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Carter D, Rosen A, Applebaum JR, Southern WN, Crossman DJ, Shelton RC, Auerbach A, Schnipper JL, Adelman JS. National Survey of Patient Safety Experiences in Hospital Medicine During the COVID-19 Pandemic. Jt Comm J Qual Patient Saf 2024; 50:260-268. [PMID: 38087723 DOI: 10.1016/j.jcjq.2023.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/21/2023] [Accepted: 10/23/2023] [Indexed: 05/07/2024]
Abstract
BACKGROUND During the COVID-19 pandemic, hospitals were caring for increasing numbers of patients with a novel and highly contagious respiratory illness, forcing adaptations in care delivery. The objective of this study was to understand the impact of these adaptations on patient safety in hospital medicine. METHODS The authors conducted a nationwide survey to understand patient safety challenges experienced by hospital medicine clinicians during the COVID-19 pandemic. The survey was distributed to members of the Society of Hospital Medicine via an e-mail listserv. It consisted of closed- and open-ended questions to elicit respondents' experience in five domains: error reporting and communication, staffing, equipment, personal protective equipment (PPE) and isolation practices, and infrastructure. Quantitative questions were reported as counts and percentages; qualitative responses were coded and analyzed for relevant themes. RESULTS Of 196 total responses, 167 respondents (85.2%) were attending physicians and 85 (43.8%) practiced at teaching hospitals. Safety concerns commonly identified included nursing shortages (71.0%), limiting patient interactions to conserve PPE (61.9%), and feeling that one was practicing in a more hazardous environment (61.4%). In free-text responses, clinicians described poor outcomes and patient decompensation due to provider and equipment shortages, as well as communication lapses and diagnostic errors resulting from decreased patient contact and the need to follow isolation protocols. CONCLUSION Efforts made to accommodate shortages in staff and equipment, adapt to limited PPE, and enforce isolation policies had unintended consequences that affected patient safety and created a more hazardous environment characterized by less efficient care, respiratory decompensations, diagnostic errors, and poor communication with patients.
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Shaw CA, Lee KR, Williams A, Shaw NA, Weeks D, Jackson L, Williams KN. Best practices for communication while wearing facemasks: A scoping review. J Nurs Scholarsh 2024; 56:227-238. [PMID: 37937861 PMCID: PMC10922106 DOI: 10.1111/jnu.12939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 09/08/2023] [Accepted: 10/24/2023] [Indexed: 11/09/2023]
Abstract
INTRODUCTION Facemasks are an important piece of personal protective equipment (PPE) to mitigate the spread of respiratory illnesses, but they can impede communication between patients and healthcare providers. The purpose of this scoping review is to identify effective communication practices while wearing facemasks. DESIGN Scoping review using a systematic search of articles from the PubMed, CINAHL, and Embase databases. METHODS The PEO (population, exposure, outcome) methodology was selected for this systematic scoping review. The population of interest (P) includes humans of all ages (children, adults, and older adults); the exposure of interest (E) is PPE that covers the mouth (i.e., facemasks); and the outcome of interest (O) is successful or unsuccessful communication practices. The Johns Hopkins Evidence-Based Practice for Nurses and Healthcare Professionals appraisal guidelines were used to determine the level and quality of the research. RESULTS Thirty-nine articles met the inclusion criteria. Seventeen of these were high- or good-quality research studies, and the remaining 22 were non-research articles included with separate analysis as part of the scoping review. The 17 articles encompassed 2656 participants. The highest quality evidence indicated that standard surgical masks have the least impact on speech perception compared to other non-transparent mask types, and that recognizing emotions is less accurate with facemasks, necessitating compensatory actions (i.e., reducing extraneous noise, using a microphone to amplify voice, and employing clear speech). Evidence was contradictory regarding the use of transparent masks. Evidence was of limited quality for other non-verbal and verbal communication strategies. CONCLUSION Awareness of communication challenges is crucial when wearing facemasks. More high-quality studies are needed to evaluate communication techniques when speakers are wearing facemasks. Basic strategies such as selecting an appropriate mask type, reducing extraneous noise, using microphones, verbalizing emotions, and employing clear speech appear to be beneficial. CLINICAL RELEVANCE The findings of this scoping review highlight the importance of considering communication challenges while wearing facemasks in the healthcare settings. The review suggests that selecting an appropriate mask type, reducing extraneous noise, verbalizing emotions, and employing clear speech are some strategies that may be effective in mitigating the impact of facemasks on communication between patients and healthcare providers.
