FWH. Additionally, the COVID-19 pandemic has resulted in increased patients in isolation with fewer visitors. Their relationship with falls has not been previously studied. METHODS This is a retrospective, single-site, 12-month before pandemic-12-month after pandemic, observational study. Multiple logistic regression analysis was used to model FWH outcome and associations with isolation and visitor restrictions. RESULTS There were 4369 isolation events and 385 FWH among 22,505 admissions during the study period. Unadjusted analysis demonstrated a FWH risk of 1.33% (95% CI 0.99, 1.67) in those who were placed in isolation compared to 1.80% (95% CI 1.60, 2.00) in those without an isolation event ( χ2 = 4.73, P = 0.03). The FWH risk during the different visitor restriction periods was significantly higher compared to the prepandemic period ( χ2 = 20.81, P < 0.001), ranging from 1.28% (95% CI 1.06, 2.50) in the prepandemic period to 2.03% (95% 1.66, 2.40) with no visitors permitted (phase A) in the pandemic period. After adjusting for potential confounders and selection bias, only phase A visitor restrictions were associated with an increased FWH risk of 0.75% (95% CI 0.32, 1.18) compared to no visitor restrictions. INTERPRETATION Our results suggest a moderately strong association between hospitalized patient FWH risk and severe visitor restrictions. This association was muted in phases with even minor allowances for visitation. This represents the first report of the adverse effects of visitor restriction policies on patients' FWH risks.
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Affiliation(s)
- Stephanie Shennan
- From the Centralized Workforce Scheduling and Timekeeping, Royal Victoria Regional Health Centre
| | - Natalie Coyle
- Patient Safety & Experience, Royal Victoria Regional Health Centre
| | - Brittany Lockwood
- Decision Support & Data Quality, Royal Victoria Regional Health Centre
| | - Giulio DiDiodato
- Chief Research Scientist & Critical Care Medicine, Royal Victoria Regional Health Centre, Barrie, Canada
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Musters SC, Coolen CM, Jongerden IP, Schijven MP, Maaskant JM, Eskes AM. Experiences of healthcare professionals, patients and families with video calls to stimulate patient- and family-centred care during hospitalization: A scoping review. J Clin Nurs 2024; 33:3429-3467. [PMID: 38597356 DOI: 10.1111/jocn.17155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 03/04/2024] [Accepted: 03/25/2024] [Indexed: 04/11/2024]
Abstract
AIM To synthesize the literature on the experiences of patients, families and healthcare professionals with video calls during hospital admission. Second, to investigate facilitators and barriers of implementation of video calls in hospital wards. DESIGN Scoping review. METHODS PubMed, CINAHL and Google Scholar were searched for relevant publications in the period between 2011 and 2023. Publications were selected if they focused on experiences of patients, families or healthcare professionals with video calls between patients and their families; or between families of hospitalized patients and healthcare professionals. Quantitative and qualitative data were summarized in data charting forms. RESULTS Forty-three studies were included. Patients and families were satisfied with video calls as it facilitated daily communication. Family members felt more engaged and felt they could provide support to their loved ones during admission. Healthcare professionals experienced video calls as an effective way to communicate when in-person visits were not allowed. However, they felt that video calls were emotionally difficult as it was hard to provide support at distance and to use communication skills effectively. Assigning local champions and training of healthcare professionals were identified as facilitators for implementation. Technical issues and increased workload were mentioned as main barriers. CONCLUSION Patients, families and healthcare professionals consider video calls as a good alternative when in-person visits are not allowed. Healthcare professionals experience more hesitation towards video calls during admission, as it increases perceived workload. In addition, they are uncertain whether video calls are as effective as in-person conservations. IMPLICATIONS FOR THE CLINICAL PRACTICE When implementing video calls in hospital wards, policymakers and healthcare professionals should select strategies that address the positive aspects of family involvement at distance and the use of digital communication skills. PATIENT CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Selma C Musters
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Cancer Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Celeste M Coolen
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Irene P Jongerden
- Department of Public and Occupational Health, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Amsterdam, The Netherlands
| | - Marlies P Schijven
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands
| | - Jolanda M Maaskant
- Amsterdam Public Health, Amsterdam, The Netherlands
- Department of Internal Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, Amsterdam, The Netherlands
| | - Anne M Eskes
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Cancer Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, The Netherlands
- School of Nursing and Midwifery, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
- Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
