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Venkataraman R, Rajiah K, Anand M, Surendran G. Social Determinants Predicting the Community Pharmacists' Workforce Preparedness for, and Response to, the Public Health Emergencies. Disaster Med Public Health Prep 2023; 17:e515. [PMID: 37859417 DOI: 10.1017/dmp.2023.155] [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] [Indexed: 10/21/2023]
Abstract
OBJECTIVES To identify the predicting factors that contribute to preparedness for public health emergencies among community pharmacists in India. METHODS Multistage cluster sampling was done. The geographic breakdown was done based on villages and areas and used as clusters. A simple random method was done in the first stage to select the villages as clusters. From each selected village, a simple random method was done in the second stage to select the areas. From each selected area, all the community pharmacies were selected. The survey questionnaire had 3 sections with 43 items: (A) demographic information, (B) preparedness, (C) response toward infectious diseases. The participants chose "Yes/No", in sections B and C. A score of 1 was given for "Yes", and a score of zero was given for "No". RESULTS Multiple correlation analyses were conducted between participants' preparedness and response (PR) scores and independent variables. The independent variables such as "More than one Pharmacist working in a pharmacy", "Pharmacists who are trained more than once on disaster management", and encountered more than 1 patient with the infectious disease were positively and significantly correlated with the dependent variable (PR scores). CONCLUSIONS Community pharmacists were aware of the issues they may face in their community concerning public health emergencies. They believed that the medications available in their pharmacy are sufficient to face any emergency. They could identify the clinical manifestations of public health emergency conditions and provide counselling to the customers toward them. Community pharmacists who were trained more than once in disaster management were the strongest predicting factor.
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Affiliation(s)
- Rajesh Venkataraman
- Department of Pharmacy Practice, Sri Adichunchanagiri College of Pharmacy, Adichunchanagiri University, B.G Nagara, India
| | - Kingston Rajiah
- School of Pharmacy and Pharmaceutical Sciences, Ulster University, Coleraine, United Kingdom
| | - Meghana Anand
- Department of Pharmacy Practice, Sri Adichunchanagiri College of Pharmacy, Adichunchanagiri University, B.G Nagara, India
| | - Gopika Surendran
- Department of Pharmacy Practice, Sri Adichunchanagiri College of Pharmacy, Adichunchanagiri University, B.G Nagara, India
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Arnold-Reed DE, Bulsara CE, Gilkes L. Disruption caused by the COVID-19 pandemic response from a Western Australian metropolitan general practice perspective: a qualitative descriptive study. Aust J Prim Health 2023; 29:385-394. [PMID: 36683177 DOI: 10.1071/py22136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 12/29/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND In 2020 and 2021, Western Australia (WA) was an early adopter of the 'COVID zero' policy, eliminating community transmission and pursuing vaccine roll out to enable a 'soft landing' once coronavirus disease 2019 (COVID-19) infiltrated the community in 2022. Optimisation and augmentation of general practice services were at the forefront of policies. This study explores metropolitan general practice responses to the resulting disruption caused. METHODS Qualitative descriptive methodology, purposive sampling and template analysis were used. Semi-structured interviews were undertaken from March to June 2021 with teams from six general practices in metropolitan WA; six general practitioners, four practice nurses and three practice managers. RESULTS Staff at all levels responded rapidly amid uncertainty and workload challenges with marked personal toll (anxiety and fear of exposure to risks, frustrations of patients and balancing work and family life). Self-reliance, teamwork and communication strategies built on inclusivity, autonomy and support were important. Responding to changes in general patient behaviour was to the fore. Increasing use of telehealth (telephone and video) became important to meet patient needs. Lessons learned from what was implemented in early-stage lockdowns provided practices with preparedness for the future, and smoother transitions during subsequent lockdowns. CONCLUSION The study demonstrates the self-reliance, teamwork and adaptability of the general practice sector in responding to a sudden, unexpected major disruption, yet maintaining ongoing service provision for their patients. Although the COVID-19 landscape has now changed, the lessons learned and the planning that took place will help general practice in WA adapt to similar future situations readily.
