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Lee H, Lee S, Jo D. A Bedside Electronic Whiteboard System for Patient Care in Isolation Rooms: A Scenario-Based Preliminary Study. J Clin Nurs 2024. [PMID: 39313959 DOI: 10.1111/jocn.17461] [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: 05/06/2024] [Revised: 09/02/2024] [Accepted: 09/06/2024] [Indexed: 09/25/2024]
Abstract
AIM To assess a commercially available electronic whiteboard's usability and acceptability in isolation rooms, focusing on improving nurse-patient communication and supporting data input. DESIGN A cross-sectional study with quantitative and qualitative mixed methods. METHODS We evaluated the usability and acceptability of electronic whiteboards among nurses using scenarios in a virtual isolation room environment. RESULTS Nurses recognised the electronic whiteboard as a valuable tool for communication and error reductions in record-keeping but noted a learning curve for less tech-savvy users. Positive correlations were found between perceived usefulness, ease of use and adoption intent. Despite challenges, electronic whiteboards show promise for enhancing patient care, requiring comprehensive training and management systems. Time allocation in patient wards and nurse-patient interactions are crucial considerations. CONCLUSION Electronic whiteboards have usability and acceptability as a tool to improve nurse-patient communication. However, considering technical issues and staff resistance, a management system and user training are necessary. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Nurses perceive electronic whiteboards as user-friendly and as facilitating data input. REPORTING METHOD TREND (Nonrandomised evaluations of behavioural and public health interventions). PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Hyeongsuk Lee
- College of Nursing, Research Institute of AI and Nursing Science, Gachon University, Incheon, South Korea
| | - Seungmin Lee
- College of Nursing, Gachon University, Incheon, South Korea
| | - Dami Jo
- College of Nursing, Gachon University, Incheon, South Korea
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In de Braekt A, Coolen CM, Maaskant JM, de Man-van Ginkel JM, Eskes AM, Jongerden IP. Views of family members on using video calls during the hospital admission of a patient: A qualitative study. J Adv Nurs 2024; 80:3757-3766. [PMID: 38243625 DOI: 10.1111/jan.16060] [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: 04/17/2023] [Revised: 12/11/2023] [Accepted: 01/07/2024] [Indexed: 01/21/2024]
Abstract
BACKGROUND Utilization of video calls on hospital wards to facilitate involvement of and communication with family members is still limited. A deeper understanding of the needs and expectations of family members regarding video calls on hospital wards is necessary, to identify potential barriers and facilitate video calls in practice. AIM The aim of this study was to explore the views, expectations and needs of a patient's family members regarding the use of video calls between family members, patients and healthcare professionals, during the patient's hospital admission. METHODS A qualitative study was carried out. Semi-structured interviews with family members of patients admitted to two hospitals were conducted between February and May 2022. Family members of patients admitted to the surgical, internal medicine and gynaecological wards were recruited. RESULTS Twelve family members of patients participated. Family members stated that they perceive video calls as a supplemental option and prefer live visits during hospital admission. They expected video calls to initiate additional moments of contact with healthcare professionals, e.g. to join in medical rounds. When deploying video calls, family members mentioned that adequate instruction and technical support by nurses should be available. CONCLUSION Family members considered video calls valuable when visiting is not possible or to participate in medical rounds or other contacts with healthcare professionals outside of visiting hours. IMPLICATIONS Family members need to be supported in options and use of video calls on hospital wards. Additional knowledge about actual participation in care through video calls is needed as well as the effect on patient, family and healthcare professional outcomes. IMPACT Using video calls on hospital wards can provide family members with flexible alternatives for contact and promote family involvement. REPORTING METHOD COREQ guidelines. PATIENT OR PUBLIC CONTRIBUTION Family members of patients admitted to hospital have contributed by sharing their perspectives in interviews. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: Family members perceive additional value from the use of video calls on hospital wards. For family, use of video calls needs to be facilitated with clear instruction materials and support. TRIAL AND PROTOCOL REGISTRATION Amsterdam UMC Medical Ethics Review Committee (ref number W21_508 # 21.560).
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Affiliation(s)
- Anna In de Braekt
- Nursing Science, Program in Clinical Health Sciences, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Surgery, Spaarne Gasthuis, Haarlem, The Netherlands
| | - Celeste M Coolen
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Jolanda M Maaskant
- Department of Pediatrics, University Medical Centre Amsterdam, University of Amsterdam, Amsterdam, The Netherlands
| | - Janneke M de Man-van Ginkel
- Nursing Science, Program in Clinical Health Sciences, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
- Nursing Science, Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Anne M Eskes
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Digital Health, Amsterdam, The Netherlands
- Menzies Health Institute Queensland and School of Nursing and Midwifery, Griffith University, Gold Coast, Australia
| | - Irene P Jongerden
- Department of Public and Occupational Health, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health research institute, Quality and Organization of Care, Amsterdam, The Netherlands
- Expertise Center for Palliative Care, Amsterdam, The Netherlands
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Garcia JP, Avila FR, Torres-Guzman RA, Maita KC, Lunde JJ, Coffey JD, Demaerschalk BM, Forte AJ. A narrative review of telemedicine and its adoption across specialties. Mhealth 2024; 10:19. [PMID: 38689613 PMCID: PMC11058596 DOI: 10.21037/mhealth-23-28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 12/17/2023] [Indexed: 05/02/2024] Open
Abstract
Background and Objective Telemedicine and video consultation are crucial advancements in healthcare, allowing remote delivery of care. Telemedicine, encompassing various technologies like wearable devices, mobile health, and telemedicine, plays a significant role in managing illnesses and promoting wellness. The corona virus disease 2019 (COVID-19) pandemic accelerated the adoption of telemedicine, ensuring convenient access to medical services while maintaining physical distance. Legislation has supported its integration into clinical practice and addressed compensation issues. However, ensuring clinical appropriateness and sustainability of telemedicine post-expansion has gained attention. We south to identify the most friendly and resistant specialties to telemedicine and to understand areas of interest within those specialties to grasp potential barriers to its use. Methods We aimed to identify articles that incorporated telemedicine in any medical or surgical specialty and determine the adoption rate and intent of this new form of care. Additionally, a secondary search within these databases was conducted to analyze the advantages, disadvantages, and implementation of telemedicine in the healthcare system. Non-English articles and those without full text were excluded. The study selection and data collection process involved using search terms such as "medicine", "surgery", "specialties", "telemedicine", and "telemedicine". Key Content and Findings Telemedicine adoption varies among specialties. The pandemic led to increased usage, with telemedicine consultations comprising 30.1% of all visits, but specialties like mental health, gastroenterology, and endocrinology showed higher rates of adoption compared to optometry, physical therapy, and orthopedic surgery. Conclusions The data shows that telemedicine uptake varies by specialty and condition due to the need for physical exams. In-person visits still dominate new patient visits despite increased telemedicine use. Telemedicine cannot fully replace in-person care but has increased visit volume and is secure. The adoption of telemedicine is higher in medical practices than in surgical practices, with neurosurgery and urology leading. Further research is needed to assess telemedicine's suitability and effectiveness in different specialties and conditions.
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Affiliation(s)
- John P. Garcia
- Division of Plastic Surgery, Mayo Clinic, Jacksonville, FL, USA
| | | | | | - Karla C. Maita
- Division of Plastic Surgery, Mayo Clinic, Jacksonville, FL, USA
| | | | | | - Bart M. Demaerschalk
- Center for Digital Health, Mayo Clinic, Rochester, MN, USA
- Department of Neurology, Mayo Clinic College of Medicine and Science, Phoenix, AZ, USA
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Rosenthal JL, Williams J, Bowers KF, Haynes SC, Kennedy L. Using inpatient telehealth for family engagement: A mixed methods study of perceptions from patients, families, and care team providers. Digit Health 2024; 10:20552076241267374. [PMID: 39130519 PMCID: PMC11316967 DOI: 10.1177/20552076241267374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 06/19/2024] [Indexed: 08/13/2024] Open
Abstract
Background The Inpatient Telehealth Program permits family to remotely communicate with the patient and care team through secure, live video. We aimed to assess the implementation of this program for family engagement from the perspectives of patients, families, and providers. Methods We used a convergent mixed methods design. The quantitative component was a cross-sectional analysis of surveys assessing patient, family, and provider experience. The qualitative component used thematic analysis of patient, family, and provider interviews plus survey free text responses. We performed memo-writing and coding. We developed hypotheses about relationships among categories and identified analytic themes. We used data transformation and narrative discussion to report the integrated findings. Results Surveys from 214 individuals (33 patients, 145 family, 36 providers) were evaluated. Mean (standard deviation) experience ratings (1-poor, 5-best) were 4.0 (1.5) for patients, 4.6 (0.8) for family, and 4.0 (1.4) for providers. We received 134 free text responses and conducted 21 interviews. Three themes emerged: (1) inpatient telehealth enhanced patient and family experience through strengthened relationships and increased support; (2) inpatient telehealth enhanced patient care through improved information sharing and engagement; (3) low awareness of the program limited adoption. Quantitative and qualitative data aligned in that participants perceived inpatient telehealth to be valuable; however, surveys revealed that patients and providers have relatively lower satisfaction with the program. Conclusion Inpatient telehealth for family engagement was perceived to improve family-centeredness of care. Future work is needed to overcome implementation challenges and to increase awareness of this resource among patients and families.