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Affiliation(s)
- Clarissa A. Shaw
- University of Iowa, College of Nursing, Division of Acute and Critical Care
| | | | | | - Nathan A. Shaw
- University of Iowa, Carver College of Medicine, Department of Family Medicine
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Mazouri-Karker S, Braillard O, Lüchinger R, Bajwa N, Achab S, Hudelson P, Dao MD, Junod-Perron N. Patients preferences for communication during video consultations. PATIENT EDUCATION AND COUNSELING 2023; 115:107894. [PMID: 37480793 DOI: 10.1016/j.pec.2023.107894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 07/24/2023]
Abstract
Objective The aim of our simulation-based study was to explore patient preferences for physician behaviours in video consultations METHODS: We conducted an exploratory study in outpatient setting in Geneva, Switzerland.Patients were invited to watch two variations videos of six simulated physician communication behaviours (camera framing, gaze orientation, initial talk at the opening phase, privacy reminder, pauses, empathy)and to indicate which one they preferred RESULTS: 417 patients watched three different video-recorded encounters. Most patients preferred framing with both face and bust (50.7 %) versus face alone (21.8 %). They valued eye gazing towards the camera (42.9 %) versus eye gazing shifting between screen and camera (13 %). The social talk related to the connection quality was appreciated (43.1 % vs 17.1 %) as well as the privacy reminder (80.8 % vs 6.5 %). Patients preferred short rather than long pauses after physician's statements (63.9 vs 14.9 %) as well as expressive rather than neutral nonverbal behaviour (46.7 % vs 17.6 %). CONCLUSION: Our results confirm that patients prefer the use of video specific communication behaviours recommended by experts except for shifting eye gaze and long pauses after physician's statements. PRACTICE IMPLICATIONS: Given the increasing use of video consultations, video communication "best practices"should be systematically addressed in physician training.
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Affiliation(s)
- Sanae Mazouri-Karker
- E-health and Telemedicine Division, Geneva University Hospitals, Geneva, Switzerland.
| | - Olivia Braillard
- Primary Care Division, Geneva University Hospitals, Geneva, Switzerland
| | - Robin Lüchinger
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Nadia Bajwa
- Primary Care Division, Geneva University Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Sophia Achab
- Primary Care Division, Geneva University Hospitals, Geneva, Switzerland; ReConnecte Unit, Addiction Division, University Hospitals, Geneva, Switzerland
| | - Patricia Hudelson
- Primary Care Division, Geneva University Hospitals, Geneva, Switzerland
| | - Mélissa Dominicé Dao
- Primary Care Division, Geneva University Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Noëlle Junod-Perron
- Primary Care Division, Geneva University Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Destino L, Lin A, Mathew R, Lee T, Aziz N, Claura R, Kim J, Lee G. Importance of inclusive leadership in the pandemic response: the critical role of the physician. BMJ LEADER 2023; 7:223-225. [PMID: 37192092 DOI: 10.1136/leader-2022-000605] [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: 02/10/2022] [Accepted: 12/23/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND The COVID-19 pandemic has resulted in multiple logistical and communication challenges in the face of ever-changing guidance, disease prevalence and increasing evidence. METHODS At Stanford Children's Health (SCH), we felt physician input was an important element of pandemic response infrastructure, given our lens into patient care across its continuum. We formed the COVID-19 Physician Liaison Team (CPLT) consisting of representative physicians across the care continuum. The CPLT met regularly and communicated to the SCH's COVID-19 task force responsible for the ongoing organisation pandemic response. The CPLT problem-solved around various issues including testing, patient care on our COVID-19 inpatient unit and communication gaps. RESULTS The CPLT contributed to conservation of rapid COVID-19 tests for critical patient care needs, decreased incident reports on our COVID-19 inpatient unit and helped enhance communication across the organisation, with a focus on physicians. CONCLUSION In retrospect, the approach taken was in line with a distributed leadership model with physicians as integral members contributing to active lines of communication, continual problem-solving and new pathways to provide care.
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Affiliation(s)
- Lauren Destino
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA
| | - Anna Lin
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA
| | - Roshni Mathew
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA
| | - Tzielan Lee
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA
| | - Natali Aziz
- Obstetrics and Gynecology, Stanford University School of Medicine, Palo Alto, California, USA
| | - Rebecca Claura
- Department of Anesthesia, Stanford University School of Medicine, Palo Alto, California, USA
| | - Joe Kim
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA
| | - Grace Lee
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA
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Dugdale LS, Esbensen KL, Sulmasy LS. Ethical Guidance on Family Caregiving, Support, and Visitation in Hospitals and Residential Health Care Facilities, Including During Public Health Emergencies: an American College of Physicians Position Paper. J Gen Intern Med 2023; 38:1986-1993. [PMID: 36940066 PMCID: PMC10027272 DOI: 10.1007/s11606-023-08070-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 01/27/2023] [Indexed: 03/21/2023]
Abstract
Public health emergencies create challenges for the accommodation of visitors to hospitals and other care facilities. To mitigate the spread of COVID-19 early in the pandemic, health care institutions implemented severe visitor restrictions, many remaining in place more than 2 years, producing serious unintended harms. Visitor restrictions have been associated with social isolation and loneliness, worse physical and mental health outcomes, impaired or delayed decision-making, and dying alone. Patients with disabilities, communication challenges, and cognitive or psychiatric impairments are particularly vulnerable without caregiver presence. This paper critically examines the justifications for, and harms imposed by, visitor restrictions during the COVID-19 pandemic and offers ethical guidance on family caregiving, support, and visitation during public health emergencies. Visitation policies must be guided by ethical principles; incorporate the best available scientific evidence; recognize the invaluable roles of caregivers and loved ones; and involve relevant stakeholders, including physicians, who have an ethical duty to advocate for patients and families during public health crises. Visitor policies should be promptly revised as new evidence emerges regarding benefits and risks in order to prevent avoidable harms.