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Affiliation(s)
- Diane E Arnold-Reed
- School of Medicine, The University of Notre Dame Australia, 19 Mouat Street, PO Box 1225, Fremantle, WA 6959, Australia
| | - Caroline E Bulsara
- School of Nursing and Midwifery, The University of Notre Dame Australia, 19 Mouat Street, PO Box 1225, Fremantle, WA 6959, Australia; and Institute for Health Research, The University of Notre Dame Australia, 19 Mouat Street, PO Box 1225, Fremantle, WA 6959, Australia
| | - Lucy Gilkes
- School of Medicine, The University of Notre Dame Australia, 19 Mouat Street, PO Box 1225, Fremantle, WA 6959, Australia
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Mogwitz S, Albus C, Beschoner P, Erim Y, Geiser F, Jerg-Bretzke L, Morawa E, Steudte-Schmiedgen S, Wintermann GB, Weidner K. Mental distress of physicians in the outpatient care throughout the COVID-19 pandemic: emotional and supportive human relations matter - Cross-sectional results of the VOICE-study. BMC Health Serv Res 2023; 23:481. [PMID: 37173735 PMCID: PMC10180613 DOI: 10.1186/s12913-023-09361-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 04/01/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND The aim of this cross-sectional study was to evaluate the course of self-reported mental distress and quality of life (QoL) of physicians, working in the outpatient care (POC). Outcomes were compared with a control group of physicians working in the inpatient care (PIC), throughout the Corona Virus Disease (COVID)-19 pandemic. The impact of risk and protective factors in terms of emotional and supportive human relations on mental distress and perceived QoL of POC were of primary interest. METHODS Within the largest prospective, multi-center survey on mental health of health care workers (HCW), conducted during the first (T1) and second (T2) wave of the COVID-19 pandemic in Europe, we investigated the course of current burden (CB), depression (Patient Health Questionnaire-2), anxiety (Generalized Anxiety Disorder-2) and QoL, cross-sectionally, in n = 848 POC (T1: n = 536, T2: n = 312). The primary outcomes were compared with an age- and gender-matchted control group of n = 458 PIC (T1: n = 262, T2: n = 196). COVID-19-, work-related, social risk and protective factors were examined. RESULTS At T1, POC showed no significant differences with respect to CB, depression, anxiety, and QoL, after Bonferroni correction. Whereas at T2, POC exhibited higher scores of CB (Cohen´s d/ Cd = .934, p < .001), depression (Cd = 1.648, p < 001), anxiety (Cd = 1.745, p < .001), work-family conflict (Cd = 4.170, p < .001) and lower QoL (Cd = .891, p = .002) compared with PIC. Nearly all assessed parameters of burden increased from T1 to T2 within the cohort of POC (e.g. depression: CD = 1.580, p < .001). Risk factors for mental distress of POC throughout the pandemic were: increased work-family conflict (CB: ß = .254, p < .001, 95% CI: .23, .28; PHQ-2: ß = .139, p = .011, 95% CI: .09, .19; GAD-2: ß = .207, p < .001, 95% CI: .16, .26), worrying about the patients´ security (CB: ß = .144, p = .007, 95% CI: .07, .22; PHQ-2: ß = .150, p = .006, 95% CI: .00, .30), fear of triage situations (GAD-2: ß = .132, p = .010, 95% CI: -.04, .31) and burden through restricted social contact in spare time (CB: ß = .146, p = .003, 95% CI: .07, .22; PHQ-2: ß = .187, p < .001, 95% CI: .03, .34; GAD-2: ß = .156, p = .003, 95% CI: -.01, .32). Protective factors for mental distress and QoL were the perceived protection by local authorities (CB: ß = -.302, p < .001, 95% CI: -.39, -.22; PHQ-2: ß = -.190, p < . 001, 95% CI: -.36, -.02; GAD-2: ß = -.211, p < .001, 95% CI: -.40, -.03; QoL: ß = .273, p < .001, 95% CI: .18, .36), trust in colleagues (PHQ-2: ß = -.181, p < .001, 95% CI: -.34, -.02; GAD-2: ß = -.199, p < .001, 95% CI: -.37, -.02; QoL: ß = .124, p = .017, 95% CI: .04, .21) and social support (PHQ-2: ß = -.180, p < .001, 95% CI: -.22, -.14; GAD-2: ß = -.127, p = .014, 95% CI: -.17, -.08; QoL: ß = .211, p < .001, 95% CI: .19, .23). CONCLUSIONS During the pandemic, the protective role of emotional and supportive human relations on the mental distress and quality of life of POC should be taken into account more thoroughly, both in practice and future research.
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Affiliation(s)
- Sabine Mogwitz
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universitaet Dresden, Dresden, Germany.
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, Medical Faculty and University Hospital of Cologne, Kerpener Str. 62, Cologne, 50937, Germany
| | - Petra Beschoner
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Maximiliansplatz 2, 91054, Erlangen, Germany
| | - Franziska Geiser
- Department of Psychosomatic Medicine and Psychotherapy, University Clinic of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Lucia Jerg-Bretzke
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Maximiliansplatz 2, 91054, Erlangen, Germany
| | - Susann Steudte-Schmiedgen
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universitaet Dresden, Dresden, Germany
| | - Gloria-Beatrice Wintermann
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universitaet Dresden, Dresden, Germany.
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universitaet Dresden, Dresden, Germany
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Cordeiro L, Gnatta JR, Ciofi-Silva CL, Price A, de Oliveira NA, Almeida RM, Mainardi GM, Srinivas S, Chan W, Levin ASS, Padoveze MC. Personal protective equipment implementation in healthcare: A scoping review. Am J Infect Control 2022; 50:898-905. [DOI: 10.1016/j.ajic.2022.01.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/22/2022] [Accepted: 01/24/2022] [Indexed: 12/23/2022]
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Matenge S, Sturgiss E, Desborough J, Hall Dykgraaf S, Dut G, Kidd M. Ensuring the continuation of routine primary care during the COVID-19 pandemic: a review of the international literature. Fam Pract 2022; 39:747-761. [PMID: 34611708 PMCID: PMC8515263 DOI: 10.1093/fampra/cmab115] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has resulted in the diversion of health resources away from routine primary care delivery. This disruption of health services has necessitated new approaches to providing care to ensure continuity. OBJECTIVES To summarize changes to the provision of routine primary care services during the pandemic. METHODS Rapid literature review using PubMed/MEDLINE, SCOPUS, and Cochrane. Eligible studies were based in primary care and described practice-level changes in the provision of routine care in response to COVID-19. Relevant data addressing changes to routine primary care delivery, impact on primary care functions and challenges experienced in adjusting to new approaches to providing care, were obtained from included studies. A narrative summary was guided by Burns et al.'s framework for primary care provision in disasters. RESULTS Seventeen of 1,699 identified papers were included. Studies reported on telehealth use and public health measures to maintain safe access to routine primary care, including providing COVID-19 screening, and establishing dedicated care pathways for non-COVID and COVID-related issues. Acute and urgent care were prioritized, causing disruptions to chronic disease management and preventive care. Challenges included telehealth use including disparities in access and practical difficulties in assessing patients, personal protective equipment shortages, and financial solvency of medical practices. CONCLUSIONS Substantial disruptions to routine primary care occurred due to the COVID-19 pandemic. Primary care practices' rapid adaptation, often with limited resources and support, demonstrates agility and innovative capacity. Findings underscore the need for timely guidance and support from authorities to optimize the provision of comprehensive routine care during pandemics.