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Affiliation(s)
| | - Jacob Williams
- Graduate School of Biomedical Sciences & Professional Studies, Drexel University, Philadelphia, PA, USA
| | | | - Sarah C. Haynes
- Department of Pediatrics, University of California, Davis, Sacramento, CA, USA
| | - Lori Kennedy
- Center for Nursing Science, University of California, Davis, Sacramento, CA, USA
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Edwards G, O'Shea JE. Is telemedicine suitable for remotely supporting non-tertiary units in providing emergency care to unwell newborns? Arch Dis Child 2023; 109:5-10. [PMID: 37438088 DOI: 10.1136/archdischild-2022-325057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/08/2023] [Indexed: 07/14/2023]
Abstract
Although the majority of term infants will breathe spontaneously at birth, the requirement for advanced resuscitation can be unpredictable, as can the precipitous delivery of an extremely preterm infant in a non-tertiary neonatal unit. Infants born in hospitals without a tertiary neonatal intensive care unit have a higher mortality which is a disparity that has been difficult to resolve.Telemedicine, the use of videoconferencing software to connect those at the scene of a resuscitation to a remote clinician, can allow for real-time two-way communication between a local unit and a tertiary neonatal specialist. It has been present for some time in neonatology to provide secure video messaging with families and its use in neonatal acute care and resuscitation has been growing in recent years.We sought to perform a review of the current evidence available on the use of telemedicine in neonatal resuscitation. Studies demonstrate improved quality of resuscitation, improved adherence to resuscitation guidelines and positive experiences reported by local and tertiary teams. Suitable technology needs to be available to establish a rapid and secure video connection, as does adequate availability of experienced neonatologists to provide remote guidance. Telemedicine is an exciting and emerging tool which is being developed as a standard of care in units which have piloted it.
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Affiliation(s)
- Gemma Edwards
- Neonatal Unit, Princess Royal Maternity Hospital, Glasgow, UK
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Cardoso AF, Pires MG, Cioga E, Abalroado I, Santos D, Duque FM, Loureiro R, Felizardo H, Fernandes AM, Silva R, Ventura F, Santana E, Cardoso D, Loureiro L. Experiences with remote communication in adult intensive care units during the COVID-19 pandemic: a systematic review protocol. JBI Evid Synth 2023; 21:2455-2464. [PMID: 37711062 DOI: 10.11124/jbies-23-00002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
OBJECTIVE The objective of this review is to explore the lived experiences of critically ill adults, their families, or health care professionals with remote communication in intensive care units (ICUs) during the COVID-19 pandemic. INTRODUCTION Family visiting restrictions in ICUs during the COVID-19 pandemic imposed significant challenges to communication between critically ill adults, their families, and the health care team. Evidence shows that several communication strategies were developed and implemented in ICUs during the COVID-19 pandemic to promote family engagement; however, the experiences of critically ill adults, their families, and health care professionals with these strategies are scattered across primary qualitative studies. INCLUSION CRITERIA This review will consider qualitative studies that include critically ill adults, their families, or health care professionals, focusing on their experiences with remote communication strategies in ICUs during the COVID-19 pandemic. METHODS This review will be conducted in accordance with JBI methodology. The search strategy will aim to locate both published and unpublished qualitative studies in English, Spanish, and Portuguese. Studies published after January 2020 will be included. Study selection, critical appraisal, and data extraction will be performed independently by 2 reviewers. Data will be presented in narrative format and synthesized using the JBI meta-aggregation process. A ConQual Summary of Findings will be presented. REVIEW REGISTRATION PROSPERO CRD42022383603.
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Affiliation(s)
- Ana Filipa Cardoso
- Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Portugal Centre for Evidence Based Practice: A JBI Centre of Excellence, Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal
| | - Miguel Grilo Pires
- Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - Elisabete Cioga
- Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - Inês Abalroado
- Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - Diana Santos
- Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - Filipa Margarida Duque
- Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Ricardo Loureiro
- Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Helena Felizardo
- Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - António Manuel Fernandes
- Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Portugal Centre for Evidence Based Practice: A JBI Centre of Excellence, Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal
| | - Rosa Silva
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Portugal Centre for Evidence Based Practice: A JBI Centre of Excellence, Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal
- Nursing School of Porto (ESEP), Porto, Portugal
| | - Filipa Ventura
- Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Elaine Santana
- Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Daniela Cardoso
- Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Portugal Centre for Evidence Based Practice: A JBI Centre of Excellence, Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal
| | - Luís Loureiro
- Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
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Kim S, Chang H, Kim T, Cha WC. Patient Anxiety and Communication Experience in the Emergency Department: A Mobile, Web-Based, Mixed-Methods Study on Patient Isolation During the COVID-19 Pandemic. J Korean Med Sci 2023; 38:e303. [PMID: 37821083 PMCID: PMC10562183 DOI: 10.3346/jkms.2023.38.e303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 06/08/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Anxiety and communication difficulties in the emergency department (ED) may increase for various reasons, including isolation due to coronavirus disease 2019 (COVID-19). However, little research on anxiety and communication in EDs exists. This study explored the isolation-related anxiety and communication experiences of ED patients during the COVID-19 pandemic. METHODS A prospective mixed-methods study was conducted from May to August 2021 at the Samsung Medical Center ED, Seoul. There were two patient groups: isolation and control. Patients measured their anxiety using the State-Trait Anxiety Inventory (STAI X1) at two time points, and we surveyed patients at two time points about factors contributing to their anxiety and communication experiences. These were measured through a mobile web-based survey. Researchers interviewed patients after their discharge. RESULTS ED patients were not anxious regardless of isolation, and there was no statistical significance between each group at the two time points. STAI X1 was 48.4 (standard deviation [SD], 8.0) and 47.3 (SD, 10.9) for early follow-up and 46.3 (SD, 13.0) and 46.2 (SD, 13.6) for late follow-up for the isolation and control groups, respectively. The clinical process was the greatest factor contributing to anxiety as opposed to the physical environment or communication. Communication was satisfactory in 71.4% of the isolation group and 66.7% of the control group. The most important aspects of communication were information about the clinical process and patient status. CONCLUSION ED patients were not anxious and were generally satisfied with medical providers' communication regardless of their isolation status. However, patients need clinical process information for anxiety reduction and better communication.
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Affiliation(s)
- Sumin Kim
- Department of Digital Health, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul, Korea
| | - Hansol Chang
- Department of Digital Health, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul, Korea
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Taerim Kim
- Department of Digital Health, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul, Korea
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Won Chul Cha
- Department of Digital Health, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul, Korea
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Digital Innovation Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Wilkerson RG, Annous Y, Farhy E, Hurst J, Smedley AD. Home Pulse Oximetry Monitoring during the COVID-19 Pandemic: An Assessment of Patient Engagement and Compliance. HEALTH POLICY AND TECHNOLOGY 2023; 12:100776. [PMID: 38620095 PMCID: PMC10291857 DOI: 10.1016/j.hlpt.2023.100776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
Objectives Patients with suspected COVID-19 remain at risk for clinical deterioration after discharge and may benefit from home oxygen saturation (SpO2) monitoring using portable pulse oximeter devices. Our study aims to evaluate patient engagement and compliance with a home SpO2 monitoring program. Methods This is a single center, prospective pilot study of patients being discharged from the ED or urgent care after evaluation of symptoms consistent with COVID-19. Subjects were given a portable pulse oximeter and instructed to obtain measurements at rest and with exertion twice daily for 14 days. Patients were contacted daily to collect recorded data. If attempts to contact the patient were unsuccessful for 3 consecutive days, patients were considered lost to follow up. The primary outcome of interest was patient engagement in the program which was defined as the percentage of patients that completed the 14-day study period, meaning they were not lost to follow up. Secondary outcomes included compliance with performing the SpO2 readings. Patient compliance was calculated as a percentage of completed readings out of the total expected readings. Results Fifty patients were enrolled - 2 withdrew and 1 was a screen failure. Overall, engagement in the program was 46.8% with no significant difference between those who tested positive for SARS-CoV-2 versus those who tested negative (48.2% vs 45%, p = 0.831). Median compliance overall was 42.9% (IQR 22.22-78.57). Median compliance for the positive group was 50.0% (IQR 20-85.71) and 42.86% (IQR 22.92-76.44) for the negative group (p= 0.838). Conclusion Our study demonstrated that there was acceptable engagement and compliance in a 14-day home SpO2 monitoring program. These results support the use of home pulse oximetry monitoring in a select group of mildly ill patients with suspected COVID-19.
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Affiliation(s)
- R Gentry Wilkerson
- Department of Emergency Medicine, University of Maryland School of Medicine, 110 S. Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201
| | - Youssef Annous
- Department of Emergency Medicine, University of Maryland School of Medicine, 110 S. Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201
| | - Eli Farhy
- Department of Emergency Medicine, University of Maryland School of Medicine, 110 S. Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201
| | - Jonathan Hurst
- Department of Emergency Medicine, University of Maryland School of Medicine, 110 S. Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201
| | - Angela D Smedley
- Department of Emergency Medicine, University of Maryland School of Medicine, 110 S. Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201
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Digby R, Manias E, Haines KJ, Orosz J, Ihle J, Bucknall TK. Family experiences and perceptions of intensive care unit care and communication during the COVID-19 pandemic. Aust Crit Care 2023; 36:350-360. [PMID: 35501199 PMCID: PMC8971060 DOI: 10.1016/j.aucc.2022.03.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/27/2022] [Accepted: 03/01/2022] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION In 2020, during the first wave of the COVID-19 pandemic in Melbourne, visitor access to acute hospitals including intensive care units (ICUs) was initially barred, followed by a limit of one person per patient for one hour per day. This study explores the care and communication experienced by family members of ICU patients during this time. METHODS This qualitative descriptive study was conducted at an Australian quaternary hospital. Semistructured phone interviews were conducted using an aide-memoire designed to understand participants' experiences as family of a patient during this time. Interviews were recorded, transcribed, and thematically analysed. FINDINGS Twenty family members of patients in the ICU participated. Three major themes were identified: 'impact of restricting visiting procedures', 'family experiences of communication', and 'care and support'. Inflexible visiting restrictions had a momentous impact on families. Participants objected to having to nominate only two people to visit during the admission and the short visiting time limit. Some family members suffered extreme stress and anxiety during their absence from the bedside. Additional challenges were experienced by rural families, visitors with disabilities, and the young children of patients who were excluded. Communication with clinicians varied. Telehealth was valued by some but not universally embraced. The relationship between staff members and families and involvement in decision-making were unaffected. CONCLUSION Families experienced significant psychological distress from being separated from their critically ill relatives. Patient care and involvement in decision-making appeared to be unchanged, but communication with staff felt to be lacking. Better alternatives to face-to-face communication must be sought to limit the impact of family separation on mental health. Families are a key link between the patient and clinicians and often play a major role in patient support and recovery after discharge. There is an urgent need to support them and facilitate meaningful engagement despite the obstacles.