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Affiliation(s)
- Lydia S Dugdale
- Columbia University Vagelos College of Physicians & Surgeons, New York-Presbyterian Hospital, 630 West 168Th Street, New York, NY, 10032, USA
| | - Kari L Esbensen
- Emory University School of Medicine, 100 Woodruff Circle, Atlanta, GA, 30322, USA
| | - Lois Snyder Sulmasy
- American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA, 19106, USA.
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Christensen A, Havyer R, Lorenz A, Alli A, Kilpatrick M, Feely M, Carey E. COVID-19 communication resources in a major health system: development and dissemination. BMJ Support Palliat Care 2022:spcare-2022-004024. [PMID: 36581452 DOI: 10.1136/spcare-2022-004024] [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: 11/04/2022] [Accepted: 12/13/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Early in the pandemic, institutional leadership recognised the importance of providing staff with practical, clinically based communication resources. This paper describes the process of cultivating and disseminating rapid communication resources across a multisite institution to assist others who may need to rapidly respond to communication challenges in the future. METHODS In April 2020, the Mayo Healthcare Incident Command System charged the Center for Palliative Medicine with developing and disseminating clinical communication resources within several weeks. The Education Chair for the Center for Palliative Medicine created a COVID-19 communication task force composed of clinician-educators with expertise in serious illness communication from all three academic Mayo Clinic sites. The task force elected to focus on providing accessible, just-in-time online content curated from existing resources and adapted to situational needs. RESULTS The task force developed one-page resources with example language on 16 topic areas. Topics included exploring patient values, discussing time-limited trials and making recommendations. The COVID-19 communication website was launched on 28 May, 6 weeks after the institutional request. CONCLUSIONS Key takeaway lessons were the need for: (1) alignment with institutional need and priority, (2) rapid team formation with communication education experts across a variety of institutional geographic settings, (3) quick consensus on topic and content delivery to be practically helpful to clinicians, (4) collaboration with outside groups to use and adapt already available resources when possible and (5) early and iterative involvement with information specialists to help facilitate institutional dissemination.
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Affiliation(s)
- April Christensen
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Rachel Havyer
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Amanda Lorenz
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Adebisi Alli
- WellNEST Medicine, Phoenix, Arizona, USA
- Department of Medicine, University of Arizona College of Medicine - Phoenix, Phoenix, Arizona, USA
| | - Molly Kilpatrick
- Department of Family Medicine, Mayo Clinic, Jacksonville, Florida, USA
| | - Molly Feely
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Elise Carey
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Woolford M, Todd J. Improving communication at NHS Nightingale Hospital North West: Medical updates to next of kin. INTERNATIONAL JOURNAL OF RISK & SAFETY IN MEDICINE 2022; 33:S111-S115. [PMID: 35912757 PMCID: PMC9844058 DOI: 10.3233/jrs-227034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND The Nightingale North West (NNW) was a UK temporary field hospital set up during the COVID-19 pandemic. Policies and standard operating procedures were undeveloped. Visitors were permitted only in exceptional circumstances, resulting in heightened anxiety for patients and next of kin (NOK). OBJECTIVE Recognising the importance of effective NOK communication, a quality improvement project (QIP) was undertaken to improve communication between doctors and NOK. METHOD NOK satisfaction with communication received from doctors (scored 1-5) was the primary outcome measure and data was collected through standardised phone-calls.A wide four point (1-5) variability in satisfaction was identified.PDSA methodology was used to introduce interventions: (1) 'Gold standard' for frequency of NOK updates; (2) Record date of NOK update on the doctors' list. RESULTS Early post-intervention data showed reduced variability in satisfaction with 82% of NOK scoring '4' or '5'. Process measures demonstrated excellent uptake of interventions. CONCLUSION Conclusions are limited by the project's short time-frame but there is a promising role for these interventions in enhancing doctor-NOK communication.
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Affiliation(s)
- Megan Woolford
- NHS Nightingale North West (Manchester Foundation Trust), Manchester, UK, Address for correspondence: Megan Woolford, NHS Nightingale North West (Manchester Foundation Trust), Manchester, UK. E-mail:
| | - James Todd
- NHS Nightingale North West (Manchester Foundation Trust), Manchester, UK
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Herrmann LE, Jones YO, Kinnear B, Rule A, Piper L, Shah SS, Klein M. Development and evaluation of a pediatric hospital medicine board review course. BMC MEDICAL EDUCATION 2022; 22:804. [PMID: 36402975 PMCID: PMC9675241 DOI: 10.1186/s12909-022-03862-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 11/03/2022] [Indexed: 05/27/2023]
Abstract
BACKGROUND The American Board of Medical Specialties recognized Pediatric Hospital Medicine (PHM) for subspecialty certification in 2016, with the first certification exam in 2019. To address the need for exam preparatory materials, we designed and evaluated a novel PHM board review course that was offered both in-person and online. METHODS Course content was based on the American Board of Pediatrics (ABP) PHM certifying exam outline. Course objectives were developed from published PHM core competencies and the 2012 ABP general pediatrics content objectives. National experts served as faculty, presenting didactic sessions, and contributing to a question bank for high-yield review. For program evaluation, we applied the Kirkpatrick Model, evaluating estimated exam pass rates (Level 4), participant learning (Level 2) via post-presentation practice questions, and participants' ratings of presenters (via five-point Likert scale) and satisfaction (Level 1). RESULTS There were 112 in-person and 144 online participants with estimated pass rates of 89 and 93%, respectively. The mean correct response for the post-presentation knowledge questions was 84%. Faculty effectiveness ratings ranged from 3.81 to 4.96 (median score 4.60). Strengths included the pace of the course, question bank, and printed syllabus. Suggestions for improvement included question bank expansion, focus on "testable" points rather than general information, and challenges with long days of didactic presentations. CONCLUSIONS This novel PHM board review course demonstrated effectiveness. Hospitalists preferred focused "testable" information, an active learning environment, and a robust question bank. Future preparatory courses should consider including more opportunities for practice questions, focused content review, and learner engagement.