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Affiliation(s)
- Sethunya Matenge
- Department of Health Services Research and Policy, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Elizabeth Sturgiss
- School of Primary and Allied Health Care, Monash University, Melbourne, VIC, Australia
| | - Jane Desborough
- Department of Health Services Research and Policy, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Sally Hall Dykgraaf
- Rural Clinical School, ANU Medical School, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Garang Dut
- ANU Medical School, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Michael Kidd
- ANU Medical School, College of Health and Medicine, Australian National University, Canberra, ACT, Australia.,Australian Government Department of Health, Canberra, ACT, Australia.,Department of Family and Community Medicine, The University of Toronto, Toronto, Canada.,Department of General Practice, The University of Melbourne, Melbourne, VIC, Australia.,Southgate Institute for Equity, Health and Society, Flinders University, Adelaide, SA, Australia
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Desborough J, Dykgraaf SH, Phillips C, Wright M, Maddox R, Davis S, Kidd M. Lessons for the global primary care response to COVID-19: a rapid review of evidence from past epidemics. Fam Pract 2021; 38:811-825. [PMID: 33586769 PMCID: PMC7928916 DOI: 10.1093/fampra/cmaa142] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND COVID-19 is the fifth and most significant infectious disease epidemic this century. Primary health care providers, which include those working in primary care and public health roles, have critical responsibilities in the management of health emergencies. OBJECTIVE To synthesize accounts of primary care lessons learnt from past epidemics and their relevance to COVID-19. METHODS We conducted a review of lessons learnt from previous infectious disease epidemics for primary care, and their relevance to COVID-19. We searched PubMed/MEDLINE, PROQUEST and Google Scholar, hand-searched reference lists of included studies, and included research identified through professional contacts. RESULTS Of 173 publications identified, 31 publications describing experiences of four epidemics in 11 countries were included. Synthesis of findings identified six key lessons: (i) improve collaboration, communication and integration between public health and primary care; (ii) strengthen the primary health care system; (iii) provide consistent, coordinated and reliable information emanating from a trusted source; (iv) define the role of primary care during pandemics; (v) protect the primary care workforce and the community and (vi) evaluate the effectiveness of interventions. CONCLUSIONS Evidence highlights distinct challenges to integrating and supporting primary care in response to infectious disease epidemics that have persisted over time, emerging again during COVID-19. These insights provide an opportunity for strengthening, and improved preparedness, that cannot be ignored in a world where the frequency, virility and global reach of infectious disease outbreaks are increasing. It is not too soon to plan for the next pandemic, which may already be on the horizon.
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Affiliation(s)
- Jane Desborough
- Department of Health Services Research and Policy, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra Australia
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Sally Hall Dykgraaf
- Australian National University Rural Clinical School, College of Health and Medicine, Australian National University, Canberra, Australia
| | - Christine Phillips
- Australian National University Medical School, College of Health and Medicine Australian National University, Canberra, Australia
| | - Michael Wright
- Centre for Health Economics Research and Evaluation (CHERE), University Technology Sydney, Sydney, Australia
| | - Raglan Maddox
- COVID-19 Primary Care Response Group, Australian Department of Health, Canberra, Australia
- National Centre for Epidemiology and Public Health, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australia
| | - Stephanie Davis
- COVID-19 Primary Care Response Group, Australian Department of Health, Canberra, Australia
- National Centre for Epidemiology and Public Health, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australia
| | - Michael Kidd
- Australian Government Department of Health, Canberra, Australia
- College of Health and Medicine, Australian National University, Canberra, Australia
- Department of Family & Community Medicine, University of Toronto, Toronto, Canada
- World Health Organization Collaborating Centre on Family Medicine and Primary Care, Geneva, Switzerland
- Murdoch Children’s Research Institute, The Royal Children’s Hospital, Melbourne, Australia
- Southgate Institute for Health, Society and Equity, Flinders University, Adelaide, Australia
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Stöcker A, Demirer I, Gunkel S, Hoffmann J, Mause L, Ohnhäuser T, Scholten N. Stockpiled personal protective equipment and knowledge of pandemic plans as predictors of perceived pandemic preparedness among German general practitioners. PLoS One 2021; 16:e0255986. [PMID: 34383827 PMCID: PMC8360569 DOI: 10.1371/journal.pone.0255986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 07/28/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic significantly changed the work of general practitioners (GPs). At the onset of the pandemic in March 2020, German outpatient practices had to adapt quickly. Pandemic preparedness (PP) of GPs may play a vital role in their management of a pandemic. OBJECTIVES The study aimed to examine the association in the stock of seven personal protective equipment (PPE) items and knowledge of pandemic plans on perceived PP among GPs. METHODS Three multivariable linear regression models were developed based on an online cross-sectional survey for the period March-April 2020 (the onset of the pandemic in Germany). Data were collected using self-developed items on self-assessed PP and knowledge of a pandemic plan and its utility. The stock of seven PPE items was queried. For PPE items, three different PPE scores were compared. Control variables for all models were gender and age. RESULTS In total, 508 GPs were included in the study; 65.16% believed that they were very poorly or poorly prepared. Furthermore, 13.83% of GPs were aware of a pandemic plan; 40% rated those plans as beneficial. The stock of FFP-2/3 masks, protective suits, face shields, safety glasses, and medical face masks were mostly considered completely insufficient or insufficient, whereas disposable gloves and disinfectants were considered sufficient or completely sufficient. The stock of PPE was significantly positively associated with PP and had the largest effect on PP; the association of the knowledge of a pandemic plan was significant but small. PPE scores did not vary considerably in their explanatory power. The assessment of a pandemic plan as beneficial did not significantly affect PP. CONCLUSION The stock of PPE seems to be the determining factor for PP among German GPs; for COVID-19, sufficient masks are the determining factor. Knowledge of a pandemic plans play a secondary role in PP.
