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3.
J Contin Educ Nurs ; 51(8): 349-351, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32722810

RESUMO

From staffing and supply shortages to furloughs and layoffs, few expected-let alone had a plan for managing-the COVID-19 pandemic. The crisis allowed nursing professional development to demonstrate its value like never before. This article explores the impact of the pandemic on nursing professional development practice at the micro (unit), meso (organization), and macro (national) levels of our specialty. [J Contin Educ Nurs. 2020;51(8):349-351.].


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/enfermagem , Educação Continuada em Enfermagem/organização & administração , Pneumonia Viral/epidemiologia , Pneumonia Viral/enfermagem , Prática Profissional , Desenvolvimento de Pessoal/organização & administração , Betacoronavirus , Competência Clínica , Avaliação Educacional , Humanos , Determinação de Necessidades de Cuidados de Saúde , Inovação Organizacional , Pandemias
4.
Ann Biol Clin (Paris) ; 78(3): 269-277, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32540814

RESUMO

The SARS-CoV-2 virus is responsible for an epidemic disease called COVID-19, which was initially evidenced in Wuhan, China, and spread very rapidly in China and around the world. In France, the first isolated case seems now to be reported in December 2019, stage 3 of the COVID-19 epidemic was triggered on March 14th, the start of the planned containment exit from May 11th. Healthcare services have faced a large influx of patients who may be beyond their capacity to receive and care, particularly in the Large-East and Ile-de-France regions. Some patients show an evolution of the disease never observed before with other coronaviruses and develop in a few days a very important inflammatory reaction, which can lead to death of patients. A working group of the French Society of Clinical Biology (SFBC) was set up with the objective of providing updated information on the current status of the biological prescriptions (focusing on biochemistry ones) and their evolution during the epidemic, and of analyzing the biological parameters associated with comorbidities and patient evolution in order to link biological results with medical events. The expanded working group covers all sectors of medical biology in France and extends to the French-speaking world: hospital sectors (CHU and CH, Army Training Hospitals) and the private sector opening a field of view on the biological situation in establishments for dependent elderly, social establishments and clinical medical institutions. The purpose of this article is the presentation of this working group and its immediate and future actions.


Assuntos
Betacoronavirus , Bioquímica/organização & administração , Biomarcadores/análise , Serviços de Laboratório Clínico/organização & administração , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , Sociedades Científicas/organização & administração , Betacoronavirus/isolamento & purificação , Betacoronavirus/patogenicidade , Bioquímica/normas , Biomarcadores/sangue , Serviços de Laboratório Clínico/normas , Redes Comunitárias/organização & administração , Redes Comunitárias/normas , Redes Comunitárias/tendências , Infecções por Coronavirus/sangue , Infecções por Coronavirus/epidemiologia , Surtos de Doenças , França/epidemiologia , História do Século XXI , Humanos , Colaboração Intersetorial , Pandemias , Pneumonia Viral/sangue , Pneumonia Viral/epidemiologia , Prática Profissional/organização & administração , Prática Profissional/normas , Prática Profissional/tendências , Sociedades Científicas/normas , Comunicação por Videoconferência/organização & administração , Comunicação por Videoconferência/normas
8.
Zhonghua Wei Chang Wai Ke Za Zhi ; 23(6): 578-583, 2020 Jun 25.
Artigo em Chinês | MEDLINE | ID: mdl-32521978