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Affiliation(s)
- Lisa E Herrmann
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
| | - Yemisi O Jones
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Benjamin Kinnear
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Amy Rule
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Laura Piper
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Samir S Shah
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Melissa Klein
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of General Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Green G, Sharon C, Gendler Y. The Communication Challenges and Strength of Nurses' Intensive Corona Care during the Two First Pandemic Waves: A Qualitative Descriptive Phenomenology Study. Healthcare (Basel) 2022; 10:837. [PMID: 35627974 PMCID: PMC9140473 DOI: 10.3390/healthcare10050837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 04/26/2022] [Accepted: 04/28/2022] [Indexed: 02/06/2023] Open
Abstract
Intensive care nurses working with patients with severe COVID-19 illness are at the center and frontline of the dynamic pandemic, which poses communication challenges and demands of unusual strength on their part. The study aim was to capture the lived experience of intensive care COVID nurses' communication challenges and strengths as they cared for COVID-19 intensive care patients during the two first pandemic waves. The study used qualitative descriptive-phenomenology research designs. Twenty-two nurses were selected using snowball sampling, and online interviews were conducted with them. Data were recorded and transcribed, then reflexively double-coded for increased rigor. Four major themes emerged from the data. The first two expressed the communication challenges and difficulties communicating with patients due to the extreme protection needed and/or their medical condition. However, the other two themes expressed the nurses' strengths-sharing feelings with other caregivers and family. Accordingly, we recommend using simple language and ensuring patient comprehension, as well as creating an optimistic environment for fostering caregiver bonding.
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Everitt R, Wong AK, Wawryk O, Le B, Yoong J, Pisasale M, Mendis R, Philip J. A multi-centre study on patients dying from COVID-19: Communication Between Clinicians, Patients, and their Families. Intern Med J 2022; 52:2068-2075. [PMID: 35471707 PMCID: PMC9111806 DOI: 10.1111/imj.15788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/25/2022] [Accepted: 04/20/2022] [Indexed: 11/28/2022]
Abstract
Background COVID−19 has led to challenges in providing effective and timely communication in healthcare. Services have been required to adapt and evolve as successful communication remains core to high quality patient‐centred care. Aim This study aims to describe the communication between admitted patients, their families and clinicians (medical, nursing, allied health) during end‐of‐life care. Methods This retrospective review included all patients (n = 230) who died directly due to COVID‐19 at five Melbourne hospitals between 1 January and 31 December 2020. Contacts and modality used (face to face, video, telephone) during the 8 days prior to death were recorded. Results Patients were predominantly elderly (median age 86 years) and from residential aged care facilities (62% (n = 141)). Communication frequency increased the closer the patient was to death, where on day of death, contact between clinicians and patients was 93% (n = 213) clinicians and families 97%(n = 222) and between patients and families 50% (n = 115). Most contact between patients and families was facilitated by a clinician (91.3% (n = 105) day of death) with the most commonly used mode being video call (n = 30 day of death). Conclusion This study is one of the first and largest Australian reports on how communication occurs at the end of life for patients dying of COVID‐19. Contact rates were relatively low between patients and families, compared to other cohorts dying from non COVID‐19 related causes. The impact of this difference on bereavement outcomes requires surveillance and attention. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Rachel Everitt
- Palliative Medicine Registrar, The Royal Melbourne Hospital, 300 Grattan St, Parkville, Victoria, Australia, 3050
| | - Aaron K Wong
- The Royal Melbourne Hospital, 300 Grattan St, Parkville, Victoria, Australia, 3050.,Peter MacCallum Cancer Centre, 305, Grattan St, Parkville, Victoria, Australia, 3000.,Department of Medicine, University of Melbourne, Eastern Hill Campus, Victoria Parade, Fitzroy, Victoria, Australia, 3065
| | - Olivia Wawryk
- Department of General Practice, University of Melbourne, Parkville, Victoria, Australia, 3050
| | - Brian Le
- Parkville Integrated Palliative Care Service, The Royal Melbourne Hospital, 300 Grattan St, Parkville, Victoria, Australia, 3050.,Department of Medicine RMH, The University of Melbourne, Parkville, Victoria, Australia, 3050
| | - Jaclyn Yoong
- Northern Health, 185 Cooper Street, Epping, Victoria, Australia, 3076.,Monash Health, Monash University, 246 Clayton Road, Clayton, Victoria, Australia, 3168
| | - Maria Pisasale
- Werribee Mercy Hospital, 300-310 Princes Highway, Werribee, Victoria, Australia, 3030
| | - Ruwani Mendis
- Western Health, 176 Furlong Road, St Albans, Victoria, Australia, 3021.,Department of Medicine, Western Health, University of Melbourne, 176 Furlong Road, St Albans, Victoria, Australia, 3021
| | - Jennifer Philip
- Department of Medicine, University of Melbourne, Eastern Hill Campus, Victoria Parade, Fitzroy, Victoria, Australia, 3065.,St Vincent's Hospital, Palliative Care Service, Victoria Parade, Fitzroy, Victoria, Australia, 3065.,The Royal Melbourne Hospital, 300 Grattan St, Parkville, Victoria, Australia, 3050