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Affiliation(s)
- R Digby
- Deakin University, School of Nursing and Midwifery, Centre for Quality and Patient Safety, Research, Institute for Health Transformation, Faculty of Health, Geelong, VIC, 3220, Australia; Alfred Health, 55 Commercial Rd, Melbourne, VIC, 3004, Australia.
| | - E Manias
- Deakin University, School of Nursing and Midwifery, Centre for Quality and Patient Safety, Research, Institute for Health Transformation, Faculty of Health, Geelong, VIC, 3220, Australia.
| | - K J Haines
- Department of Physiotherapy, Western Health, Melbourne, Victoria, Australia; Department of Critical Care, School of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.
| | - J Orosz
- Department of Intensive Care, The Alfred Hospital, Melbourne, Australia; Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia.
| | - J Ihle
- Department of Intensive Care, The Alfred Hospital, Melbourne, Australia; Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia.
| | - T K Bucknall
- Deakin University, School of Nursing and Midwifery, Centre for Quality and Patient Safety, Research, Institute for Health Transformation, Faculty of Health, Geelong, VIC, 3220, Australia; Alfred Health, 55 Commercial Rd, Melbourne, VIC, 3004, Australia.
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Aledreesi TM, Alrewaished M. Assessing the Satisfaction and Usability of Patient Families in the ICU With the Use of the Telehealth Communication Application myVisit. Cureus 2023; 15:e38078. [PMID: 37113462 PMCID: PMC10129043 DOI: 10.7759/cureus.38078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND During the Covid-19 pandemic, there were many restrictions on family meetings, especially on patients' families meeting their dear ones in hospitals. We aimed to evaluate patients' family members' experience using the mobile application myVisit which was developed in KAMC, to connect patients in the ICU to their families and allow them to talk to them securely. METHODOLOGY We conducted a cross-sectional study with mixed qualitative and quantitative methods, using the technique of thematic analysis for a qualitative approach to assess user satisfaction responses and a quantitative approach to using a validated survey and comparing our findings in both methods to determine existing usability issues and potential improvements. The survey included two sections, closed and open-ended questions, which were distributed online to 63 patient family members. RESULTS The response rate was 85%, the overall mean score for the first part of the closed questions (advantages of using myVisit telehealth) was 4.32 and for the second part of the scale on the ease of use of the system (advantages of using myVisit telehealth) was 3.52. Three useful topics were generated concerning the open questions, covering 220 codes from the participants' responses. In general, there is a great interest in technology and its ability to improve people's lives, especially in the medical field and cases where things do not go normally, as well as in exceptional circumstances. CONCLUSIONS The overall evaluation of the myVisit application was positive in terms of the idea and content, as usability of the system is very good at 71%, plus the users' opinions of the myVisit application are that it saves time at 96%, and save money and effort for the patient's family 74%.
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Affiliation(s)
- Thamer M Aledreesi
- Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
- Health Informatics, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Meshal Alrewaished
- Health Informatics, Ministry of National Guard Health Affairs, Riyadh, SAU
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Emergency nurses' communication experiences with patients and their families during the COVID-19 pandemic: A qualitative study. Int Emerg Nurs 2023; 66:101240. [PMID: 36584657 PMCID: PMC9676159 DOI: 10.1016/j.ienj.2022.101240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 10/22/2022] [Accepted: 11/15/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND In the emergency department, essential information is verified primarily through communication with patients and families. Thus, an in-depth understanding of emergency nurses' communication experiences with patients is required to facilitate the provision of effective therapeutic care. OBJECTIVE To analyze emergency nurses' communication experiences with patients and their families. METHODS A qualitative descriptive design was used. Interviews were conducted with 15 nurses between 2021 and 2022. Thematic analysis was carried out. This study was conducted in accordance with the consolidated criteria for reporting qualitative studies (COREQ). RESULTS Three themes were identified: transformation of communication approaches due to COVID-19, obstacles in therapeutic communication, and continuous endeavors for improved communication. CONCLUSION Emergency nurses experienced various barriers in communication with patients and their families, which were exacerbated by COVID-19. Nevertheless, nurses attempted to enhance their communication skills. Organizational support is pertinent to establish effective communication strategies.
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12
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Chen R(T, Truong M, Watterson JR, Burrell A, Wong P. The impact of the intensive care unit family liaison nurse role on communication during the COVID-19 pandemic: A qualitative descriptive study of healthcare professionals' perspectives. Aust Crit Care 2023; 36:127-132. [PMID: 36351854 PMCID: PMC9510056 DOI: 10.1016/j.aucc.2022.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 09/11/2022] [Accepted: 09/17/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has deeply impacted patient and family communication and patient- and family-centred care in the intensive care unit (ICU). A new role-the ICU Family Liaison Nurse (FLN)-was introduced in an Australian metropolitan hospital ICU to facilitate communication between patient and family and ICU healthcare professionals, although there is limited knowledge about the impact of this from the ICU healthcare professionals' perspectives. OBJECTIVE The aim of this study was to explore the impact of the ICU FLN role on communication with patients and their family during the COVID-19 pandemic, from the ICU healthcare professionals' perspectives. METHODS A qualitative descriptive study was conducted. Seven participants including ICU FLNs, ICU doctors, nurses, and social workers who worked with the ICU FLNs were interviewed. Thematic analysis was used to analyse the data. RESULTS Two main themes related to the ICU FLN role were identified. First, the COVID-19 pandemic posed challenges to patient and family communication, but it also created opportunities to improve patient and family communication. Second, the ICU FLN role brought beneficial impacts to the ICU healthcare professionals' workflow and work experience, as well as patient and family communication. The ICU FLN role has potential benefits that extend beyond the pandemic. CONCLUSION We found that during the COVID-19 pandemic, the ICU FLN role was acceptable, beneficial, and appreciated from the ICU healthcare professionals' perspectives. Further research should continue the evaluation of the ICU FLN role during and post the pandemic.
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Affiliation(s)
- Ruofei (Trophy) Chen
- Nursing and Midwifery, Monash University, Australia,Corresponding author at. Nursing and Midwifery, Monash University, Clayton Campus, VIC, 3800, Australia
| | - Mandy Truong
- Nursing and Midwifery, Monash University, Australia
| | - Jason R. Watterson
- Department of Intensive Care Medicine, Frankston Hospital, Peninsula Health, Australia,Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Australia
| | - Aidan Burrell
- Department of Intensive Care Medicine, The Alfred Hospital, Australia
| | - Pauline Wong
- Nursing and Midwifery, Monash University, Australia
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Corbaz-Kurth S, Juvet TM, Benzakour L, Cereghetti S, Fournier CA, Moullec G, Nguyen A, Suard JC, Vieux L, Wozniak H, Pralong JA, Weissbrodt R, Roos P. How things changed during the COVID-19 pandemic's first year: A longitudinal, mixed-methods study of organisational resilience processes among healthcare workers. SAFETY SCIENCE 2022; 155:105879. [PMID: 35891964 PMCID: PMC9304155 DOI: 10.1016/j.ssci.2022.105879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 07/18/2022] [Indexed: 05/14/2023]
Abstract
COVID-19 had a huge impact on healthcare systems globally. Institutions, care teams and individuals made considerable efforts to adapt their practices. The present longitudinal, mixed-methods study examined a large sample of healthcare institution employees in Switzerland. Organisational resilience processes were assessed by identifying problematic real-world situations and evaluating how they were managed during three phases of the pandemic's first year. Results highlighted differences between resilience processes across the different types of problematic situations encountered by healthcare workers. Four configurations of organisational resilience were identified depending on teams' performance and ability to adapt over time: "learning from mistakes", "effective development", "new standards" and "hindered resilience". Resilience trajectories differed depending on professional categories, hierarchical status and the problematic situation's perceived severity. Factors promoting or impairing organisational resilience are discussed. Findings highlighted the importance of individuals', teams' and institutions' meso- and micro-level adaptations and macro-level actors' structural actions.