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Affiliation(s)
- Arno Stöcker
- Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Ibrahim Demirer
- Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Sophie Gunkel
- Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Jan Hoffmann
- Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Laura Mause
- Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Tim Ohnhäuser
- Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Nadine Scholten
- Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
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Sasaki H, Maruya H, Abe Y, Fujita M, Furukawa H, Fuda M, Kamei T, Yaegashi N, Tominaga T, Egawa S. Scoping Review of Hospital Business Continuity Plans to Validate the Improvement after the 2011 Great East Japan Earthquake and Tsunami. TOHOKU J EXP MED 2021; 251:147-159. [PMID: 32641641 DOI: 10.1620/tjem.251.147] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
During a disaster, all hospitals are expected to function as "social critical institutions" that protect the lives and health of people. In recent disasters, numerous hospitals were damaged, and this hampered the recovery of the affected communities. Had these hospitals business continuity plans (BCPs) to recover quickly after the disaster, most of the damage could have been avoided. This study conducted a scoping review of the historical trend and regional differences in hospital BCPs to validate the improvement of the BCP concept based on our own experience at Tohoku University Hospital, which was affected by the 2011 Great East Japan Earthquake and Tsunami (GEJET). We searched PubMed by using keywords related to BCP and adapted 97 articles for our analysis. The number of articles on hospital BCPs has increased in the 2000s, especially after Hurricane Katrina in 2005. While there are regional specificity of hazards, there were many common topics and visions for BCP implementation, education, and drills. From our 2011 GEJET experience, we found that BCPs assuming region-specific disasters are applicable in various types of disasters. Thus, we suggest the following integral and universal components for hospital BCPs: (1) alternative methods and resources, (2) priority of operation, and (3) resource management. Even if the type and extent of disasters vary, the development of BCPs and business continuity management strategies that utilize the abovementioned integral components can help a hospital survive disasters in the future.
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Affiliation(s)
- Hiroyuki Sasaki
- Division of International Cooperation for Disaster Medicine, International Research Institute of Disaster Science (IRIDeS), Tohoku University.,Committee of Business Continuity Plan, Tohoku University Hospital
| | - Hiroaki Maruya
- Division of Social Systems for Disaster Management, IRIDeS, Tohoku University
| | - Yoshiko Abe
- Committee of Business Continuity Plan, Tohoku University Hospital.,Disaster Response Management Center, Tohoku University Hospital
| | - Motoo Fujita
- Committee of Business Continuity Plan, Tohoku University Hospital.,Department of Emergency and Critical Care Medicine, Tohoku University Hospital
| | - Hajime Furukawa
- Committee of Business Continuity Plan, Tohoku University Hospital.,Department of Emergency and Critical Care Medicine, Tohoku University Hospital
| | - Mikiko Fuda
- Committee of Business Continuity Plan, Tohoku University Hospital.,Nutrition Support Center, Tohoku University Hospital
| | - Takashi Kamei
- Committee of Business Continuity Plan, Tohoku University Hospital.,Department of Surgery, Tohoku University Graduate School of Medicine
| | - Nobuo Yaegashi
- Committee of Business Continuity Plan, Tohoku University Hospital.,Department of Gynecology and Obstetrics, Tohoku University Graduate School of Medicine
| | - Teiji Tominaga
- Committee of Business Continuity Plan, Tohoku University Hospital.,Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Shinichi Egawa
- Division of International Cooperation for Disaster Medicine, International Research Institute of Disaster Science (IRIDeS), Tohoku University.,Committee of Business Continuity Plan, Tohoku University Hospital
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9
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Baral P. Health Systems and Services During COVID-19: Lessons and Evidence From Previous Crises: A Rapid Scoping Review to Inform the United Nations Research Roadmap for the COVID-19 Recovery. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2021; 51:474-493. [DOI: 10.1177/0020731421997088] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This rapid scoping review has informed the development of the November 2020 United Nations Research Roadmap for the COVID-19 Recovery, by providing a synthesis of available evidence on the impact of pandemics and epidemics on (1) essential services and (2) health systems preparedness and strengthening. Emerging findings point to existing disparities in health systems and services being further exacerbated, with marginalized populations and low- and middle-income countries burdened disproportionately. More broadly, there is a need to further understand short- and long-term impacts of bypassed essential services, quality assurance of services, the role of primary health care in the frontline, and the need for additional mechanisms for effective vaccine messaging and uptake during epidemics. The review also highlights how trust—of institutions, of science, and between communities and health systems—remains central to a successful pandemic response. Finally, previous crises had repeatedly foreshadowed the inability of health systems to handle upcoming pandemics, yet the reactive nature of policies and practices compounded by lack of resources, infrastructure, and political will have resulted in the current failed response to COVID-19. There is therefore an urgent need for investments in implementation science and for strategies to bridge this persistent research–practice gap.