RESUMO

Objective: To understand the current practice of preoperative bowel preparation in elective colorectal surgery in China. Methods: A cross-sectional questionnaire survey was conducted through wechat. The content of the questionnaire survey included professional title of the participants, the hospital class, dietary preparation and protocol, oral laxatives and specific types, oral antibiotics, gastric intubation, and mechanical enema before elective colorectal surgery. A stratified analysis based on hospital class was conducted to understand their current practice of preoperative bowel preparation in elective colorectal surgery. Result: A total of 600 questionnaires were issued, and 516 (86.00%) questionnaires of participants from different hospitals, engaged in colorectal surgery or general surgeons were recovered, of which 366 were from tertiary hospitals (70.93%) and 150 from secondary hospitals (29.07%). For diet preparation, the proportions of right hemicolic, left hemicolic and rectal surgery were 81.59% (421/516), 84.88% (438/516) and 84.88% (438/516) respectively. The average time of preoperative dietary preparation was 2.03 days. The study showed that 85.85% (443/516) of surgeons chose oral laxatives for bowel preparation in all colorectal surgery, while only 4.26% (22/516) of surgeons did not choose oral laxatives. For mechanical enema, the proportions of right hemicolic, left hemicolic and rectal surgery were 19.19% (99/516), 30.04% (155/516) and 32.75% (169/516) respectively. Preoperative oral antibiotics was used by 34.69% (179/516) of the respondents. 94.38% (487/516) of participants were satisfied with bowel preparation, and 55.43% (286/516) of participants believed that preoperative bowel preparation was well tolerated. In terms of preoperative oral laxatives, there was no statistically significant difference between different levels of hospitals [secondary hospitals vs. tertiary hospitals: 90.00% (135/150) vs. 84.15% (308/366), χ(2)=2.995, P=0.084]. Compared with the tertiary hospitals, the surgeons in the secondary hospitals accounted for higher proportions in diet preparation [87.33% (131/150) vs. 76.78% (281/366), χ(2)=7.369, P=0.007], gastric intubation [54.00% (81/150) vs. 36.33% (133/366), χ(2)=13.672, P<0.001], preoperative oral antibiotics [58.67% (88/150) vs. 24.86% (91/366), χ(2)=12.259, P<0.001] and enema [28.67% (43/150) vs. 15.30% (56/366), χ(2)=53.661, P<0.001]. Conclusion: Although the preoperative bowel preparation practice in elective colorectal surgery for most of surgeons in China is basically the same as the current international protocol, the proportions of mechanical enema and gastric intubation before surgery are still relatively high.


Assuntos
Colectomia/métodos , Enema/métodos , Protectomia/métodos , Prática Profissional/normas , Infecção da Ferida Cirúrgica/prevenção & controle , Antibacterianos/uso terapêutico , Catárticos/administração & dosagem , China , Colectomia/efeitos adversos , Estudos Transversais , Procedimentos Cirúrgicos Eletivos/efeitos adversos , Procedimentos Cirúrgicos Eletivos/métodos , Pesquisas sobre Serviços de Saúde , Humanos , Intubação Gastrointestinal , Cuidados Pré-Operatórios/métodos , Protectomia/efeitos adversos , Infecção da Ferida Cirúrgica/etiologia
9.
Rev Assoc Med Bras (1992) ; 66(4): 491-497, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32578784

RESUMO

BACKGROUND: Physiotherapy services are necessary for hospitalized patients of COVID-19 as well as chronic patients. Thus, physiotherapists present an increased risk of exposure to coronavirus. This study aimed to determine the number of physiotherapists who interrupted their services because of the COVID-19 pandemic and to verify the procedures adopted by the ones who are still working. METHODS: The sample comprised 619 physiotherapists who worked in Portugal, 154 (24.9%) male and 465 (75.1%) female, aged between 22 and 67 years (34.47±8.70). The measurement instrument was an on-line questionnaire applied in late March 2020 through contacts and social networks. RESULTS: 453 (73.2%) physiotherapists interrupted their work activities in person because of the pandemic and 166 (26.8%) continue to work in person. The main measures adopted by physical therapists who continue to work in person included: hand washing (21.5%), mask use (20.3%), material disinfection (19.3%) and, glove use (19.3%). Of the physiotherapists who are not working in person (n = 453), 267 (58.9%) continue to monitor their patients at a distance, and 186 (41.1%) are not monitoring the patients. The main measures used by physiotherapists to monitor their patients at a distance included: written treatment prescription (38%), making explanatory videos (26.7%), and synchronous video conference treatment (23.5%). CONCLUSIONS: Our data revealed that most of the physiotherapists interrupted their face-to-face practices because of the COVID-19 pandemic, however, once they do not follow up their patients' treatment in person, most of them adapted to monitor their patients from a distance.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Fisioterapeutas/provisão & distribução , Modalidades de Fisioterapia/organização & administração , Pneumonia Viral/prevenção & controle , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fisioterapeutas/tendências , Modalidades de Fisioterapia/tendências , Portugal , Prática Profissional/organização & administração , Prática Profissional/tendências , Inquéritos e Questionários , Telerreabilitação/organização & administração , Adulto Jovem
10.
Ann R Coll Surg Engl ; 102(5): 323-332, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32352836