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Affiliation(s)
- Sandrine Corbaz-Kurth
- Haute École Arc Santé, University of Applied Sciences and Arts Western Switzerland (HES-SO), Delémont and Neuchâtel, Switzerland
- Geneva University Hospitals, Geneva, Switzerland
| | - Typhaine M Juvet
- Haute École Arc Santé, University of Applied Sciences and Arts Western Switzerland (HES-SO), Delémont and Neuchâtel, Switzerland
| | | | | | | | - Gregory Moullec
- School of Public Health, University of Montréal, Quebec, Canada
| | - Alice Nguyen
- School of Public Health, University of Montréal, Quebec, Canada
| | | | - Laure Vieux
- Geneva University Hospitals, Geneva, Switzerland
| | | | | | | | - Pauline Roos
- Haute École Arc Santé, University of Applied Sciences and Arts Western Switzerland (HES-SO), Delémont and Neuchâtel, Switzerland
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14
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Gutierrez J, Rewerts K, CarlLee S, Kuperman E, Anderson ML, Kaboli PJ. A systematic review of telehealth applications in hospital medicine. J Hosp Med 2022; 17:291-302. [PMID: 35535926 DOI: 10.1002/jhm.12801] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 01/12/2022] [Accepted: 01/28/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Despite the proliferation of telehealth, uptake for acute inpatient services has been slower. Hospitalist shortages in rural and critical access hospitals as well as the COVID-19 pandemic have led to a renewed interest in telehealth to deliver acute inpatient services. Understanding current evidence is crucial for promoting uptake and developing evidence-based practices. OBJECTIVE To conduct a systematic review of telehealth applications in acute inpatient general medicine and pediatric hospital wards and synthesize available evidence. DATA SOURCES A search of five databases (PubMed, CINAHL, Embase, Scopus, and ProQuest Theses, and Dissertations) using a combination of search terms including telemedicine and hospital medicine/inpatient care keywords yielded 17,015 citations. STUDY SELECTION AND DATA EXTRACTION Two independent coders determined eligibility based on inclusion and exclusion criteria. Data were extracted and organized into main categories based on findings: (1) feasibility and planning, (2) implementation and technology, and (3) telehealth application process and outcome measures. RESULTS Of the 20 publications included, three were feasibility and planning studies describing the creation of the program, services provided, and potential cost implications. Five studies described implementation and technology used, including training, education, and evaluation methods. Finally, twelve discussed process and outcome measures, including patient and provider satisfaction and costs. CONCLUSION Telehealth services for hospital medicine were found to be effective, well received, and initial cost estimates appear favorable. A variety of services were described across programs with considerable benefit appreciated by rural and smaller hospitals. Additional work is needed to evaluate clinical outcomes and overall program costs.
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Affiliation(s)
- Jeydith Gutierrez
- VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Iowa City, Iowa City VA Healthcare System, Iowa City, Iowa, USA
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Kelby Rewerts
- VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Iowa City, Iowa City VA Healthcare System, Iowa City, Iowa, USA
- The Comprehensive Access and Delivery Research and Evaluation (CADRE) Center at the Iowa City VA Healthcare System, Iowa City, Iowa, USA
| | - Sheena CarlLee
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Fayetteville, Arkansas, USA
| | - Ethan Kuperman
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Melver L Anderson
- Department of Internal Medicine, University of Colorado Anschutz School of Medicine, Denver, Colorado, USA
| | - Peter J Kaboli
- VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Iowa City, Iowa City VA Healthcare System, Iowa City, Iowa, USA
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
- The Comprehensive Access and Delivery Research and Evaluation (CADRE) Center at the Iowa City VA Healthcare System, Iowa City, Iowa, USA
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15
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Moslehpour M, Shalehah A, Rahman FF, Lin KH. The Effect of Physician Communication on Inpatient Satisfaction. Healthcare (Basel) 2022; 10:healthcare10030463. [PMID: 35326941 PMCID: PMC8954154 DOI: 10.3390/healthcare10030463] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 02/22/2022] [Accepted: 02/25/2022] [Indexed: 12/16/2022] Open
Abstract
(1) Background: The importance of physician-patient communication and its effect on patient satisfaction has become a hot topic and has been studied from various aspects in recent years. However, there is a lack of systematic reviews to integrate recent research findings into patient satisfaction studies with physician communication. Therefore, this study aims to systematically examine physician communication’s effect on patient satisfaction in public hospitals. (2) Methods: Using a keywords search, data was collected from five databases for the papers published until October 2021. Original studies, observational studies, intervention studies, cross-sectional studies, cohort studies, experimental studies, and qualitative studies published in English, peer-reviewed research, and inpatients who communicated with the physician in a hospital met the inclusion criteria. (3) Results: Overall, 11 studies met the inclusion criteria from the 4810 articles found in the database. Physicians and organizations can influence two determinants of inpatient satisfaction in physician communication. Determinants of patient satisfaction that physicians influence consist of amounts of time spent with the patient, verbal and nonverbal indirect interpersonal communication, and understanding the demands of patients. The organization can improve patient satisfaction with physician communication by the organization’s availability of interpreter service and physician workload. Physicians’ communication with inpatients can affect patient satisfaction with hospital services. (4) Conclusions: To improve patient satisfaction with physician communication, physicians and organizational determinants must be considered.
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Affiliation(s)
- Massoud Moslehpour
- Department of Business Administration, College of Management, Asia University, No. 500, Liufeng Road, Wufeng District, Taichung City 41354, Taiwan; (M.M.); (A.S.)
- Department of Management, California State University, San Bernardino, CA 92407, USA
| | - Anita Shalehah
- Department of Business Administration, College of Management, Asia University, No. 500, Liufeng Road, Wufeng District, Taichung City 41354, Taiwan; (M.M.); (A.S.)
- International Relations Department, Faculty of Economy, Bussines and Politics, Universitas Muhammadiyah Kalimantan Timur, Jl. Ir. H. Juanda No. 15, Samarinda 75124, Kalimantan Timur, Indonesia
| | - Ferry Fadzlul Rahman
- Department of Public Health, College of Public Health, Universitas Muhammadiyah Kalimantan Timur, Jl. Ir. H. Juanda No. 15, Samarinda 75124, Kalimantan Timur, Indonesia;
| | - Kuan-Han Lin
- Department of Healthcare Administration, College of Medical and Health Sciences, Asia University, No. 500, Liufeng Road, Wufeng District, Taichung City 41354, Taiwan
- Correspondence:
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Yang R, Ganeshan S, Thompson A, McAllister S, Mourad M. Impact of a resident and student-led video visitation navigation program. BMC MEDICAL EDUCATION 2022; 22:110. [PMID: 35183182 PMCID: PMC8857532 DOI: 10.1186/s12909-022-03172-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 02/07/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Many institutions implemented telehealth initiatives to provide social support for patients during the SARS-CoV-2 (COVID-19) pandemic. Little is known about the impact of these programs on patient support persons and the trainees who facilitated them. OBJECTIVE To assess perceptions of a resident physician and medical student-driven video visit program. METHODS We designed and implemented a trainee-led video visit navigation program across three affiliated urban hospitals to facilitate video visits between patients and their support persons. We used descriptive statistics to understand the patient population served by the program and employed surveys for support persons and trainees to assess attitudes on the program. RESULTS From April to June 2020, a total of 443 video visits were completed. Surveys were conducted for 101 out of 184 (54.9%) support persons and 39 out of 65 (60.0%) of medical trainees. Surveys demonstrated that video visits helped alleviate the stress and anxiety of support persons having a hospitalized loved one they could not visit. For trainees, facilitating these connections helped mitigate stress and provided a mechanism to contribute to the pandemic response. CONCLUSION Telehealth navigation programs provide high levels of connection for patients and their support persons during the COVID-19 pandemic and potentially beyond. Residents and medical students involved in these initiatives mobilized telehealth modalities to improve experiences with care delivery.
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Affiliation(s)
- Rachel Yang
- School of Medicine, University of California San Francisco, San Francisco, CA, USA.
| | - Smitha Ganeshan
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Avery Thompson
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Sophie McAllister
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Michelle Mourad
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
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17
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Yen TE, Kim A, Benson ME, Ratnaparkhi S, Woolley AE, Mc Causland FR. Serum Sodium, Patient Symptoms, and Clinical Outcomes in Hospitalized Patients with COVID-19. J Prim Care Community Health 2022; 13:21501319211067349. [PMID: 34986694 PMCID: PMC8744185 DOI: 10.1177/21501319211067349] [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] [Indexed: 11/23/2022] Open
Abstract
Introduction: Disorders of serum sodium (SNa) are common in hospitalized patients with
COVID-19 and may reflect underlying disease severity. However, the
association of SNa with patient-reported outcomes is not clear. Methods: The Brigham and Women’s Hospital COVID-19 Registry is a prospective cohort
study of consecutively admitted adult patients with confirmed SARS-CoV-2
infection (n = 809). We examined the associations of SNa (continuous and
tertiles) on admission with: (1) patient symptoms obtained from detailed
chart review; and (2) in-hospital mortality, length of stay, and intensive
care unit (ICU) admission using unadjusted and adjusted logistic regression
models. Covariates included demographic data and comorbidities. Results: Mean age was 60 years, 48% were male, and 35% had diabetes. The most frequent
symptoms were cough (64%), fever (60%), and shortness of breath (56%). In
adjusted models, higher SNa (per mmol/L) was associated with lower odds of
GI symptoms (OR 0.96; 95% CI 0.92-0.99), higher odds of confusion (OR 1.08;
95% CI 1.04-1.13), in-hospital mortality (OR 1.06; 95% CI 1.02-1.11), and
ICU admission (OR 1.09; 95% CI 1.05-1.13). The highest sodium tertile
(compared with the middle tertile) showed similar associations, in addition
to lower odds of either anosmia or ageusia (OR 0.30; 95% CI 0.12-0.74). Conclusion: In this prospective cohort study of hospitalized patients with COVID-19,
hypernatremia was associated with higher odds of confusion and in-hospital
mortality. These findings may aid providers in identifying high-risk
patients who warrant closer attention, thereby furthering patient-centered
approaches to care.