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Affiliation(s)
- Prativa Baral
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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10
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Verhoeven V, Tsakitzidis G, Philips H, Van Royen P. Impact of the COVID-19 pandemic on the core functions of primary care: will the cure be worse than the disease? A qualitative interview study in Flemish GPs. BMJ Open 2020; 10:e039674. [PMID: 32554730 PMCID: PMC7306272 DOI: 10.1136/bmjopen-2020-039674] [Citation(s) in RCA: 200] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES The current COVID-19 pandemic, as well as the measures taken to control it, have a profound impact on healthcare. This study was set up to gain insights into the consequences of the COVID-19 outbreak on the core competencies of general practice, as they are experienced by general practitioners (GPs) on the frontline. DESIGN, SETTING, PARTICIPANTS We performed a descriptive study using semistructured interviews with 132 GPs in Flanders, using a topic list based on the WONCA definition of core competencies in general practice. Data were analysed qualitatively using framework analysis. RESULTS Changes in practice management and in consultation strategies were quickly adopted. There was a major switch towards telephone triage and consults, for covid-related as well as for non-covid related problems. Patient-centred care is still a major objective. Clinical decision-making is largely focused on respiratory assessment and triage, and GPs feel that acute care is compromised, both by their own changed focus and by the fact that patients consult less frequently for non-covid problems. Chronic care is mostly postponed, and this will have consequences that will extend and become visible after the corona crisis. Through the holistic eyes of primary care, the current outbreak-as well as the measures taken to control it-will have a profound impact on psychological and socioeconomic well-being. This impact is already visible in vulnerable people and will continue to become clear in the medium and long terms. GPs think that they are at high risk of getting infected. Dropping out and being unable to contribute their part or becoming virus transmitters are reported to be greater concerns than getting ill themselves. CONCLUSIONS The current times have a profound impact on the core competences of primary care. Although the vast increase in patients soliciting medical help and the necessary separate covid and non-covid flows have been dealt with, GPs are worried about the continuity of regular care and the consequences of the anticovid measures. These may become a threat for the general health of the population and for the provision of primary healthcare in the near and distant future.
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Affiliation(s)
- Veronique Verhoeven
- Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerpen, Belgium
| | - Giannoula Tsakitzidis
- Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerpen, Belgium
| | - Hilde Philips
- Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerpen, Belgium
| | - Paul Van Royen
- Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerpen, Belgium
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Garg S, Basu S, Rustagi R, Borle A. Primary Health Care Facility Preparedness for Outpatient Service Provision During the COVID-19 Pandemic in India: Cross-Sectional Study. JMIR Public Health Surveill 2020; 6:e19927. [PMID: 32452819 PMCID: PMC7265797 DOI: 10.2196/19927] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/24/2020] [Accepted: 05/26/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Primary health centers (PHCs) represent the first tier of the Indian health care system, providing a range of essential outpatient services to people living in the rural, suburban, and hard-to-reach areas. Diversion of health care resources for containing the coronavirus disease (COVID-19) pandemic has significantly undermined the accessibility and availability of essential health services. Under these circumstances, the preparedness of PHCs in providing safe patient-centered care and meeting the current health needs of the population while preventing further transmission of the severe acute respiratory syndrome coronavirus 2 infection is crucial. OBJECTIVE The aim of this study was to determine the primary health care facility preparedness toward the provision of safe outpatient services during the COVID-19 pandemic in India. METHODS We conducted a cross-sectional study among supervisors and managers of primary health care facilities attached to medical colleges and institutions in India. A list of 60 faculties involved in the management and supervision of PHCs affiliated with the community medicine departments of medical colleges and institutes across India was compiled from an accessible private organization member database. We collected the data through a rapid survey from April 24 to 30, 2020, using a Google Forms online digital questionnaire that evaluated preparedness parameters based on self-assessment by the participants. The preparedness domains assessed were infrastructure availability, health worker safety, and patient care. RESULTS A total of 51 faculties responded to the survey. Each medical college and institution had on average a total of 2.94 (SD 1.7) PHCs under its jurisdiction. Infrastructural and infection control deficits at the PHC were reported in terms of limited physical space and queuing capacity, lack of separate entry and exit gates (n=25, 49%), inadequate ventilation (n=29, 57%), and negligible airborne infection control measures (n=38, 75.5%). N95 masks were available at 26 (50.9%) sites. Infection prevention and control measures were also suboptimal with inadequate facilities for handwashing and hand hygiene reported in 23.5% (n=12) and 27.4% (n=14) of sites, respectively. The operation of outpatient services, particularly related to maternal and child health, was significantly disrupted (P<.001) during the COVID-19 pandemic. CONCLUSIONS Existing PHC facilities in India providing outpatient services are constrained in their functioning during the COVID-19 pandemic due to weak infrastructure contributing to suboptimal patient safety and infection control measures. Furthermore, there is a need for effective planning, communication, and coordination between the centralized health policy makers and health managers working at primary health care facilities to ensure overall preparedness during public health emergencies.