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Moser CH, Freeman-Sanderson A, Keeven E, Higley KA, Ward E, Brenner MJ, Pandian V. Tracheostomy care and communication during COVID-19: Global interprofessional perspectives. Am J Otolaryngol 2022; 43:103354. [PMID: 34968814 PMCID: PMC8695522 DOI: 10.1016/j.amjoto.2021.103354] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 12/13/2021] [Indexed: 12/26/2022]
Abstract
Objective Investigate healthcare providers, caregivers, and patient perspectives on tracheostomy care barriers during COVID-19. Study design Cross-sectional anonymous survey Setting Global Tracheostomy Collaborative Learning Community Methods A 17-item questionnaire was electronically distributed, assessing demographic and occupational data; challenges in ten domains of tracheostomy care; and perceptions regarding knowledge and preparedness for navigating the COVID-19 pandemic. Results Respondents (n = 115) were from 20 countries, consisting of patients/caregivers (10.4%) and healthcare professionals (87.0%), including primarily otolaryngologists (20.9%), nurses (24.3%), speech-language pathologists (18.3%), respiratory therapists (11.3%), and other physicians (12.2%). The most common tracheostomy care problem was inability to communicate (33.9%), followed by mucus plugging and wound care. Need for information on how to manage cuffs and initiate speech trials was rated highly by most respondents, along with other technical and knowledge areas. Access to care and disposable supplies were also prominent concerns, reflecting competition between community needs for routine tracheostomy supplies and shortages in intensive care units. Integrated teamwork was reported in 40 to 67% of respondents, depending on geography. Forty percent of respondents reported concern regarding personal protective equipment (PPE), and 70% emphasized proper PPE use. Conclusion While safety concerns, centering on personal protective equipment and pandemic resources are prominent concerns in COVID-19 tracheostomy care, patient-centered concerns must also be prioritized. Communication and speech, adequate supplies, and care standards are critical considerations in tracheostomy. Stakeholders in tracheostomy care can partner to identify creative solutions for delays in restoring communication, supply disruptions, and reduced access to tracheostomy care in both inpatient and community settings.
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Affiliation(s)
- Chandler H Moser
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States.
| | - Amy Freeman-Sanderson
- Graduate School of Health, University of Technology, Sydney, NSW, Australia; Royal Prince Alfred Hospital, Sydney, NSW, Australia; Critical Care Division, The George Institute for Global Health, Sydney, NSW, Australia.
| | - Emily Keeven
- Patient Care Services, Children's Mercy Hospitals and Clinics, University of Kansas Health System, Kansas City, MO, United States.
| | - Kylie A Higley
- Children's Mercy Hospitals and Clinics, University of Kansas Health System, Kansas City, MO, United States; Global Tracheostomy Collaborative, Raleigh, NC, United States.
| | - Erin Ward
- Global Tracheostomy Collaborative, Raleigh, NC, United States; Family Liaison, Boston Children's Hospital Tracheostomy Team, Boston Children's Hospital, Boston, MA, United States; MTM-CNM Family Connection, Inc., Methuen, MA, United States
| | - Michael J Brenner
- Global Tracheostomy Collaborative, Raleigh, NC, United States; Department of Otolaryngology - Head & Neck Surgery, University of Michigan Medical School, Ann Arbor, MI, United States.
| | - Vinciya Pandian
- Department of Nursing Faculty, Johns Hopkins University School of Nursing; Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University, Baltimore, MD, United States.
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A narrative review exploring the professional practice training requirement of therapeutic radiographers undertaking effective remote/telephone review clinics in place of face-to-face radiographer-led review clinics during the COVID-19 pandemic. JOURNAL OF RADIOTHERAPY IN PRACTICE 2021. [DOI: 10.1017/s1460396921000613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Background and purpose:
The COVID-19 pandemic has led to the introduction of alternative on-treatment and post-treatment radiographer-led review clinics in an attempt to protect patients, staff and the public. Pre-COVID, patient reviews were routinely undertaken face-to-face, led by therapeutic review radiographers with advanced practice qualifications and skills in radiotherapy symptom management, triage, referral and support services. During the COVID-19 pandemic, an alternative option has been to follow-up in the form of telephone reviews to reduce face-to-face exposure whilst continuing to manage patient radiotherapy treatment-related toxicities. The aim of the narrative review is to explore the subject of telephone reviews and how therapeutic review radiographers might need to adapt communication skills so that they can continue to effectively assess and manage radiotherapy patient treatment reactions remotely.
Method and discussion:
A narrative review was conducted using the SCOPUS database and 28 publications were included from 2013 to 2021. The review highlights a paucity of literature exploring specific telephone training for radiographers and other allied healthcare professionals. Experiences within medical and nursing programmes demonstrate that development and integration of training in this area is critical in preparing for patient interaction via telephone.