RESUMO

INTRODUCTION: Several articles have been published about the reorganisation of surgical activity during the COVID-19 pandemic but few, if any, have focused on the impact that this has had on emergency and trauma surgery. Our aim was to review the most current data on COVID-19 to provide essential suggestions on how to manage the acute abdomen during the pandemic. METHODS: A systematic review was conducted of the most relevant English language articles on COVID-19 and surgery published between 15 December 2019 and 30 March 2020. FINDINGS: Access to the operating theatre is almost exclusively restricted to emergencies and oncological procedures. The use of laparoscopy in COVID-19 positive patients should be cautiously considered. The main risk lies in the presence of the virus in the pneumoperitoneum: the aerosol released in the operating theatre could contaminate both staff and the environment. CONCLUSIONS: During the COVID-19 pandemic, all efforts should be deployed in order to evaluate the feasibility of postponing surgery until the patient is no longer considered potentially infectious or at risk of perioperative complications. If surgery is deemed necessary, the emergency surgeon must minimise the risk of exposure to the virus by involving a minimal number of healthcare staff and shortening the occupation of the operating theatre. In case of a lack of security measures to enable safe laparoscopy, open surgery should be considered.


Assuntos
Abdome Agudo/cirurgia , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/complicações , Salas Cirúrgicas/organização & administração , Pandemias , Pneumonia Viral/complicações , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Abdome Agudo/complicações , Aerossóis/efeitos adversos , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Humanos , Controle de Infecções/métodos , Laparoscopia/efeitos adversos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Pneumoperitônio Artificial/efeitos adversos , Prática Profissional/organização & administração , Procedimentos Cirúrgicos Operatórios/métodos
11.
Cont Lens Anterior Eye ; 43(3): 208-210, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32354653

RESUMO

PURPOSE: The aim of this project was to evaluate which personal protective equipment (PPE) eye care practitioners (ECP) will use during the next months and also what they will ask the patient to use in clinical practice. METHODS: A social-media survey was carried out, asking 257 optometrists and opticians in Germany, Austria and Switzerland (i) which PPE they intended to use in the future (after lockdown and before herd immunity and / or vaccine availability) and (ii) what they would ask the patient to do in terms of this. RESULTS: 75 % of the ECPs planned on wearing masks during refractions and 69 % when fitting contact lens. 62 % of the ECPs also expected their patients to wear masks in these tasks. This number is higher than for distance tasks such as fitting frames. Around 90 % of the ECPs would, in addition to hand washing, disinfect their hands and around 80 % expected their patients to do so too. Less than one third of ECPs favoured wearing safety spectacles, gloves and / or protective facial shields. 73 % planed on disinfecting frames after they would have been tried on by customers. CONCLUSIONS: In summary, most ECPs planed on continuing to use higher standards of PPE. Those, who intended to wear masks themselves, would ask their patients to also do so, combined with hand disinfection.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Controle de Infecções/métodos , Optometristas/tendências , Pandemias/prevenção & controle , Equipamento de Proteção Individual/tendências , Pneumonia Viral/prevenção & controle , Prática Profissional/tendências , Infecções por Coronavirus/epidemiologia , Infecção Hospitalar/prevenção & controle , Transmissão de Doença Infecciosa/prevenção & controle , Dispositivos de Proteção dos Olhos/estatística & dados numéricos , Desinfecção das Mãos/tendências , Inquéritos Epidemiológicos , Humanos , Máscaras/estatística & dados numéricos , Optometristas/estatística & dados numéricos , Equipamento de Proteção Individual/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Prática Profissional/estatística & dados numéricos
12.
World J Emerg Surg ; 15(1): 36, 2020 05 24.
Artigo em Inglês | MEDLINE | ID: mdl-32448333