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Cadorin L, Mazzega-Fabbro C, Cedrone S. Cancer nurses' experience during the COVID-19 pandemic: Multicenter mixed-methods study on coping and resilience strategies. BMC Nurs 2024; 23:502. [PMID: 39039595 PMCID: PMC11264387 DOI: 10.1186/s12912-024-02085-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 06/10/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND In early 2020, the COVID-19 pandemic created severe difficulties in clinical and organizational fields. Healthcare workers needed to protect their health and avoid infecting their family members, but also limit the virus's spread among vulnerable oncology patients undergoing hospital treatment. OBJECTIVE To evaluate the resilience and coping strategies of nurses working in the oncology setting. METHODS A mixed-methods study was conducted. First, two questionnaires (CD-RISK and COPE- NVI-25) were used to assess nurses' resilience strategies and coping mechanisms quantitatively. Second, qualitative semi-structured interviews were conducted to explore the personal experiences of nurses who cared for patients during the pandemic, and Colaizzi's framework was used for content analysis. RESULTS The 164 participants, the majority of whom were women (88.4%), reported high resilience. The CD-RISK score varied according to education. With respect to COPE-NIV-25, transcendent orientation and avoidance strategies had the lowest mean scores, while problem orientation was higher in nurses aged ≥ 40. Five themes emerged: (1) changes in work and personal areas; (2) feelings/emotions, such as fear of infection of themselves or their loved ones, difficulty in using the face mask, relational repercussions with patients or their families; (3) personal and working group strategies used to counteract the suffering attributable to COVID-19; (4) professionalism/nursing responsibilities in developing new rules and protocols, and (5) metaphors to describe their experiences. CONCLUSIONS The COVID-19 pandemic led to major changes in the nurses' roles, but they showed resilience and generated a positive working climate. IMPLICATION FOR PRACTICE Even in emergency situations, nursing administrations and policymakers ought to ensure that nurses receive adequate training and support to develop resilience and coping strategies.
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Affiliation(s)
- Lucia Cadorin
- Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Via F. Gallini, 2, Aviano, 33081, Italy.
| | - Cristina Mazzega-Fabbro
- Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Via F. Gallini, 2, Aviano, 33081, Italy
- University of Udine, Viale Ungheria, 49, Udine, 33100, Italy
| | - Sonja Cedrone
- Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Via F. Gallini, 2, Aviano, 33081, Italy
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Evans S, Stimson J, Pople D, White PJ, Wilcox MH, Robotham JV. Impact of interventions to reduce nosocomial transmission of SARS-CoV-2 in English NHS Trusts: a computational modelling study. BMC Infect Dis 2024; 24:475. [PMID: 38714946 PMCID: PMC11075183 DOI: 10.1186/s12879-024-09330-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 04/18/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Prior to September 2021, 55,000-90,000 hospital inpatients in England were identified as having a potentially nosocomial SARS-CoV-2 infection. This includes cases that were likely missed due to pauci- or asymptomatic infection. Further, high numbers of healthcare workers (HCWs) are thought to have been infected, and there is evidence that some of these cases may also have been nosocomially linked, with both HCW to HCW and patient to HCW transmission being reported. From the start of the SARS-CoV-2 pandemic interventions in hospitals such as testing patients on admission and universal mask wearing were introduced to stop spread within and between patient and HCW populations, the effectiveness of which are largely unknown. MATERIALS/METHODS Using an individual-based model of within-hospital transmission, we estimated the contribution of individual interventions (together and in combination) to the effectiveness of the overall package of interventions implemented in English hospitals during the COVID-19 pandemic. A panel of experts in infection prevention and control informed intervention choice and helped ensure the model reflected implementation in practice. Model parameters and associated uncertainty were derived using national and local data, literature review and formal elicitation of expert opinion. We simulated scenarios to explore how many nosocomial infections might have been seen in patients and HCWs if interventions had not been implemented. We simulated the time period from March-2020 to July-2022 encompassing different strains and multiple doses of vaccination. RESULTS Modelling results suggest that in a scenario without inpatient testing, infection prevention and control measures, and reductions in occupancy and visitors, the number of patients developing a nosocomial SARS-CoV-2 infection could have been twice as high over the course of the pandemic, and over 600,000 HCWs could have been infected in the first wave alone. Isolation of symptomatic HCWs and universal masking by HCWs were the most effective interventions for preventing infections in both patient and HCW populations. Model findings suggest that collectively the interventions introduced over the SARS-CoV-2 pandemic in England averted 400,000 (240,000 - 500,000) infections in inpatients and 410,000 (370,000 - 450,000) HCW infections. CONCLUSIONS Interventions to reduce the spread of nosocomial infections have varying impact, but the package of interventions implemented in England significantly reduced nosocomial transmission to both patients and HCWs over the SARS-CoV-2 pandemic.
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Affiliation(s)
- Stephanie Evans
- Fungal, HCAI, AMU & Sepsis Division, UK Health Security Agency, London, AMR, UK.