Conclusion and implications for practice:
Multiple teaching modalities including simulation are ideal for teaching telephone-specific skills and content, demonstrating improvement in student knowledge, competence and confidence. Less is known regarding whether this knowledge translates to an improved patient experience. Enhancements in education and training, guided by the Health and Care Professions Council, may be warranted to ensure that patients continue to receive the optimal quality of care in a world where remote reviews are likely to become commonplace. Patient-reported outcome measures might be utilized for future training evaluations to ensure that effective patient care is being maintained.
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13
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Craddock KES, Grilo S, McCann TA, Catallozzi M, Banker SL. Physician Perspectives on the Impact of the COVID-19 Pandemic on Family-Centered Rounds. Hosp Pediatr 2021; 11:hpeds.2021-006004. [PMID: 34808670 DOI: 10.1542/hpeds.2021-006004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND The coronavirus disease 2019 pandemic has required modifications to family-centered rounds (FCR), although the specific changes and the effects on patients, families, and providers are not well known. In this study, we explore physician perspectives on changes made to FCR during the initial wave of the coronavirus disease 2019 pandemic and recommendations for the future. METHODS Semistructured individual interviews were conducted with 20 pediatric attending and resident physicians who cared for hospitalized patients between March and May 2020 on pediatric hospital medicine and subspecialty services that typically perform FCR. Transcripts were reviewed by using principles of framework analysis to iteratively develop a codebook. Review of coded segments, with attention to code co-occurrences, was used to clarify themes in the data relating to the research objective and the conceptual framework. RESULTS The rounding format changed for all providers and varied on the basis of clinical service and phase of the pandemic. Themes highlighted specific areas of change: (1) the process of FCR, (2) reaching consensus with families, (3) collaboration with members of the medical team, and (4) resident education, modeling, and supervision. Participants offered recommendations, including standardization of rounds, intentional involvement of nursing staff, and inclusion of families through virtual or small-group bedside rounds. CONCLUSIONS The pandemic led to a variety of modifications to FCR, and these changes had varied effects on communication and education. These findings provide insight into the state of FCR during the pandemic and may frame future recommendations for the development of shared guidelines for circumstances requiring limited bedside rounding.
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Affiliation(s)
| | - Stephanie Grilo
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City, New York
| | - Teresa A McCann
- Department of Pediatrics, Vagelos College of Physicians and Surgeons
- Department of Pediatrics, Columbia University Irving Medical Center, New York City, New York
| | - Marina Catallozzi
- Department of Pediatrics, Vagelos College of Physicians and Surgeons
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City, New York
- Department of Pediatrics, Columbia University Irving Medical Center, New York City, New York
| | - Sumeet L Banker
- Department of Pediatrics, Vagelos College of Physicians and Surgeons
- Department of Pediatrics, Columbia University Irving Medical Center, New York City, New York
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14
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Redelmeier DA, Etchells EE, Najeeb U. Principles and Practice of Gossiping About Colleagues in Medicine. J Hosp Med 2021; 16:763-766. [PMID: 34798004 DOI: 10.12788/jhm.3702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/24/2021] [Indexed: 11/20/2022]
Affiliation(s)
- Donald A Redelmeier
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Centre for Quality Improvement and Patient Safety, University of Toronto, Toronto, Ontario, Canada
| | - Edward E Etchells
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Centre for Quality Improvement and Patient Safety, University of Toronto, Toronto, Ontario, Canada
| | - Umberin Najeeb
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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15
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Grondin C, Houchens N, Gupta A. Quality and Safety in the Literature: November 2021. BMJ Qual Saf 2021; 30:921-926. [PMID: 34497135 DOI: 10.1136/bmjqs-2021-014193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 08/31/2021] [Indexed: 11/03/2022]
Affiliation(s)
- Christopher Grondin
- Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA .,Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Nathan Houchens
- Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.,Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Ashwin Gupta
- Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.,Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
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16
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Ersek M, Smith D, Griffin H, Carpenter JG, Feder SL, Shreve ST, Nelson FX, Kinder D, Thorpe JM, Kutney-Lee A. End-Of-Life Care in the Time of COVID-19: Communication Matters More Than Ever. J Pain Symptom Manage 2021; 62:213-222.e2. [PMID: 33412269 PMCID: PMC7784540 DOI: 10.1016/j.jpainsymman.2020.12.024] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/23/2020] [Accepted: 12/26/2020] [Indexed: 11/28/2022]
Abstract
CONTEXT The COVID-19 pandemic resulted in visitation restrictions across most health care settings, necessitating the use of remote communication to facilitate communication among families, patients and health care teams. OBJECTIVE To examine the impact of remote communication on families' evaluation of end-of-life care during the COVID-19 pandemic. METHODS Retrospective, cross-sectional, mixed methods study using data from an after-death survey administered from March 17-June 30, 2020. The primary outcome was the next of kin's global assessment of care during the Veteran's last month of life. RESULTS Data were obtained from the next-of-kin of 328 Veterans who died in an inpatient unit (i.e., acute care, intensive care, nursing home, hospice units) in one of 37 VA medical centers with the highest numbers of COVID-19 cases. The adjusted percentage of bereaved families reporting excellent overall end-of-life care was statistically significantly higher among those reporting Very Effective remote communication compared to those reporting that remote communication was Mostly, Somewhat, or Not at All Effective (69.5% vs. 35.7%). Similar differences were observed in evaluations of remote communication effectiveness with the health care team. Overall, 81.3% of family members who offered positive comments about communication with either the Veteran or the health care team reported excellent overall end-of-life care vs. 28.4% who made negative comments. CONCLUSIONS Effective remote communication with the patient and the health care team was associated with significantly better ratings of the overall experience of end-of-life care by bereaved family members. Our findings offer timely insights into the importance of remote communication strategies.
