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Wemyss C, Hobson S, Sweeney J, Chua PR, Binti Mohd Khairi SA, Edwards M, Burns J, McGoldrick N, Braid R, Gorman M, Redmond S, Clark C, Brown C, Watling C, Conway DI, Culshaw S. Improving participation and engagement with a COVID-19 surveillance programme in an outpatient setting. BMJ Open Qual 2022; 11:bmjoq-2021-001700. [PMID: 35347067 PMCID: PMC8960458 DOI: 10.1136/bmjoq-2021-001700] [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] [Received: 10/10/2021] [Accepted: 02/13/2022] [Indexed: 11/29/2022] Open
Abstract
Background On 3 August 2020, Public Health Scotland commenced a prospective surveillance study to monitor the prevalence of COVID-19 among asymptomatic outpatients attending dental clinics across 14 health boards in Scotland. Objectives The primary aim of this quality improvement project was to increase the number of COVID-19 tests carried out in one of the participating sites, Glasgow Dental Hospital and School. The secondary aim was to identify barriers to patient participation and staff engagement when implementing a public health initiative in an outpatient setting. Method A quality improvement working group met weekly to discuss hospital findings, identify drivers and change ideas. Details on reasons for patient non-participation were recorded and questionnaires on project barriers were distributed to staff. In response to findings, rapid interventions were implemented to fast-track increases in the numbers of tests being carried out. Results Over 16 weeks, 972 tests were carried out by Glasgow Dental Hospital and School Secondary Care Services. The number of tests per week increased from 19 (week 1) to 129 (week 16). This compares to a similar ‘control’ site, where the number of tests carried out remained unchanged; 38 (week 1) to 36 (week 16). The most frequent reason given for non-participation was fear that the swab would hurt. For staff, lack of time and forgetting to ask patients were identified as the most significant barriers. Conclusion Public health surveillance programmes can be integrated rapidly into outpatient settings. This project has shown that a quality improvement approach can be successful in integrating such programmes. The key interventions used were staff engagement initiatives and front-line data collection. Implementation barriers were also identified using staff questionnaires.
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Affiliation(s)
- Callum Wemyss
- Department of Oral Surgery, Glasgow Dental Hospital and School, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Simon Hobson
- Glasgow Dental Hospital and School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Jill Sweeney
- Department of Paediatric Dentistry, Glasgow Dental Hospital and School, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Pei Rong Chua
- Glasgow Dental Hospital and School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Siti Aishah Binti Mohd Khairi
- Glasgow Dental Hospital and School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Maura Edwards
- Department of Public Health, NHS Ayrshire and Arran, Ayr, South Ayrshire, UK
| | | | | | | | | | | | | | - Clare Brown
- Glasgow Dental Hospital and School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | | | - David I Conway
- Glasgow Dental Hospital and School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.,Public Health Scotland, Glasgow, UK
| | - Shauna Culshaw
- Glasgow Dental Hospital and School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.,Public Health Scotland, Glasgow, UK
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Abstract
OBJECTIVE This scoping review aims to map the roles of rural and remote primary health care professionals (PHCPs) during disasters. INTRODUCTION Disasters can have catastrophic impacts on society and are broadly classified into natural events, man-made incidents, or a mixture of both. The PHCPs working in rural and remote communities face additional challenges when dealing with disasters and have significant roles during the Prevention, Preparedness, Response, and Recovery (PPRR) stages of disaster management. METHODS A Johanna Briggs Institute (JBI) scoping review methodology was utilized, and the search was conducted over seven electronic databases according to a priori protocol. RESULTS Forty-one papers were included and sixty-one roles were identified across the four stages of disaster management. The majority of disasters described within the literature were natural events and pandemics. Before a disaster occurs, PHCPs can build individual resilience through education. As recognized and respected leaders within their community, PHCPs are invaluable in assisting with disaster preparedness through being involved in organizations' planning policies and contributing to natural disaster and pandemic surveillance. Key roles during the response stage include accommodating patient surge, triage, maintaining the health of the remaining population, instituting infection control, and ensuring a team-based approach to mental health care during the disaster. In the aftermath and recovery stage, rural and remote PHCPs provide long-term follow up, assisting patients in accessing post-disaster support including delivery of mental health care. CONCLUSION Rural and remote PHCPs play significant roles within their community throughout the continuum of disaster management. As a consequence of their flexible scope of practice, PHCPs are well-placed to be involved during all stages of disaster, from building of community resilience and contributing to early alert of pandemics, to participating in the direct response when a disaster occurs and leading the way to recovery.
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Abstract
AIM The present study reports factors affecting nurses' ability and willingness to work during pandemic flu (PF). BACKGROUND Previous studies suggest some nurses may be unable or unwilling to work during PF. METHOD A questionnaire was mailed to nurses during October to December 2009, the second wave of the 2009 A/H1N1 flu pandemic. RESULTS Most (90.1%) reported they would work. Willingness decreased primarily as personal protective equipment (PPE) dwindled, family or nurse were perceived to be at risk and when vaccine or antiviral medication was not provided to both nurse and family although many other factors also affected willingness to work. Ability decreased primarily when the nurse was sick, a loved one needed care at home or transportation problems existed although many other factors also affected ability to work. CONCLUSION Certain factors can decrease willingness and ability of nurses to work during a flu pandemic. IMPLICATIONS FOR NURSING MANAGEMENT Managers can anticipate factors that may decrease nurse's ability and willingness to work during pandemic flu. Preparing for staffing during emergencies can retain the health care workforce when it is needed most.
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