- Statistics, Modelling and Economics, UK Health Security Agency, London, UK.
| | - James Stimson
- Fungal, HCAI, AMU & Sepsis Division, UK Health Security Agency, London, AMR, UK
- Statistics, Modelling and Economics, UK Health Security Agency, London, UK
| | - Diane Pople
- Fungal, HCAI, AMU & Sepsis Division, UK Health Security Agency, London, AMR, UK
- Statistics, Modelling and Economics, UK Health Security Agency, London, UK
| | - Peter J White
- Statistics, Modelling and Economics, UK Health Security Agency, London, UK
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK
- NIHR Health Protection Research Unit in Modelling and Health Economics at Imperial College London in partnership with the UK Health Security Agency and London School of Hygiene and Tropical Medicine, London, UK
| | - Mark H Wilcox
- Healthcare-Associated Infections Research Group, Leeds Institute of Medical Research, University of Leeds, Leeds, LS1 9JT, UK
- Microbiology, Leeds Teaching Hospitals, Leeds, UK
| | - Julie V Robotham
- Fungal, HCAI, AMU & Sepsis Division, UK Health Security Agency, London, AMR, UK
- Statistics, Modelling and Economics, UK Health Security Agency, London, UK
- NIHR Health Protection Research Unit in Modelling and Health Economics at Imperial College London in partnership with the UK Health Security Agency and London School of Hygiene and Tropical Medicine, London, UK
- NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in partnership with the, UK Health Security Agency, Oxford, UK
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Jackson D, Aveyard H, Commodore-Mensah Y, Dale C, Noyes J, Smith GD, Sharps P, Timmins F, Yu D. The future is ours to shape: Nursing emerging from the pandemic with insight, optimism and courage. J Adv Nurs 2024; 80:1-3. [PMID: 37165794 DOI: 10.1111/jan.15706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 05/04/2023] [Indexed: 05/12/2023]
Affiliation(s)
- Debra Jackson
- Susan Wakil School of Nursing, University of Sydney, Sydney, Australia
| | - Helen Aveyard
- School of Nursing, Oxford Brookes University, Oxford, UK
| | | | - Craig Dale
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Jane Noyes
- School of Medical and Health Sciences, Bangor University, Bangor, UK
| | | | - Phyllis Sharps
- Johns Hopkins School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Fiona Timmins
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, UK
| | - Doris Yu
- LKS Faculty of Medicine, School of Nursing, The University of Hong Kong, Hong Kong, China
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Nieto-García L, Carpio-Pérez A, Moreiro-Barroso MT, Rubio-Gil FJ, Ruiz-Antúnez E, Nieto-García A, Alonso-Sardón M. Is the Increase in Record of Skin Wounds in Hospitalized Patients in Internal Medicine Units a Side Effect of the COVID-19 Pandemic? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2228. [PMID: 36767595 PMCID: PMC9916326 DOI: 10.3390/ijerph20032228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 01/22/2023] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
Wound care is an important public health challenge that is present in all areas of the healthcare system, whether in hospitals, long term care institutions or in the community. We aimed to quantify the number of skin wounds reported after and during the COVID-19 pandemic. This descriptive longitudinal retrospective study compared of wound records in patients hospitalized in the internal medicine service during the first year of the COVID-19 pandemic (from 1 March 2020, to 28 February 2021) and previous-year to the outbreak (from 1 January 2019, to 31 December 2019). A sample of 1979 episodes was collected corresponding to 932 inpatients, 434 from the pre-pandemic year and 498 from the first year of COVID-19 pandemic; 147 inpatients were diagnosed with SARS-CoV-2 infection (3.2%). The percentage of wound episodes in the first year of the COVID-19 pandemic was higher than the pre-pandemic year, 17.9% (1092/6090) versus 15% (887/5906), with a significant increase in the months with the highest incidence of COVID cases. This study shows an increase in the burden of wound care during the COVID-19 pandemic, and it could be attributable to the increase in the number of patients hospitalized for SARS-CoV-2 infection in internal medicine units.
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Affiliation(s)
- Leticia Nieto-García
- School of Nursing and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain
| | - Adela Carpio-Pérez
- Internal Medicine Service, Institute for Biomedical Research of Salamanca (IBSAL), University Hospital of Salamanca, 37007 Salamanca, Spain
| | | | | | - Emilia Ruiz-Antúnez
- Training, Development and Innovation Area, University Hospital of Salamanca, 37007 Salamanca, Spain
| | - Ainhoa Nieto-García
- School of Nursing and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain
| | - Montserrat Alonso-Sardón
- Preventive Medicine, Epidemiology and Public Health Area, University of Salamanca, 37007 Salamanca, Spain
- Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Faculty of Pharmacy, University of Salamanca, 37007 Salamanca, Spain
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