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Affiliation(s)
- Timothy E Yen
- Division of Renal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Andy Kim
- Division of Infectious Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Maura E Benson
- Division of Infectious Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Saee Ratnaparkhi
- Division of Infectious Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ann E Woolley
- Division of Infectious Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Finnian R Mc Causland
- Division of Renal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Whear R, Abbott RA, Bethel A, Richards DA, Garside R, Cockcroft E, Iles‐Smith H, Logan PA, Rafferty AM, Shepherd M, Sugg HVR, Russell AM, Cruickshank S, Tooze S, Melendez‐Torres GJ, Thompson Coon J. Impact of COVID-19 and other infectious conditions requiring isolation on the provision of and adaptations to fundamental nursing care in hospital in terms of overall patient experience, care quality, functional ability, and treatment outcomes: systematic review. J Adv Nurs 2022; 78:78-108. [PMID: 34554585 PMCID: PMC8657334 DOI: 10.1111/jan.15047] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 07/02/2021] [Accepted: 09/05/2021] [Indexed: 01/28/2023]
Abstract
AIM This systematic review identifies, appraises and synthesizes the evidence on the provision of fundamental nursing care to hospitalized patients with a highly infectious virus and the effectiveness of adaptations to overcome barriers to care. DESIGN Systematic review. DATA SOURCES In July 2020, we searched Medline, PsycINFO (OvidSP), CINAHL (EBSCOhost), BNI (ProQuest), WHO COVID-19 Database (https://search.bvsalud.org/) MedRxiv (https://www.medrxiv.org/), bioRxiv (https://www.biorxiv.org/) and also Google Scholar, TRIP database and NICE Evidence, forwards citation searching and reference checking of included papers, from 2016 onwards. REVIEW METHODS We included quantitative and qualitative research reporting (i) the views, perceptions and experiences of patients who have received fundamental nursing care whilst in hospital with COVID-19, MERS, SARS, H1N1 or EVD or (ii) the views, perceptions and experiences of professional nurses and non-professionally registered care workers who have provided that care. We included review articles, commentaries, protocols and guidance documents. One reviewer performed data extraction and quality appraisal and was checked by another person. RESULTS Of 3086 references, we included 64 articles; 19 empirical research and 45 review articles, commentaries, protocols and guidance documents spanning five pandemics. Four main themes (and 11 sub-themes) were identified. Barriers to delivering fundamental care were wearing personal protective equipment, adequate staffing, infection control procedures and emotional challenges of care. These barriers were addressed by multiple adaptations to communication, organization of care, staff support and leadership. CONCLUSION To prepare for continuation of the COVID-19 pandemic and future pandemics, evaluative studies of adaptations to fundamental healthcare delivery must be prioritized to enable evidence-based care to be provided in future. IMPACT Our review identifies the barriers nurses experience in providing fundamental care during a pandemic, highlights potential adaptations that address barriers and ensure positive healthcare experiences and draws attention to the need for evaluative research on fundamental care practices during pandemics.
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Affiliation(s)
- Rebecca Whear
- College of Medicine and HealthUniversity of ExeterExeterUK
- The National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) South West Peninsula (PenARC)ExeterUK
| | - Rebecca A. Abbott
- College of Medicine and HealthUniversity of ExeterExeterUK
- The National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) South West Peninsula (PenARC)ExeterUK
| | - Alison Bethel
- College of Medicine and HealthUniversity of ExeterExeterUK
- The National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) South West Peninsula (PenARC)ExeterUK
| | - David A. Richards
- College of Medicine and HealthUniversity of ExeterExeterUK
- Department of Health and Caring SciencesWestern Norway University of Applied SciencesBergenNorway
| | - Ruth Garside
- College of Medicine and HealthUniversity of ExeterExeterUK
| | - Emma Cockcroft
- College of Medicine and HealthUniversity of ExeterExeterUK
| | - Heather Iles‐Smith
- School of Health and SocietyUniversity of SalfordSalfordUK
- Northern Care Alliance NHS GroupSalfordUK
| | - Pip A. Logan
- School of MedicineUniversity of NottinghamQueens Medical CentreNottinghamUK
| | - Ann Marie Rafferty
- Faculty of Nursing, Midwifery and Palliative CareKing’s College LondonLondonUK
| | - Maggie Shepherd
- NIHR Exeter Clinical Research FacilityRoyal Devon and Exeter NHS Foundation TrustExeterUK
- Institute of Biomedical and Clinical ScienceCollege of Medicine and HealthUniversity of ExeterExeterUK
| | | | | | | | - Susannah Tooze
- College of Medicine and HealthUniversity of ExeterExeterUK
| | | | - Jo Thompson Coon
- College of Medicine and HealthUniversity of ExeterExeterUK
- The National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) South West Peninsula (PenARC)ExeterUK
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Stenman L, Högberg L, Engström Å. Critical Care Nurses' Experiences Caring for Patients When Relatives Were not Allowed in the ICUs due to COVID-19 Pandemic. SAGE Open Nurs 2022; 8:23779608221103627. [PMID: 35669888 PMCID: PMC9163743 DOI: 10.1177/23779608221103627] [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: 12/29/2021] [Revised: 04/13/2022] [Accepted: 05/10/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction Health care workers faced new challenges during the COVID-19 pandemic when physical contact with relatives more or less disappeared. Objectives The aim of this study is to describe the experiences of critical care nurses (CCNs) working in intensive care units (ICUs) under the visiting restrictions imposed as a result of COVID-19. Method This study followed a qualitative design. The purposive sample included CCNs with at least 1 year of experience working in an ICU with a visiting policy affected by the pandemic. Data collection was carried out via semi-structured interviews and analyzed through a qualitative content analysis with an inductive approach. Results The study results are presented in three categories with 10 subcategories. CCNs value the presence of patients’ relatives at the bedside and described many challenges when relatives could not be present with the patient during the pandemic. Conclusion Close relatives are able to share essential information about the patients and provide much-needed emotional support to them, the relatives’ role is of central importance and CCNs value their presence in ICUs more than any positive consequences of them not being there.
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Affiliation(s)
- Lina Stenman
- Critical Care Nurse, Skellefteå Hospital, Skellefteå, Sweden
| | - Lisa Högberg
- Critical Care Nurse, Lycksele Hospital, ICU, Lycksele, Sweden
| | - Åsa Engström
- Department of Health, Education and Technology, Division of Nursing and Medical Technology, Lulea University of Technology, Luleå, Sweden
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Oktaviani R, Dewanto I. Assessment of factors influencing the patient's perception of teledentistry services. SCRIPTA MEDICA 2022. [DOI: 10.5937/scriptamed53-41336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Background/Aim: The trend of using teledentistry increased significantly during the pandemic. Many studies have analysed patients' perceptions of teledentistry, but no studies have examined the factors that influence these perceptions. Aim of this study was to determine the factors that influenced the patient's perception of teledentistry. Methods: This type of research was a descriptive analysis with a cross sectional design. A total of 170 respondents filled out a questionnaire containing sociodemographic data and statements with a Likert scale related to the five perceptual domains of teledentistry. The data were analysed for correlation test with SPSS and model test with SEM-PLS. Results: There were only two factors, namely age and level of education that appear as factors that affect the patient's perception with a correlation significance value of 0.001 for age and 0.005 for education. The value of the correlation coefficient was positive, which means that the higher the age and level of education, there was a greater tendency for perceived value to be more strongly agreed. These results were reinforced by the results of the coefficient values on the SEM-PLS model test which were positive and significant, namely 0.311. The results of the goodness of fit analysis in this study were in the moderate category with a value of 0.265. However, the imbalance in the number of respondents in each sociodemographic group makes the results of this study less representative. Conclusion: There was a significant positive correlation between the level of education and the perception of teledentistry. This means that the higher a person's education level, the better his perception of teledentistry. Age had a significant positive correlation and influence with the patient's perception of teledentistry.
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Impact of Restricted Visitation Policies During the First Wave of the COVID-19 Pandemic on Communication Between Critically Ill Patients, Families and Clinicians: A Qualitative Interview Study. Ann Am Thorac Soc 2021; 19:1169-1176. [PMID: 34914537 PMCID: PMC9278629 DOI: 10.1513/annalsats.202107-877oc] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Rationale Restricted visitation policies during the first wave of the coronavirus disease (COVID-19) pandemic have had a major impact on the ways that intensive care unit (ICU) clinicians communicated with patients and their families, requiring the use of innovative strategies to adapt to new communication structures. Objectives The purpose of this study is to describe the impact of restricted visitation policies on communication and to identify strategies that could be used to facilitate better communication within Canadian ICUs from the perspective of those affected. Methods We conducted semistructured individual interviews with critically ill patients, their families, and clinicians from 23 Canadian ICUs during the first wave of the COVID-19 pandemic between July 2020 and October 2020. We used inductive thematic analysis to identify relevant themes and subthemes. Results Forty-one interviews were conducted with 3 patients, 8 family members, 17 nurses, and 13 physicians. Five themes were identified from the analysis: 1) patient and family psychosocial and information needs; 2) communication tools; 3) quality of communication; 4) changing roles and responsibilities of patients and nurses/physicians; and 5) facilitators or barriers to implementing alternative communication. Participants identified strategies to leverage new videoconference technology and communication structures to preserve the quality of communication. Conclusions Our study identified challenges and opportunities related to communication between critically ill patients, families, and ICU clinicians due to the restricted hospital visitation policies during the first wave of the COVID-19 pandemic. The use of videoconference technology and changes to communication structure were important strategies to facilitate effective communication within the ICU.