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Affiliation(s)
- Suneela Garg
- Department of Community Medicine, Maulana Azad Medical College, New Delhi, India
| | - Saurav Basu
- Department of Community Medicine, Maulana Azad Medical College, New Delhi, India
| | - Ruchir Rustagi
- Department of Community Medicine, Maulana Azad Medical College, New Delhi, India
| | - Amod Borle
- Department of Community Medicine, Maulana Azad Medical College, New Delhi, India
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12
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Stawicki SP, Jeanmonod R, Miller AC, Paladino L, Gaieski DF, Yaffee AQ, De Wulf A, Grover J, Papadimos TJ, Bloem C, Galwankar SC, Chauhan V, Firstenberg MS, Di Somma S, Jeanmonod D, Garg SM, Tucci V, Anderson HL, Fatimah L, Worlton TJ, Dubhashi SP, Glaze KS, Sinha S, Opara IN, Yellapu V, Kelkar D, El-Menyar A, Krishnan V, Venkataramanaiah S, Leyfman Y, Saoud Al Thani HA, WB Nanayakkara P, Nanda S, Cioè-Peña E, Sardesai I, Chandra S, Munasinghe A, Dutta V, Dal Ponte ST, Izurieta R, Asensio JA, Garg M. The 2019-2020 Novel Coronavirus (Severe Acute Respiratory Syndrome Coronavirus 2) Pandemic: A Joint American College of Academic International Medicine-World Academic Council of Emergency Medicine Multidisciplinary COVID-19 Working Group Consensus Paper. J Glob Infect Dis 2020; 12:47-93. [PMID: 32773996 PMCID: PMC7384689 DOI: 10.4103/jgid.jgid_86_20] [Citation(s) in RCA: 186] [Impact Index Per Article: 46.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 04/25/2020] [Accepted: 05/04/2020] [Indexed: 02/06/2023] Open
Abstract
What started as a cluster of patients with a mysterious respiratory illness in Wuhan, China, in December 2019, was later determined to be coronavirus disease 2019 (COVID-19). The pathogen severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel Betacoronavirus, was subsequently isolated as the causative agent. SARS-CoV-2 is transmitted by respiratory droplets and fomites and presents clinically with fever, fatigue, myalgias, conjunctivitis, anosmia, dysgeusia, sore throat, nasal congestion, cough, dyspnea, nausea, vomiting, and/or diarrhea. In most critical cases, symptoms can escalate into acute respiratory distress syndrome accompanied by a runaway inflammatory cytokine response and multiorgan failure. As of this article's publication date, COVID-19 has spread to approximately 200 countries and territories, with over 4.3 million infections and more than 290,000 deaths as it has escalated into a global pandemic. Public health concerns mount as the situation evolves with an increasing number of infection hotspots around the globe. New information about the virus is emerging just as rapidly. This has led to the prompt development of clinical patient risk stratification tools to aid in determining the need for testing, isolation, monitoring, ventilator support, and disposition. COVID-19 spread is rapid, including imported cases in travelers, cases among close contacts of known infected individuals, and community-acquired cases without a readily identifiable source of infection. Critical shortages of personal protective equipment and ventilators are compounding the stress on overburdened healthcare systems. The continued challenges of social distancing, containment, isolation, and surge capacity in already stressed hospitals, clinics, and emergency departments have led to a swell in technologically-assisted care delivery strategies, such as telemedicine and web-based triage. As the race to develop an effective vaccine intensifies, several clinical trials of antivirals and immune modulators are underway, though no reliable COVID-19-specific therapeutics (inclusive of some potentially effective single and multi-drug regimens) have been identified as of yet. With many nations and regions declaring a state of emergency, unprecedented quarantine, social distancing, and border closing efforts are underway. Implementation of social and physical isolation measures has caused sudden and profound economic hardship, with marked decreases in global trade and local small business activity alike, and full ramifications likely yet to be felt. Current state-of-science, mitigation strategies, possible therapies, ethical considerations for healthcare workers and policymakers, as well as lessons learned for this evolving global threat and the eventual return to a "new normal" are discussed in this article.