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Affiliation(s)
- Mary Ersek
- Veteran Experience Center, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA; University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA; Leonard Davis Institute of Health Economics at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
| | - Dawn Smith
- Veteran Experience Center, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | - Hilary Griffin
- Veteran Experience Center, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | - Joan G Carpenter
- Veteran Experience Center, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA; University of Maryland School of Nursing, Baltimore, Maryland, USA
| | - Shelli L Feder
- Yale University School of Nursing, New Haven, Connecticut, USA; VA Connecticut Health Care System, West Haven, Connecticut, USA
| | - Scott T Shreve
- Palliative and Hospice Care Program, US Department of Veterans Affairs, Washington, District of Columbia, USA; Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Francis X Nelson
- Veteran Experience Center, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | - Daniel Kinder
- Veteran Experience Center, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | - Joshua M Thorpe
- Center for Health Equity Research and Promotion, Pittsburgh VA Medical Center, Pittsburgh, Pennsylvania, USA; University of North Carolina School of Pharmacy, Chapel Hill, NC, USA
| | - Ann Kutney-Lee
- Veteran Experience Center, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA; University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
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17
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Bolton KC, Lawler M, Hauptman J, Madden M, DeVoe SG, Kennedy AG, Tomkins BJ, Hodde NM. Patient Experience on a Hospital Oncology Service Before and After Implementation of a No-Visitor Policy During COVID-19. J Patient Exp 2021; 8:23743735211034620. [PMID: 34377777 PMCID: PMC8323412 DOI: 10.1177/23743735211034620] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Hospital visitor restriction policies prompted by Coronavirus Disease 2019
(COVID-19) may lead to a less comfortable or informed inpatient experience for
oncology patients admitted for non-COVID-19 conditions. We surveyed oncology
inpatients before (n = 47) and after (n = 65) implementation of a no-visitor
policy using a validated questionnaire to measure patient experience. Results
revealed no significant difference in the percentage of patients reporting “no
problems” (P < .05) in all questions. Patient experience was
not adversely impacted by visitor restrictions enacted in response to COVID-19
on an oncology service, as measured by a questionnaire capturing common concerns
among inpatients.
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Affiliation(s)
- Kenyon C Bolton
- The University of Vermont Medical Center, Burlington, VT, USA
| | - Michael Lawler
- The Robert Larner, MD College of Medicine, The University of Vermont, Burlington, VT, USA
| | | | - Marissa Madden
- The University of Vermont Medical Center, Burlington, VT, USA
| | - Stephen G DeVoe
- Department of Medicine Quality Program, The Robert Larner, MD College of Medicine, The University of Vermont, Burlington, VT, USA
| | - Amanda G Kennedy
- Department of Medicine Quality Program, The Robert Larner, MD College of Medicine, The University of Vermont, Burlington, VT, USA
| | - Bradley J Tomkins
- Department of Medicine Quality Program, The Robert Larner, MD College of Medicine, The University of Vermont, Burlington, VT, USA
| | - Naomi M Hodde
- The University of Vermont Medical Center, Burlington, VT, USA.,The Robert Larner, MD College of Medicine, The University of Vermont, Burlington, VT, USA
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18
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Anxiety, Post-Traumatic Stress, and Burnout in Health Professionals during the COVID-19 Pandemic: Comparing Mental Health Professionals and Other Healthcare Workers. Healthcare (Basel) 2021; 9:healthcare9060635. [PMID: 34071970 PMCID: PMC8229458 DOI: 10.3390/healthcare9060635] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 05/21/2021] [Accepted: 05/25/2021] [Indexed: 12/23/2022] Open
Abstract
The psychological impact of the pandemic on healthcare workers has been assessed worldwide, but there are limited data on how mental health professionals (MHPs) have been affected. Thus, this paper aims to investigate anxiety, post-traumatic stress, and burnout in a sample of MHPs. We conducted a descriptive, cross-sectional study on 167 participants: 56 MHPs, 57 physicians working closely with COVID-19 patients, and 54 physicians not working closely with such patients. MHPs reported good overall mental health. Most MHPs reported no post-traumatic stress, and their scores were significantly lower compared to HPs working closely with COVID-19 patients. MHPs' hyperarousal scores were also significantly lower compared to HPs working closely with COVID-19 patients, while their intrusion scores were statistically significantly lower than those of all other professionals. Multivariable logistic regressions showed that MHPs had lower odds of exhibiting state anxiety and low personal accomplishment compared to HPs not working closely with COVID-19 patients. In sum, MHPs seem to show almost preserved mental health. Thus, given the high mental healthcare demand during a pandemic, it would be useful to rely on these professionals, especially for structuring interventions to improve and support the mental health of the general population and other healthcare workers.