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22
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Kuo YS, Lu CH, Chiu PW, Chang HC, Lin YY, Huang SP, Wang PY, Chen CJ, Lin IC, Tang JS, Chang YH, Chang RH, Lin CH. Challenges of Using Instant Communication Technology in the Emergency Department during the COVID-19 Pandemic: A Focus Group Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312463. [PMID: 34886188 PMCID: PMC8656867 DOI: 10.3390/ijerph182312463] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 11/21/2021] [Accepted: 11/23/2021] [Indexed: 11/16/2022]
Abstract
A record outbreak of community-spread COVID-19 started on 10 May 2021, in Taiwan. In response to the COVID-19 pandemic, care facilities have adopted various protocols using instant communication technology (ICT) to provide remote yet timely healthcare while ensuring staff safety. The challenges of patient evaluation in the emergency department (ED) using ICT are seldom discussed in the literature. The objective of this study was to investigate the factors influencing the utility of ICT for patient assessment in emergency settings during the pandemic. The patient flow protocol and the ED layout were modified and regionalized into different areas according to the patient’s risk of COVID-19 infection. Nine iPads were stationed in different zones to aid in virtual patient assessment and communication between medical personnel. A focus group study was performed to assess and analyze the utility of the ICT module in the ED. Eight emergency physicians participated in the study. Of them, four (50%) had been directly involved in the development of the ICT module in the study hospital. Three main themes that influenced the application of the ICT module were identified: setting, hardware, and software. The setting theme included six factors: patient evaluation, subspecialty consultation, patient privacy and comfortableness, sanitation, cost, and patient acceptability. The hardware theme included six factors: internet connection, power, quality of image and voice, public or personal mode, portable or fixed mode, and maintenance. The software theme included six factors: platform choices, security, ICT accounts, interview modes, video/voice recording, and time limitation. Future studies should focus on quantifying module feasibility, user satisfaction, and protocol adjustment for different settings.
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Affiliation(s)
- Yuh-Shin Kuo
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan; (Y.-S.K.); (C.-H.L.); (P.-W.C.); (H.-C.C.); (Y.-Y.L.); (S.-P.H.); (P.-Y.W.); (C.-J.C.); (I.-C.L.); (Y.-H.C.)
| | - Chien-Hsin Lu
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan; (Y.-S.K.); (C.-H.L.); (P.-W.C.); (H.-C.C.); (Y.-Y.L.); (S.-P.H.); (P.-Y.W.); (C.-J.C.); (I.-C.L.); (Y.-H.C.)
| | - Po-Wei Chiu
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan; (Y.-S.K.); (C.-H.L.); (P.-W.C.); (H.-C.C.); (Y.-Y.L.); (S.-P.H.); (P.-Y.W.); (C.-J.C.); (I.-C.L.); (Y.-H.C.)
| | - Hung-Chieh Chang
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan; (Y.-S.K.); (C.-H.L.); (P.-W.C.); (H.-C.C.); (Y.-Y.L.); (S.-P.H.); (P.-Y.W.); (C.-J.C.); (I.-C.L.); (Y.-H.C.)
| | - Yu-Yuan Lin
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan; (Y.-S.K.); (C.-H.L.); (P.-W.C.); (H.-C.C.); (Y.-Y.L.); (S.-P.H.); (P.-Y.W.); (C.-J.C.); (I.-C.L.); (Y.-H.C.)
| | - Shao-Peng Huang
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan; (Y.-S.K.); (C.-H.L.); (P.-W.C.); (H.-C.C.); (Y.-Y.L.); (S.-P.H.); (P.-Y.W.); (C.-J.C.); (I.-C.L.); (Y.-H.C.)
| | - Pei-Yu Wang
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan; (Y.-S.K.); (C.-H.L.); (P.-W.C.); (H.-C.C.); (Y.-Y.L.); (S.-P.H.); (P.-Y.W.); (C.-J.C.); (I.-C.L.); (Y.-H.C.)
| | - Cheng-Jen Chen
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan; (Y.-S.K.); (C.-H.L.); (P.-W.C.); (H.-C.C.); (Y.-Y.L.); (S.-P.H.); (P.-Y.W.); (C.-J.C.); (I.-C.L.); (Y.-H.C.)
| | - I-Chen Lin
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan; (Y.-S.K.); (C.-H.L.); (P.-W.C.); (H.-C.C.); (Y.-Y.L.); (S.-P.H.); (P.-Y.W.); (C.-J.C.); (I.-C.L.); (Y.-H.C.)
| | - Jing-Shia Tang
- Department of Nursing, Chung Hwa University of Medical Technology, Tainan 71703, Taiwan;
- International Doctoral Program in Nursing, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan
| | - Ying-Hsin Chang
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan; (Y.-S.K.); (C.-H.L.); (P.-W.C.); (H.-C.C.); (Y.-Y.L.); (S.-P.H.); (P.-Y.W.); (C.-J.C.); (I.-C.L.); (Y.-H.C.)
| | - Ray Hsienho Chang
- Department of Security and Emergency Services, Embry-Riddle Aeronautical University-Worldwide, Daytona Beach, FL 32114, USA
- Correspondence: (R.H.C.); (C.-H.L.)
| | - Chih-Hao Lin
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan; (Y.-S.K.); (C.-H.L.); (P.-W.C.); (H.-C.C.); (Y.-Y.L.); (S.-P.H.); (P.-Y.W.); (C.-J.C.); (I.-C.L.); (Y.-H.C.)
- Correspondence: (R.H.C.); (C.-H.L.)
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23
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Lopez-Soto C, Bates E, Anderson C, Saha S, Adams L, Aulakh A, Bowtell F, Buckel M, Emms T, Shebl M, Metaxa V. The Role of a Liaison Team in ICU Family Communication During the COVID 19 Pandemic. J Pain Symptom Manage 2021; 62:e112-e119. [PMID: 33892123 PMCID: PMC8057931 DOI: 10.1016/j.jpainsymman.2021.04.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 04/09/2021] [Accepted: 04/14/2021] [Indexed: 11/18/2022]
Abstract
CONTEXT In the name of public safety, a general suspension on hospital visiting was imposed in the U.K., prohibiting family and friends to visit hospitalized patients, even if they were critically ill. OBJECTIVES we aimed to assess the impact of the FLT on the communication with patients' family and friends (PFF), especailly around end-of-life care, and their interaction with CC clinicians. METHODS A retrospective, mixed-methods analysis of a family liaison team (FLT) formed by redeployed clinicians in critical care (CC) during the first surge of the 2020 COVID 19 pandemic. RESULTS The FLT was constituted predominantly of non-ICU consultants (30/39, 77%). Following two one-hourly webinars around basic communication skills, the FLT facilitated over 12,000 video and telephone calls with 172 patients' family and friends (PFF). The majority of the PFF interviewed were mostly, very or extremely satisfied with the frequency, ease, understanding, honesty, completeness, and consistency of the information provided. Approximately 5% of the interviewees reported to be slightly or very dissatisfied in one or more of the following 3 categories: frequency, consistency, and ease of getting the information. The thematic analysis identified 3 themes: 1) being there with/ for the patient; 2) breakdown in communication; 3) disbelief at the speed of deterioration. In 14.9% of cases there was documented discrepancy between the information transmitted by the CC team and that by the FLT, particularly around the severity of the patient's illness and their imminent death. CONCLUSION The formation of a dedicated FLT was feasible and associated with high levels of satisfaction by the PFF. Friction was created when communication was not consistent and did not convey the severity of the patient's condition, to prepare the PFF for a bad outcome.
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Affiliation(s)
- Carmen Lopez-Soto
- Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK
| | - Eleanor Bates
- Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK
| | - Charlotte Anderson
- Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK
| | - Sian Saha
- Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK
| | - Laura Adams
- Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK
| | - Alex Aulakh
- Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
| | - Francesca Bowtell
- Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK
| | - Marie Buckel
- The National Hospital for Neurology and Neurosurgery, London, UK
| | - Thomas Emms
- Ashford & St Peter's Hospital NHS Trust, Ashford, UK
| | - Moustafa Shebl
- Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK
| | - Victoria Metaxa
- Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK.
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24
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Curfman A, McSwain SD, Chuo J, Yeager-McSwain B, Schinasi DA, Marcin J, Herendeen N, Chung SL, Rheuban K, Olson CA. Pediatric Telehealth in the COVID-19 Pandemic Era and Beyond. Pediatrics 2021; 148:peds.2020-047795. [PMID: 34215677 PMCID: PMC8669573 DOI: 10.1542/peds.2020-047795] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/23/2021] [Indexed: 11/24/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic led to an unprecedented demand for health care at a distance, and telehealth (the delivery of patient care using telecommunications technology) became more widespread. Since our 2018 state-of-the-art review assessing the pediatric telehealth landscape, there have been many changes in technology, policy, payment, and physician and patient acceptance of this care model. Clinical best practices in telehealth, on the other hand, have remained unchanged during this time, with the primary difference being the need to implement them at scale.Because of the pandemic, underlying health system weaknesses that have previously challenged telehealth adoption (including inequitable access to care, unsustainable costs in a fee-for-service system, and a lack of quality metrics for novel care delivery modalities) were simultaneously exacerbated. Higher volume use has provided a new appreciation of how patients from underrepresented backgrounds can benefit from or be disadvantaged by the shift toward virtual care. Moving forward, it will be critical to assess which COVID-19 telehealth changes should remain in place or be developed further to ensure children have equitable access to high-quality care.With this review, we aim to (1) depict today's pediatric telehealth practice in an era of digital disruption; (2) describe the people, training, processes, and tools needed for its successful implementation and sustainability; (3) examine health equity implications; and (4) critically review current telehealth policy as well as future policy needs. The American Academy of Pediatrics (AAP) is continuing to develop policy, specific practice tips, training modules, checklists, and other detailed resources, which will be available later in 2021.