RESUMO

BACKGROUND: COVID-19 pandemic has rapidly spread in Italy in late February 2020. Almost all surgical services have been reorganized, with the aim of maintaining an adequate therapeutic path, especially for surgical emergencies. The knowledge of how surgeons dealing with emergency surgery have reacted to the epidemic in the real life can be useful while drafting clinical recommendations. METHODS: Surgeons from multiple Italian regions were invited answering to an online survey in order to make a snapshot of their current behaviors towards COVID-19-positive patients bearing urgent surgical diseases. Questions about institutional rules and personal approach for patient treatment and to limit epidemic spread were included in a 37-item questionnaire. RESULTS: Seventy-one questionnaires from institutions dealing with emergency surgery were accepted. Participating surgeons were equally subdivided from a geographical point of view, with a large proportion of public (97.2%) and non-academical (91.5%) centers. In 80.3% of cases, the hospitals treated COVID-19 patients; in 69.1% of centers, a change in work plan was necessary, and 33.8% of teams had almost a surgeon infected or in preventive quarantine. The vast majority of surgeons operated only on urgent cases (73.9%), but the number of interventions significantly dropped. Up to 40% of non-traumatic abdominal emergency cases had an unusual delayed treatment. The laparoscopic approach was used in 69.6% of interventions on COVID-19 patients. Strategies to protect health care workers against COVID-19 infection and to identify asymptomatic infected surgeons were suboptimal with respect to the WHO recommendations in 70.4% and 90.2% of centers, respectively. Advanced personal protective equipment for operating room workers was adopted for all surgeries in only 12.7% of centers. DISCUSSION: This survey confirms that the COVID-19 outbreak is dramatically changing the practice of emergency surgery centers in Italy. Despite the reduction in number, urgent cases were on average more challenging owing to diagnostic delay. Recommendations from the International Scientific Societies are frequently not complied concerning the use of laparoscopic approach, the availability of personal protective equipment in the operating rooms, and the testing of both asymptomatic physicians and patients scheduled for surgery. A further evaluation of the short-term results of these attitudes is warranted to modulate international recommendations.


Assuntos
Infecções por Coronavirus/prevenção & controle , Transmissão de Doença Infecciosa/prevenção & controle , Cirurgia Geral/organização & administração , Controle de Infecções/normas , Unidades de Terapia Intensiva/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Prática Profissional/normas , Betacoronavirus , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Emergências , Hospitais/estatística & dados numéricos , Humanos , Itália/epidemiologia , Laparoscopia/métodos , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Inquéritos e Questionários
13.
Encephale ; 46(3S): S99-S106, 2020 Jun.
Artigo em Francês | MEDLINE | ID: mdl-32405083

RESUMO

COVID-19 is a multi-organ disease due to an infection with the SARS-CoV2 virus. It has become a pandemic in early 2020. The disease appears less devastating in children and adolescents. However, stress, quarantine and eventually mourning have major impacts on development. It is difficult to describe what this pandemic implies for a child psychiatrist, other than by giving a first-hand account. I propose to go through the main ethical questions that have arisen; to describe how my hospital team has reorganized itself to meet the new demands and questions, in particular by opening a unit dedicated to people with autism and challenging behaviors affected by COVID-19; and to address, in a context of national discussion, how the discipline has sought to understand the conditions of a certain well-being during quarantine. Finally, I will try to conclude with more speculative reflections on re-opening.


Assuntos
Psiquiatria do Adolescente , Atitude do Pessoal de Saúde , Transtorno Autístico/terapia , Betacoronavirus , Psiquiatria Infantil , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Psiquiatria , Adolescente , Comportamento do Adolescente , Psiquiatria do Adolescente/ética , Transtorno Autístico/complicações , Transtorno Autístico/psicologia , Criança , Comportamento Infantil , Psiquiatria Infantil/ética , Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/transmissão , Infecção Hospitalar/complicações , Infecção Hospitalar/psicologia , Infecção Hospitalar/terapia , Exposição Ambiental , França , Acesso aos Serviços de Saúde , Reestruturação Hospitalar , Unidades Hospitalares/organização & administração , Humanos , Controle de Infecções/métodos , Serviços de Saúde Mental/ética , Serviços de Saúde Mental/organização & administração , Transtornos do Olfato/etiologia , Transtornos do Olfato/psicologia , Pandemias/prevenção & controle , Aceitação pelo Paciente de Cuidados de Saúde , Equipe de Assistência ao Paciente , Isolamento de Pacientes/psicologia , Ludoterapia , Pneumonia Viral/complicações , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Pneumonia Viral/transmissão , Prática Profissional/ética , Equipamentos de Proteção , Fatores de Risco , Estresse Psicológico/etiologia
15.
J Dent Hyg ; 94(2): 54-65, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32354852