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Affiliation(s)
- Stanislaw P Stawicki
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA,COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA,Address for correspondence: Dr. Stanislaw P Stawicki, Department of Research and Innovation, St. Luke's University Health Network, 801 Ostrum Street, Bethlehem, Pennsylvania, USA. E-mail:
| | - Rebecca Jeanmonod
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA,COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Andrew C Miller
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
| | - Lorenzo Paladino
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA,COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - David F Gaieski
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Anna Q Yaffee
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
| | - Annelies De Wulf
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
| | - Joydeep Grover
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Thomas J. Papadimos
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
| | - Christina Bloem
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
| | - Sagar C Galwankar
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA,COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Vivek Chauhan
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Michael S. Firstenberg
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA,COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Salvatore Di Somma
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Donald Jeanmonod
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA,COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Sona M Garg
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
| | - Veronica Tucci
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
| | - Harry L Anderson
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA,COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Lateef Fatimah
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Tamara J Worlton
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
| | | | - Krystal S Glaze
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
| | - Sagar Sinha
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Ijeoma Nnodim Opara
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
| | - Vikas Yellapu
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
| | - Dhanashree Kelkar
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Ayman El-Menyar
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Vimal Krishnan
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - S Venkataramanaiah
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Yan Leyfman
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
| | | | | | - Sudip Nanda
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
| | - Eric Cioè-Peña
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
| | - Indrani Sardesai
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Shruti Chandra
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Aruna Munasinghe
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Vibha Dutta
- COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Silvana Teixeira Dal Ponte
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
| | - Ricardo Izurieta
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA
| | - Juan A Asensio
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA,COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
| | - Manish Garg
- Working Group on International Health Security, The American College of Academic International Academic Medicine, USA,COVID-19 Pandemic Taskforce, World Academic Council of Emergency Medicine, USA
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13
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Chughtai AA, Seale H, Islam MS, Owais M, Macintyre CR. Policies on the use of respiratory protection for hospital health workers to protect from coronavirus disease (COVID-19). Int J Nurs Stud 2020; 105:103567. [PMID: 32203757 PMCID: PMC7174826 DOI: 10.1016/j.ijnurstu.2020.103567] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 03/06/2020] [Indexed: 12/18/2022]
Affiliation(s)
- Abrar A Chughtai
- School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Samuels Building, Kensington 2052, NSW, Australia.
| | - Holly Seale
- School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Samuels Building, Kensington 2052, NSW, Australia
| | - Md Saiful Islam
- School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Samuels Building, Kensington 2052, NSW, Australia
| | - Mohammad Owais
- School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Samuels Building, Kensington 2052, NSW, Australia
| | - C Raina Macintyre
- Biosecurity Program, The Kirby Institute, The University of New South Wales, Sydney, Kensington 2052, NSW, Australia AND College of Public Service & Community Solutions, Arizona State University, Phoenix, AZ, USAArizona State University, Tempe, AZ, United States
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14
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Chughtai AA, Khan W. Use of personal protective equipment to protect against respiratory infections in Pakistan: A systematic review. J Infect Public Health 2020; 13:385-390. [PMID: 32146139 PMCID: PMC7102706 DOI: 10.1016/j.jiph.2020.02.032] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 10/07/2018] [Accepted: 01/21/2019] [Indexed: 11/26/2022] Open
Abstract
Like other low-income countries, limited data are available on the use of personal protective equipment (PPE) in Pakistan. We conducted a systematic review of studies on PPE use for respiratory infections in healthcare settings in Pakistan. MEDLINE, Embase and Goggle Scholar were searched for clinical, epidemiological and laboratory-based studies in English, and 13 studies were included; all were observational/cross-sectional studies. The studies examined PPE use in hospital (n=7), dental (n=4) or laboratory (n=2) settings. Policies and practices on PPE use were inconsistent. Face masks and gloves were the most commonly used PPE to protect from respiratory and other infections. PPE was not available in many facilities and its use was limited to high-risk situations. Compliance with PPE use was low among healthcare workers, and reuse of PPE was reported. Clear policies on the use of PPE and available PPE are needed to avoid inappropriate practices that could result in the spread of infection. Large, multimethod studies are recommended on PPE use to inform national infection-control guidelines.
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Affiliation(s)
- Abrar Ahmad Chughtai
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
| | - Wasiq Khan
- University of Bath, Bath, United Kingdom
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15
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Denslow S, Fromewick J, Scott K, Bossingham J, Cass B, Hodge B, Richman EL, Garrity T, Mottus K, Halladay JR. COVID-19 Needs Assessment and Support for Primary Care Practices in Western North Carolina. HCA HEALTHCARE JOURNAL OF MEDICINE 2020; 1:16. [PMID: 35814342 PMCID: PMC9268006 DOI: 10.36518/2689-0216.1157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND It is critical to ensure that Primary Care Providers (PCPs) have adequate personal protective equipment (PPE), supplies, training, staffing, and contingency planning during pandemics, particularly in rural areas. In March 2020, during the onset of the COVID-19 pandemic, the Mountain Area Health Education Center (MAHEC), in collaboration with the Cecil G. Sheps Center for Health Services Research at UNC Chapel Hill, rapidly created and conducted a needs assessment of PCPs in western North Carolina (WNC). METHODS A group of twenty volunteers conducted a telephone survey of PCPs in a 16 county region of WNC. Practices were asked about their COVID-19 testing and telehealth offerings, PPE adequacy, and capacity to continue serving patients. The survey's emergency alert feature linked practices to immediate support. Descriptive data were generated to identify regional needs. RESULTS Out of 110 practices, 48 (43.6%) offered COVID-19 testing, with testing more common in rural counties (56.3% vs 33.9%). Telehealth services, including phone-only visits, were offered by almost all practices (91.8%). PPE needs included N-95 respirators (49.1%), face shields (45.5%), and staff gowns (38.2%). Rural practices were more likely to report the need for PPE. Assistance was requested for staff member childcare (34.5%) and providing or billing for telehealth (31.8%). The most urgent practice requests were related to finances, PPE, and telehealth. MAHEC's Practice Support team linked practices to virtual coaching, tip sheets, case-based video didactics and communication forums, and newsletters. CONCLUSION During a pandemic, it is crucial to ensure that PCPs can continue to serve their patients. A rapid needs assessment of PCPs can allow for immediate and ongoing support that matches regional and practice-specific needs. Rural practices may require more assistance than their urban counterparts. Our rapid survey process jumpstarted a statewide system for enhanced communications with PCPs to better prepare for future emergencies.