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Affiliation(s)
- Alison Curfman
- Department of Pediatrics, Mercy Children's Hospital, St Louis, Missouri
| | - S. David McSwain
- Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina
| | - John Chuo
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Dana A. Schinasi
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois,Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - James Marcin
- Department of Pediatrics, School of Medicine, University of California Davis, Sacramento, California
| | - Neil Herendeen
- Division of General Pediatrics, Golisano Children’s Hospital, University of Rochester Medical Center, Rochester, New York
| | | | - Karen Rheuban
- Department of Pediatrics, University of Virginia Health System, Charlottesville, Virginia
| | - Christina A. Olson
- Children’s Hospital Colorado, Aurora, Colorado,Department of Pediatrics, School of Medicine, University of Colorado, Aurora, Colorado
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25
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Fernandes CS, Magalhães B, Silva S, Edra B. (Re)'Thinking' family in nursing care in pandemic times. Int Nurs Rev 2021; 69:47-57. [PMID: 34409599 DOI: 10.1111/inr.12708] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 07/19/2021] [Accepted: 07/27/2021] [Indexed: 11/29/2022]
Abstract
AIM This study aimed to identify which strategies are being adopted to deal with family restrictions in health units and assess nurses' perceptions of including families in nursing care during the current pandemic. BACKGROUND Due to the COVID-19 pandemic, health organisations limited access for visitors. INTRODUCTION Family centred care needs to be guaranteed, and alternatives for face-to-face interaction should be fostered. Therefore, there is an urgent need to rethink the family in nursing care during a pandemic. METHODS We conducted a descriptive exploratory mixed-method study in Portugal using an electronic questionnaire. The study included 192 nurses recruited using a non-probabilistic convenience sample. The study was reported using the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. RESULTS A total of 41.1% of participants (n = 79) reported that visits to their services were not authorised, and 66.7% (n = 128) reported resorting to video calls because of the restrictions imposed. Regarding attitude assessment, the average score of the scale was 77.9 (SD = 10.0), ranging between 26 and 98. When analysing the different dimensions of the 'Families' Importance in Nursing Care - Nurses Attitudes' scale, family data stand out as a burden. CONCLUSION Although a large percentage of participants had a positive attitude towards families and tried to find strategies to maintain family centred care, many nurses still considered the family as a burden. The current COVID-19 pandemic may have aggravated this perception. IMPLICATIONS FOR NURSING PRACTICE, NURSING POLICY AND HEALTH POLICY: The continued implementation of family centred nursing practice is essential for child-well-being, including during the current pandemic. Therefore, having intervention policies with alternative forms of care is highly recommended.
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Affiliation(s)
- Carla Sílvia Fernandes
- Nursing School of Porto, Porto, Portugal.,Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
| | - Bruno Magalhães
- Center for Health Technology and Services Research (CINTESIS), Porto, Portugal.,Santa Maria Health School, Porto, Portugal
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26
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Abstract
Purpose of Review The concept of telehealth has been around since the early twentieth century and has been used in different healthcare specialties. However, with the recent COVID-19 pandemic necessitating physical distancing, there has been an increased emphasis and utilization of this mode of healthcare delivery. With increasing reliance on telehealth services, data from investigator groups have brought to light several merits as well as failings of telehealth. Recent Findings Telehealth services have been associated with improved healthcare outcomes while remaining a cost-effective mode of healthcare delivery. Improving access and timeliness of care has also been observed by multiple telehealth-related studies. Finally, telehealth services are also anticipated to serve as part of emergency preparedness protocol and have shown to reduce provider-patient supply-demand mismatch, prevalent in certain subspecialties. With these benefits come certain challenges that have been highlighted in the literature. Indiscriminate utilization of telehealth services may widen public health disparities among minority groups and may increase overall healthcare expenditure due to overutilization of care, and the digital platform may jeopardize security of patient data. Summary COVID-19 has been a catalyst in increasing utilization of telehealth services. As we move forward from the current pandemic, lessons learned from the studies demonstrating benefits and challenges associated with telehealth should be taken into account when drafting post-pandemic telehealth policies. Special attention should be paid to ensure that telehealth narrows, and not widens, the currently existing disparities in access to healthcare.
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27
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Juvet TM, Corbaz-Kurth S, Roos P, Benzakour L, Cereghetti S, Moullec G, Suard JC, Vieux L, Wozniak H, Pralong JA, Weissbrodt R. Adapting to the unexpected: Problematic work situations and resilience strategies in healthcare institutions during the COVID-19 pandemic's first wave. SAFETY SCIENCE 2021; 139:105277. [PMID: 34720426 PMCID: PMC8545718 DOI: 10.1016/j.ssci.2021.105277] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 03/22/2021] [Indexed: 05/08/2023]
Abstract
The COVID-19 pandemic's first wave required considerable adaptation efforts on the part of healthcare workers. The literature on resilient healthcare describes how the collective regulation strategies implemented by frontline employees make essential contributions to institutions' abilities to cope with major crises. The present mixed-methodology study was thus conducted among a large sample of employees in a variety of Swiss healthcare institutions and focused on problematic real-world situations experienced by them and their managers during the pandemic's first wave. It highlighted the anticipatory and adaptive strategies implemented by institutions, teams and individuals. The most frequently cited problematic situations involved organisational changes, interpersonal conflicts and workloads. In addition to the numerous top-down measures implemented by institutions, respondents also identified personal or team regulation strategies such as increasing staff flexibility, prioritising tasks, interprofessional collaboration, peer support or creating new communication channels to families. The present findings underlined the importance of taking greater account of healthcare support staff and strengthening managerial capacity to support interprofessional teams including those support staff.
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Affiliation(s)
| | - Sandrine Corbaz-Kurth
- Arc School of Health, HES-SO, Neuchâtel & Delémont, Switzerland
- Geneva University Hospitals, Geneva, Switzerland
| | - Pauline Roos
- Arc School of Health, HES-SO, Neuchâtel & Delémont, Switzerland
| | | | | | - Gregory Moullec
- School of Public Health, University of Montréal, Quebec, Canada
| | | | - Laure Vieux
- Geneva University Hospitals, Geneva, Switzerland
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28
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Taylor M, Reynolds C, Jones R. Challenges and Potential Solutions for Patient Safety in an Infectious-Agent-Isolation Environment: A Study of 484 COVID-19-Related Event Reports Across 94 Hospitals. PATIENT SAFETY 2021. [DOI: 10.33940/infection/2021.6.4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Previous research has shown that patients in infectious-agent isolation are at greater risk for certain types of safety-related events. We conducted a study to explore the relationship between the various types of events that occur in an isolation environment and the associated factors, which may have implications for the likelihood of the event and severity of patient harm. We conducted a query of the Pennsylvania Patient Safety Reporting System (PA-PSRS) database to identify event reports submitted by acute care hospitals between January 1 and September 30, 2020. We identified 484 relevant event reports from 94 hospitals for inclusion in our descriptive study (excluding near-miss events). We measured the frequency of relationship between categories of safety-related event types and 18 categories of associated factors. Among the seven categories of event types, the most frequently identified were skin integrity (141 of 484, 29%), falls (129 of 484, 27%), and medication-related (78 of 484, 16%). Across all 18 categories of associated factors, which had or may have had an influence on the event type, the most frequent were patient’s mental status (80 of 484, 17%), staff’s time to don personal protective equipment (62 of 484, 13%), and patient’s interference with equipment/supplies (45 of 484, 9%). Overall, our results revealed that the frequency of certain associated factors varied considerably from one event type to another, which indicates that the relation between event types and associated factors should guide selection of risk mitigation strategies. We encourage readers to leverage our results along with Table 9, which provides a list of challenges identified in an isolation environment and potential solutions. We envision hospital staff proactively and systematically using the information in our manuscript to facilitate their evaluation of the isolation environment and prioritization of risk mitigation strategies.
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29
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Uscher-Pines L, Sousa J, Mehrotra A, Schwamm LH, Zachrison KS. Rising to the Challenges of the Pandemic: Telehealth Innovations in U.S. Emergency Departments. J Am Med Inform Assoc 2021; 28:1910-1918. [PMID: 34022045 PMCID: PMC8194856 DOI: 10.1093/jamia/ocab092] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/10/2021] [Indexed: 11/24/2022] Open
Abstract
Objective During the first 9 months of the coronavirus disease 2019 (COVID-19) pandemic, many emergency departments (EDs) experimented with telehealth applications to reduce virus exposure, decrease visit volume, and conserve personal protective equipment. We interviewed ED leaders who implemented telehealth programs to inform responses to the ongoing COVID-19 pandemic and future emergencies. Materials and Methods From September to November 2020, we conducted semi-structured interviews with ED leaders across the United States. We identified EDs with pandemic-related telehealth programs through literature review and snowball sampling. Maximum variation sampling was used to capture a range of experiences. We used standard qualitative analysis techniques, consisting of both inductive and deductive approaches to identify and characterize themes. Results We completed 15 interviews with EDs leaders in 10 states. From March to November 2020, participants experimented with more than a dozen different types of telehealth applications including tele-isolation, tele-triage, tele-consultation, virtual postdischarge assessment, acute care in the home, and tele-palliative care. Prior experience with telehealth was key for implementation of new applications. Most new telehealth applications turned out to be temporary because they were no longer needed to support the response. The leading barriers to telehealth implementation during the pandemic included technology challenges and the need for “hands-on” implementation support in the ED. Conclusions In response to the COVID-19 pandemic, EDs rapidly implemented many telehealth innovations. Their experiences can inform future responses.
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Affiliation(s)
| | | | | | - Lee H Schwamm
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Kori S Zachrison
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
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30
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Piscitello GM, Fukushima CM, Saulitis AK, Tian KT, Hwang J, Gupta S, Sheldon M. Family Meetings in the Intensive Care Unit During the Coronavirus Disease 2019 Pandemic. Am J Hosp Palliat Care 2021; 38:305-312. [PMID: 33207937 PMCID: PMC7859662 DOI: 10.1177/1049909120973431] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Visitor restrictions during the COVID-19 pandemic limit in-person family meetings for hospitalized patients. We aimed to evaluate the quantity of family meetings by telephone, video and in-person during the COVID-19 pandemic by manual chart review. Secondary outcomes included rate of change in patient goals of care between video and in-person meetings, the timing of family meetings, and variability in meetings by race and ethnicity. METHODS A retrospective cohort study evaluated patients admitted to the intensive care unit at an urban academic hospital between March and June 2020. Patients lacking decision-making capacity and receiving a referral for a video meeting were included in this study. RESULTS Most patients meeting inclusion criteria (N = 61/481, 13%) had COVID-19 pneumonia (n = 57/61, 93%). A total of 650 documented family meetings occurred. Few occurred in-person (n = 70/650, 11%) or discussed goals of care (n = 233/650, 36%). For meetings discussing goals of care, changes in patient goals of care occurred more often for in-person meetings rather than by video (36% vs. 11%, p = 0.0006). The average time to the first goals of care family meeting was 11.4 days from admission. More documented telephone meetings per admission were observed for White (10.5, SD 9.5) and Black/African-American (7.1, SD 6.6) patients compared to Hispanic or Latino patients (4.9, SD 4.9) (p = 0.02). CONCLUSIONS During this period of strict visitor restrictions, few family meetings occurred in-person. Statistically significant fewer changes in patient goals of care occurred following video meetings compared to in-person meetings, providing support limiting in-person meetings may affect patient care.