RESUMO

Purpose: The purpose of this study was to identify current requirements for initial licensure and entry into the dental hygiene profession across state dental and dental hygiene licensing boards in the United States.Methods: A non-experimental study design was used to study dental and dental hygiene board licensing requirements in the United States, Puerto Rico and the Virgin Islands. Each regulatory board website was searched for requirements for entry-level dental hygiene licensure. Requirements were recorded on an Excel spreadsheet. State dental practice acts were reviewed to gather further information and 20 regulatory bodies were contacted to verify accuracy. Descriptive statistics were used to analyze data.Results: Information from a total of 52 dental boards (n=52) was examined for this study. Nearly all boards (n=51, 98.1%), with the exception of Alabama, required completion of entry-level education from a CODA accredited dental hygiene program and successful completion of the National Board Dental Hygiene Examination. Most states (n=51, 98.1%), except Delaware, also required a live-patient, a clinical board examination. Application fees ranged from $47.70 to $600. States varied considerably in terms of requirements for background checks, age, military status, and infection control training.Conclusion: Although the majority of regulatory bodies require completion of entry-level dental hygiene education from a CODA accredited program and successful completion of national board and a live-patient, clinical examination, there is considerable variation in other additional requirements for initial dental hygiene licensure.


Assuntos
Licenciamento , Higiene Bucal , Higienistas Dentários , Humanos , Licenciamento em Odontologia , Prática Profissional , Estados Unidos
16.
Hand Surg Rehabil ; 39(3): 159-166, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32278932

RESUMO

The emergence of the COVID-19 pandemic has severely affected medical treatment protocols throughout the world. While the pandemic does not affect hand surgeons at first glance, they have a role to play. The purpose of this study was to describe the different measures that have been put in place in response to the COVID-19 pandemic by hand surgeons throughout the world. The survey comprised 47 surgeons working in 34 countries who responded to an online questionnaire. We found that the protocols varied in terms of visitors, health professionals in the operating room, patient waiting areas, wards and emergency rooms. Based on these preliminary findings, an international consensus on hand surgery practices for the current viral pandemic, and future ones, needs to be built rapidly.


Assuntos
Infecções por Coronavirus/prevenção & controle , Mãos/cirurgia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Padrões de Prática Médica/organização & administração , Prática Profissional/organização & administração , Infecções por Coronavirus/transmissão , Pesquisas sobre Serviços de Saúde , Humanos , Internacionalidade , Internet , Pneumonia Viral/transmissão , Padrões de Prática Médica/normas , Prática Profissional/normas
17.
Zhonghua Wai Ke Za Zhi ; 58(6): 404-407, 2020 Jun 01.
Artigo em Chinês | MEDLINE | ID: mdl-32253891

RESUMO

As a newly epidemic, 2019 coronavirus disease (COVID-19) with a concentrated outbreak poses a great challenge to medical treatment. The severe and critical patients are complex complicatied with the psychological problems, and the medical staff are overworked and under tremendous psychological pressure. The surgeon participated in emergency medical rescue could provide professional treatment for the patients combined with surgical diseases, as well as specialized training for the non-surgeon crew, to reduce surgical-related mortality. With the advantages of good team consciousness, strong aseptic concept and good psychological quality, the surgeons can quickly adapt to and carry out rescue work under the premise of good self-protection. Surgeons need to develop critical care management concepts and focus on the critical care support equipment. Some suggestions are put forward for the standardized training of resident surgeons to cultivate compound talents. It is hoped that this article can lead to the thinking of how to participate in the emergency medical rescue of infectious diseases among surgeons and provide some enlightenment for future surgical education.