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Affiliation(s)
| | | | - Kacey Scott
- University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC
| | - Jesse Bossingham
- University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC
| | - Brian Cass
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Erica L. Richman
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Kathleen Mottus
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC
- North Carolina Translational and Clinical Science Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Jacqueline R. Halladay
- UNC Health Sciences at MAHEC, Asheville, NC
- Department of Family Medicine, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC
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16
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Chughtai AA, Khan W. Use of personal protective equipment to protect against respiratory infections in Pakistan: A systematic review. J Infect Public Health 2019; 12:522-527. [PMID: 30738757 PMCID: PMC7102795 DOI: 10.1016/j.jiph.2019.01.064] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 10/07/2018] [Accepted: 01/21/2019] [Indexed: 11/18/2022] Open
Abstract
Like other low-income countries, limited data are available on the use of personal protective equipment (PPE) in Pakistan. We conducted a systematic review of studies on PPE use for respiratory infections in healthcare settings in Pakistan. MEDLINE, Embase and Goggle Scholar were searched for clinical, epidemiological and laboratory-based studies in English, and 13 studies were included; all were observational/cross-sectional studies. The studies examined PPE use in hospital (n=7), dental (n=4) or laboratory (n=2) settings. Policies and practices on PPE use were inconsistent. Face masks and gloves were the most commonly used PPE to protect from respiratory and other infections. PPE was not available in many facilities and its use was limited to high-risk situations. Compliance with PPE use was low among healthcare workers, and reuse of PPE was reported. Clear policies on the use of PPE and available PPE are needed to avoid inappropriate practices that could result in the spread of infection. Large, multimethod studies are recommended on PPE use to inform national infection-control guidelines.
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Affiliation(s)
- Abrar Ahmad Chughtai
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
| | - Wasiq Khan
- University of Bath, Bath, United Kingdom
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17
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Outbreak Response and Incident Management: SHEA Guidance and Resources for Healthcare Epidemiologists in United States Acute-Care Hospitals. Infect Control Hosp Epidemiol 2017; 38:1393-1419. [PMID: 29187263 PMCID: PMC7113030 DOI: 10.1017/ice.2017.212] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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18
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[Epidemics and pandemics in general practice. What can we learn from the swine flu (H1N1) and EHEC outbreak?]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2015; 57:687-93. [PMID: 24817143 PMCID: PMC7079901 DOI: 10.1007/s00103-014-1970-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Hintergrund Als Primärbehandler mit Koordinationsfunktion haben die hausärztlich tätigen Ärztinnen und Ärzte im Rahmen von Epidemien/Pandemien eine Schlüsselrolle. Bisher gibt es keine Untersuchungen darüber, welche Schwierigkeiten sich aus hausärztlicher Sicht bei der Patientenversorgung während vergangener Epidemien/Pandemien in Deutschland ergaben. Fragestellung Ziel der vorliegenden Studie ist die Identifikation von Problembereichen in der hausärztlichen Patientenversorgung während der H1N1- und EHEC-Ausbrüche. Daraus werden Empfehlungen zur Sicherstellung der Patientenversorgung bei zukünftigen Epidemien/Pandemien abgeleitet. Material und Methoden Es wurden 12 qualitative, semistrukturierte offene Leitfadeninterviews mit Hausärzten in Hamburg und Lübeck durchgeführt, transkribiert und mittels qualitativer Inhaltsanalyse ausgewertet. Ergebnisse Es konnten 5 Bereiche der ambulanten Patientenversorgung identifiziert werden, in denen aus hausärztlicher Sicht Handlungsbedarf besteht: Bereitstellung von Informationen für Hausärzte, Arbeitsbelastung, Finanzierung ausbruchbedingter Maßnahmen, Praxisorganisation, Versorgung der Erkrankten. Diskussion Insbesondere die Arbeitsbelastung der Hausärzte kann und sollte im Fall einer Epidemie/Pandemie durch eine gelungene, zentralisierte Informationspolitik gesenkt werden. Die Koordinationsfunktion der Hausärzte sollte gestärkt werden, um den stationären Sektor im Ernstfall zu entlasten. Die gesicherte Finanzierung ausbruchbedingter Maßnahmen kann dazu beitragen, die Patientenbehandlung sicherzustellen.
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