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Affiliation(s)
| | | | | | | | | | | | - Mark Sheldon
- Department of Philosophy, Northwestern University, Evanston, IL, USA
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31
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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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32
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Duan X, Sun H, He Y, Yang J, Li X, Taparia K, Zheng B. Personal Protective Equipment in COVID-19: Impacts on Health Performance, Work-Related Injuries, and Measures for Prevention. J Occup Environ Med 2021; 63:221-225. [PMID: 33394877 PMCID: PMC7934332 DOI: 10.1097/jom.0000000000002123] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To assess impact of personal protective equipment (PPE) on healthcare providers (HCPs) in caring for COVID-19 patients. METHODS A cross-sectional survey was conducted over 50 hospitals in China. Descriptive analyses and Chi-square tests were performed on the collected data. RESULTS All 104 frontline HCPs report negative impacts of PPE on their clinical performance, 97% of them experienced discomfort and injuries caused by wearing PPE for long hours. Frontline HCPs provided suggestions to alleviate the negative impacts and to enhance communication between healthcare staff and patients. Two hundred eighty two non-frontline HCPs also revealed similar problems; however, we recorded a few discrepancies between answers given by frontline and non-frontline HCPs. CONCLUSIONS Wearing PPE for long hours degrades health performance. Measures were suggested to improve the design of PPE for protecting HCPs and enhancing their services to COVID patients.
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Affiliation(s)
- Xiaoqin Duan
- Department of Rehabilitation Medicine (Dr Duan); Department of Emergency and Critical Care Medicine (Dr Sun); Grade 2019 in Clinical Medicine, Jilin University (Mr He); Department of Respiratory and Critical Care Medicine (Dr Yang), Jilin University Second Hospital, Changchun, China; Department of Mechanical Engineering (Dr Li); Faculty of Science (Ms Taparia); Department of Surgery (Dr Duan, Dr Zheng), University of Alberta, Edmonton, Canada
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33
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Dhahri AA, De Thabrew AU, Ladva N, Pardoe H. The Benefits and Risks of the Provision of a Hospital-Wide High-Definition Video Conferencing Virtual Visiting Service for Patients and Their Relatives. Cureus 2021; 13:e13435. [PMID: 33633917 PMCID: PMC7899281 DOI: 10.7759/cureus.13435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Since the start of the coronavirus disease 2019 (COVID-19) pandemic, virtual visiting (VV) has become important because of visiting restrictions in hospitals. This project aimed to determine the impact of VV on staff and patients’ loved ones (visitors). Methodology VV is defined as high-resolution video communication between admitted COVID-19 patients and their loved ones in the presence of a staff member using a healthcare platform. VV was introduced in a 419-bedded hospital in the UK in April 2020. Qualitative data on the VV experience were collected from relatives and staff via an open feedback email address and reflective practice. Data were entered and analyzed in person by two independent assessors. Grounded theory methodology and thematic analysis were used to draw conclusions. Results Between April 16, 2020 and November 30, 2020, 1,009 visits were delivered. There were 138 feedback responses; 108 (78.3%) from relatives and 30 (21.7%) from staff. The amalgamation of data was resolved into five themes: appreciative factors (129, 93.5%), organizational skills (44, 31.9%), palliative care (38, 27.5%), staff communication (14, 10.1%), and VV process issues (11, 7.9%). A total of 131 (94.9%) responses had positive comments (111 from relatives, 20 from staff); negative comments were greater in the staff cohort (23%) than the relative group (4%). Trends included sub-themes in overwhelming emotions, emotional strain for staff members, and difficult situations. Conclusions VV in hospitals is a new and valuable way to connect patients with loved ones with mostly positive consequences. VV also has risks to mental health and well-being, particularly for healthcare workers facilitating the call.
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Affiliation(s)
| | | | - Nirali Ladva
- Physician Associate, Princess Alexandra Hospital NHS Trust, Harlow, GBR
| | - Helen Pardoe
- General Surgery, Princess Alexandra Hospital NHS Trust, Harlow, GBR
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Woong NL, Ekstrom VSM, Xin X, Lim C, Boon ESK, Teo SWJ, Ng PCS, Ang TPS, Lim SH, Lam AYR, Fan EMP, Ang SY, Chow WC. Empower to connect and connect to empower: experience in using a humanistic approach to improve patients' access to, and experience of, care in isolation wards during the COVID-19 outbreak in Singapore. BMJ Open Qual 2021; 10:bmjoq-2020-000996. [PMID: 33408099 PMCID: PMC7789203 DOI: 10.1136/bmjoq-2020-000996] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 12/01/2020] [Accepted: 12/10/2020] [Indexed: 12/25/2022] Open
Abstract
Patients admitted to the isolation ward during the COVID-19 outbreak face multiple psychosocial stressors including the disruptive experience of being in quarantine, anxiety over contracting a newly emerging infectious disease and limited access to their healthcare team. This quality improvement project aims to leverage on technology to improve patients’ access to, and experience of, care while in isolation. Patients admitted to two isolation wards in Singapore General Hospital (SGH) between 28 February and 19 March 2020 were each provided an iPad loaded with the MyCare application (app), curated materials and mobile games. During this period, 83 of them accessed the device and the app. MyCare app is an app developed by the nursing team in SGH as part of an existing interprofessional collaboration to help patients navigate their care during their inpatient stay. In response to COVID-19, MyCare app was supplemented with materials to address affected patients’ informational and psychosocial needs. These materials included an information sheet on COVID-19, interviews with previous severe acute respiratory syndrome survivors, psychosocial support materials, and uplifting literature, illustrated storybooks and artwork. This paper describes the process of planning for, and executing, the intervention and reports the initial results of its effect. Initial feedback indicated a positive response to the intervention. 9 out of 10 respondents (90%) rated their hospital experience with a maximum of five stars and all 10 respondents (100%) rated the psychosocial support materials with five stars. Doctors managing the patients also observed a reduction in the number of commonly asked questions following the deployment of the iPad. This quality improvement project is ongoing with plans for further research to determine how to better support the psychosocial needs of patients in isolation during a novel disease outbreak. This report is written based on the Standards for Quality Improvement Reporting Excellence guidelines.
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Affiliation(s)
- Natalie Liling Woong
- Internal Medicine, Singapore General Hospital, Singapore .,Medicine Academic Clinical Programme, Duke-NUS Medical School, Singapore
| | - Victoria Sze Min Ekstrom
- Medicine Academic Clinical Programme, Duke-NUS Medical School, Singapore.,Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
| | - Xiaohui Xin
- Health Services Research Unit, Singapore General Hospital, Singapore
| | - Crystal Lim
- Medicine Academic Clinical Programme, Duke-NUS Medical School, Singapore.,Medical Social Services, Singapore General Hospital, Singapore
| | | | - Shaun Wei Jie Teo
- Integrated Health Information Systems, SingHealth Chief Informatics Officer Office, SingHealth, Singapore
| | - Patrick Chee Sang Ng
- Integrated Health Information Systems, SingHealth Chief Informatics Officer Office, SingHealth, Singapore
| | | | - Shu Hui Lim
- Nursing, Singapore General Hospital, Singapore
| | - Amanda Yun Rui Lam
- Medicine Academic Clinical Programme, Duke-NUS Medical School, Singapore.,Endocrinology, Singapore General Hospital, Singapore
| | | | | | - Wan Cheng Chow
- Medicine Academic Clinical Programme, Duke-NUS Medical School, Singapore.,Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
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35
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Rapid Telehealth Implementation during the COVID-19 Global Pandemic: A Rapid Review. Healthcare (Basel) 2020; 8:healthcare8040517. [PMID: 33260457 PMCID: PMC7712147 DOI: 10.3390/healthcare8040517] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/24/2020] [Accepted: 11/26/2020] [Indexed: 12/13/2022] Open
Abstract
The implementation and continued expansion of telehealth services assists a variety of health care organizations in the delivery of care during the current COVID-19 global pandemic. However, limited research has been conducted on recent, rapid telehealth implementation and expansion initiatives regarding facilitators and barriers surrounding the provision of quality patient care. Our rapid review evaluated the literature specific to rapid telehealth implementation during the current COVID-19 pandemic from three research databases between January 2020 and May 2020 and reported using preferred reporting items for systematic reviews and meta-analyses (PRISMA). The results indicate the rapid implementation and enhanced use of telehealth during the COVID-19 pandemic in the United States surrounding the facilitators and barriers to the provision of patient care, which are categorized into three identified themes: (1) descriptive process-oriented implementations, (2) the interpretation and infusion of the CARES Act of 2020 telehealth exemptions related to the relaxation of patient privacy and security (HIPAA) protocols, and (3) the standard of care protocols and experiences addressing organizational liability and the standard of care. While the study limitation of sample size exists (n = 21), an identification of rapid telehealth implementation advancements and challenges during the current pandemic may assist health care organizations in the delivery of ongoing quality care during the COVID-19 pandemic.
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