Assuntos
Infecções por Coronavirus/terapia , Cuidados Críticos/normas , Assistência à Saúde/normas , Administração dos Cuidados ao Paciente/normas , Pneumonia Viral/terapia , Prática Profissional/normas , Cirurgiões/normas , Betacoronavirus , Competência Clínica , Cuidados Críticos/psicologia , Emergências , Humanos , Internato e Residência/normas , Estresse Ocupacional/prevenção & controle , Pandemias , Cirurgiões/educação , Cirurgiões/psicologia
18.
Cont Lens Anterior Eye ; 43(3): 196-203, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32273245

RESUMO

A novel coronavirus (CoV), the Severe Acute Respiratory Syndrome Coronavirus - 2 (SARS-CoV-2), results in the coronavirus disease 2019 (COVID-19). As information concerning the COVID-19 disease continues to evolve, patients look to their eye care practitioners for accurate eye health guidance. There is currently no evidence to suggest an increased risk of contracting COVID-19 through contact lens (CL) wear compared to spectacle lens wear and no scientific evidence that wearing standard prescription spectacles provides protection against COVID-19 or other viral transmissions. During the pandemic there will potentially be significant changes in access to local eyecare. Thus, it is imperative CL wearers are reminded of the steps they should follow to minimise their risk of complications, to reduce their need to leave isolation and seek care. Management of adverse events should be retained within optometric systems if possible, to minimise the impact on the wider healthcare service, which will be stretched. Optimal CL care behaviours should be the same as those under normal circumstances, which include appropriate hand washing (thoroughly with soap and water) and drying (with paper towels) before both CL application and removal. Daily CL cleaning and correct case care for reusable CL should be followed according to appropriate guidelines, and CL exposure to water must be avoided. Where the availability of local clinical care is restricted, practitioners could consider advising patients to reduce or eliminate sleeping in their CL (where patients have the appropriate knowledge about correct daily care and access to suitable lens-care products) or consider the option of moving patients to daily disposable lenses (where patients have appropriate lens supplies available). Patients should also avoid touching their face, including their eyes, nose and mouth, with unwashed hands and avoid CL wear altogether if unwell (particularly with any cold or flu-like symptoms).


Assuntos
Betacoronavirus , Lentes de Contato/tendências , Infecções por Coronavirus/epidemiologia , Infecção Hospitalar/prevenção & controle , Transmissão de Doença Infecciosa/prevenção & controle , Controle de Infecções/métodos , Pandemias , Pneumonia Viral/epidemiologia , Prática Profissional/tendências , Soluções para Lentes de Contato , Lentes de Contato/normas , Higiene das Mãos , Humanos , Prática Profissional/normas
19.
Cont Lens Anterior Eye ; 43(3): 204-207, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32336578

RESUMO

The COVID-19 pandemic has necessitated government-imposed restrictions on social interactions and travel. For many, the guidance has led to new ways of working, most notably a shift towards working remotely. While eye care practitioners (ECPs) may continue to provide urgent or emergency eye care, in many cases the travel restrictions present a unique challenge by preventing conventional face-to-face examination. Telephone triage provides a useful starting point for establishing at-risk and emergency patients; but patient examination is central to contact lens patient care. The indeterminate period over which conventional practice will be suspended, and the risk that resumption of 'normal' practice could be impeded by a potential secondary peak in COVID-19 cases, hastens the need for practitioners to adapt their delivery of eyecare. Specifically, it is prudent to reflect upon supportive evidence for more comprehensive approaches to teleoptometry in contact lens practice. Smartphone based ocular imaging is an area which has seen considerable growth, particularly for imaging the posterior eye. Smartphone imaging of the anterior eye requires additional specialised instrumentation unlikely to be available to patients at home. Further, there is only limited evidence for self-administered image capture. In general, digital photographs, are useful for detection of gross anterior eye changes, but subtle changes are less discernible. For the assessment of visual acuity, many electronic test charts have been validated for use by practitioners. Research into self-administered visual acuity measures remains limited. The absence of a comprehensive evidence base for teleoptometry limits ECPs, particularly during this pandemic. Knowledge gaps ought to be addressed to facilitate development of optometry specific evidence-based guidance for telecare. In particular, advances in ocular self-imaging could help move this field forwards.


Assuntos
Betacoronavirus , Lentes de Contato/tendências , Infecções por Coronavirus/epidemiologia , Optometria/tendências , Pandemias , Pneumonia Viral/epidemiologia , Prática Profissional/tendências , Telemedicina/métodos , Infecção Hospitalar/prevenção & controle , Transmissão de Doença Infecciosa/prevenção & controle , Pesquisa sobre Serviços de Saúde , Humanos , Controle de Infecções/métodos , Monitorização Ambulatorial/métodos , Optometria/organização & administração , Assistência ao Paciente , Avaliação da Tecnologia Biomédica , Telemedicina/organização & administração , Acuidade Visual
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