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19
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Ferrari G, Dobrina R, Buchini S, Rudan I, Schreiber S, Bicego L. The impact of personal protective equipment and social distancing on communication and relation between nurses, caregivers and children: a descriptive qualitative study in a maternal and child health hospital. J Clin Nurs 2021. [PMID: 34036654 DOI: 10.1111/jocn.15857] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 04/30/2021] [Accepted: 05/04/2021] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES The main objective was to explore the impact of personal protective equipment and social distancing on nurses, caregivers and children's communication and relationship in a maternal and child health hospital. BACKGROUND The spread of COVID-19 pandemic made it necessary to apply infection prevention and control measures, including interpersonal distancing and the use of personal protective equipment. These measures may impact communication and relationship between nurses, patients and caregivers especially in a complex environment, such as a paediatric setting. DESIGN A qualitative descriptive study design was adopted. Reporting followed the COREQ guidelines. METHODS Semi-structured interviews were conducted in two wards of a maternal and child health hospital in north-east Italy. Data were collected between September and November 2020. Transcripts were analysed using inductive content analysis. RESULTS Seventeen caregivers and 17 nurses were recruited using convenience sampling. Three themes were identified, namely: "Impact on a trustworthy relationship"; "Impact on common communication resources"; and "Strategies to overcome barriers". Participants agreed Covid-19 infection prevention and control measures impacted key elements of family-centred and compassionate care. Communication strategies and play were critical to overcoming the barriers encountered. CONCLUSIONS COVID-19 containment measures impact communication and family-centred care in paediatric hospital settings. There is a need for stakeholders to consider family needs in interventions aimed at controlling pandemics' impact. CLINICAL RELEVANCE While COVID-19 pandemic urgency intensified the use of PPE and social distancing, strategies to overcome issues related to family-centred care should be considered in those wards such as oncology or infectious disease paediatric departments where these measures are continuously adopted. Beyond a greater communication awareness, strategies may comprise the implementation of virtual care to guarantee support, continuity of care and information between the child, the healthcare team and the family members that are not admitted to the hospital for safety reasons.
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Affiliation(s)
- Giada Ferrari
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Raffaella Dobrina
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Sara Buchini
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Iva Rudan
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Silvana Schreiber
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Livia Bicego
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
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20
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Wittenberg E, Goldsmith JV, Chen C, Prince-Paul M, Johnson RR. Opportunities to improve COVID-19 provider communication resources: A systematic review. PATIENT EDUCATION AND COUNSELING 2021; 104:438-451. [PMID: 33455825 PMCID: PMC7831717 DOI: 10.1016/j.pec.2020.12.031] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 12/26/2020] [Accepted: 12/29/2020] [Indexed: 05/20/2023]
Abstract
OBJECTIVE Communication related to COVID-19 between provider and the patient/family is impacted by isolation requirements, time limitations, and lack of family/partner access. Our goal was to determine the content of provider communication resources and peer-reviewed articles on COVID-19 communication in order to identify opportunities for developing future COVID-19 communication curricula and support tools. METHODS A systematic review was conducted using the UpToDate clinical decision support resource database, CINAHL, PubMed, PsycInfo, and Web of Science. The grey literature review was conducted in September 2020 and articles published between January-September 2020 written in English were included. RESULTS A total of 89 sources were included in the review, (n = 36 provider communication resources, n = 53 peer-reviewed articles). Resources were available for all providers, mainly physicians, and consisted of general approaches to COVID-19 communication with care planning as the most common topic. Only four resources met best practices for patient-centered communication. All but three articles described physician communication where a general emphasis on patient communication was the most prevalent topic. Reduced communication channels, absence of family, time, burnout, telemedicine, and reduced patient-centered care were identified as communication barriers. Communication facilitators were team communication, time, patient-centered and family communication, and available training resources. CONCLUSIONS Overall, resources lack content that address non-physician providers, communication with family, and strategies for telehealth communication to promote family engagement. The gaps identified in this review reveal a need to develop more materials on the following topics: provider moral distress, prevention communication, empathy and compassion, and grief and bereavement. An evidence-base and theoretical grounding in communication theory is also needed. PRACTICE IMPLICATIONS Future development of COVID-19 communication resources for providers should address members of the interdisciplinary team, communication with family, engagement strategies for culturally-sensitive telehealth interactions, and support for provider moral distress.
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Affiliation(s)
- Elaine Wittenberg
- From California State University Los Angeles, Department of Communication Studies, Los Angeles CA, USA.
| | - Joy V Goldsmith
- From University of Memphis, Department of Communication and Film, Memphis TN, USA
| | - Chiahui Chen
- From University at Buffalo-The State University of New York, School of Nursing, Buffalo, NY, USA
| | | | - Renee R Johnson
- From California State University Los Angeles, Patricia A. Chin School of Nursing, Los Angeles CA, USA
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21
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Abstract
Health care providers are coping with unprecedented deaths, decisions for which patient receives a lifesaving ventilator, and the personal fear of contracting a virus that presently has no known treatment protocol. This article discusses the concepts of moral injury; compassion fatigue; experiencing secondary stress associated with a continuous demanding daily work environment; and the idea of giving your patient a “good death” during a time when even if family and friends are present during the dying process, there is no touching, kissing, or ability to offer physical comfort. Suggestions for self-care for yourself and colleagues are discussed.
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22
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Feder S, Schulman-Green D, Akgün KM. Palliative Care During a Pandemic. Respir Med 2021. [DOI: 10.1007/978-3-030-81788-6_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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