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1.
BMJ Open ; 10(8): e039897, 2020 08 11.
Artigo em Inglês | MEDLINE | ID: mdl-32788192

RESUMO

OBJECTIVES: Relevant guidelines and consensuses for COVID-19 contain recommendations aimed at optimising the management in paediatric wards. The goal of this study was to determine the quality of those recommendations and provide suggestions to hospital managers for the adjustment of existing hospital prevention and control strategies, and also to offer recommendations for further research. DESIGN: A rapid review of the guidelines and consensuses for the management in paediatric wards facing COVID-19. METHODS: PubMed, EMBASE, the Cochrane Library, UpToDate, China National Knowledge Infrastructure, the Wanfang database and relevant websites such as medlive.cn, dxy.cn, the National Health and Health Commission and the China Center for Disease Control and Prevention were systematically searched through late May 2020. The Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool was then used to assess the quality of the selected articles and summarise the relevant evidence concerning management in paediatric wards. RESULTS: A total of 35 articles were included, composed of 3 consensus guidelines, 25 expert consensuses and 7 expert opinions. Of the 35 papers, 24 were from China, 2 from the USA, 1 from Spain, 1 from Brazil, 1 from Saudi Arabia and 6 from multinational cooperative studies. Scores for the six domains of the AGREE II tool (scope and purpose, stakeholder involvement, rigour of development, clarity of presentation, applicability and editorial independence) were 98.57%, 53.57%, 17.92%, 69.62%, 26.96% and 50.35%, respectively. Recommendations for nosocomial infection and control, human resource management as well as management of paediatric patients and their families were summarised. CONCLUSIONS: Due to the outbreak of COVID-19, the quality of rapid guidelines and consensuses for the management in paediatric wards affected by COVID-19 is unsatisfactory. In the future, it will be necessary to develop more high-quality guidelines or consensuses for the management in paediatric wards to deal with nosocomial outbreaks in order to fully prepare for emergency medical and health problems.


Assuntos
Infecções por Coronavirus/transmissão , Infecção Hospitalar/prevenção & controle , Departamentos Hospitalares/organização & administração , Medicina de Emergência Pediátrica/organização & administração , Pneumonia Viral/transmissão , Betacoronavirus , Aconselhamento , Família , Humanos , Pandemias , Isolamento de Pacientes , Guias de Prática Clínica como Assunto , Visitas a Pacientes
2.
J Nucl Med Technol ; 48(3): 218-226, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32709666

RESUMO

Traditionally, practice in nuclear medicine has involved strong emphasis on radiation safety principles. Nuclear medicine technologists (NMTs) focus on practices that keep patients, the public, and the technologist safe from potentially harmful effects of unnecessary radiation exposure using concepts of time, distance, and shielding as well as ALARA (As low as reasonably achievable) principles. The current COVID-19 pandemic has brought to light the need to apply focus on infection prevention in practice and update knowledge and procedures on such measures. In this article, the authors outline the need for NMTs to develop practices and values focused on infection prevention measures.


Assuntos
Infecções por Coronavirus/epidemiologia , Medicina Nuclear/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Higiene das Mãos , Serviços de Saúde/provisão & distribução , Departamentos Hospitalares/organização & administração , Departamentos Hospitalares/estatística & dados numéricos , Humanos , Imagem Molecular , Medicina Nuclear/organização & administração , Pandemias , Alta do Paciente , Alocação de Recursos , Estados Unidos/epidemiologia
3.
J Nucl Med Technol ; 48(3): 227-233, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32709668

RESUMO

Coronavirus disease 2019 has changed the way the world is navigated and has had a massive impact on health care. Depending on where you are in the world, the guidance on dealing with potential infected patients is varied. With the high risk of a second wave, it is important to learn from initial responses to plan for the future. With proper preparation, it is possible to minimize exposure and risk of contamination to individuals visiting molecular imaging departments. Such precautions will help departments operate at full capacity. From the widespread nature of this pandemic, a global perspective can be useful; what follows is the United Kingdom's perspective.


Assuntos
Infecções por Coronavirus/epidemiologia , Departamentos Hospitalares/normas , Imagem Molecular/normas , Pneumonia Viral/epidemiologia , Humanos , Pandemias , Padrões de Referência , Reino Unido , Recursos Humanos/estatística & dados numéricos
4.
J Nucl Med ; 61(9): 1278-1283, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32709733

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic has placed significant challenges on health-care systems worldwide, whether in the preparation, response, or recovery phase of the pandemic. This has been primarily managed by dramatically reducing in- and outpatient services for other diseases and implementing infection prevention and control measures. The impact of the pandemic on nuclear medicine departments and their services has not yet been established. The aim of this online survey was to evaluate the impact of COVID-19 on nuclear medicine departments. Methods: A web-based questionnaire, made available from April 16 to May 3, 2020, was designed to determine the impact of the pandemic on in- and outpatient nuclear medicine departments, including the number of procedures, employee health, availability of radiotracers and other essential supplies, and availability of personal protective equipment. The survey also inquired about operational aspects and types of facilities as well as other challenges. Results: A total of 434 responses from 72 countries were registered and analyzed. Respondents reported an average decline of 54% in diagnostic procedures. PET/CT scans decreased by an average of 36%, whereas sentinel lymph-node procedures decreased by 45%, lung scans by 56%, bone scans by 60%, myocardial studies by 66%, and thyroid studies by 67%. Of all participating centers, 81% performed radionuclide therapies, and they reported a reduction of 45% on average in the last 4 wk, ranging from over 76% in Latin America and South East Asia to 16% in South Korea and Singapore. Survey results showed that 52% of participating sites limited their 99mTc/99Mo generator purchases, and 12% of them temporarily cancelled orders. Insufficient supplies of essential materials (radioisotopes, generators, and kits) were reported, especially for 99mTc/99Mo generators and 131I, particularly in Africa, Asia, and Latin America. Conclusion: Both diagnostic and therapeutic nuclear medicine procedures declined precipitously, with countries worldwide being affected by the pandemic to a similar degree. Countries that were in the postpeak phase of the pandemic when they responded to the survey, such as South Korea and Singapore, reported a less pronounced impact on nuclear medicine services; however, the overall results of the survey showed that nuclear medicine services worldwide had been significantly impacted. In relation to staff health, 15% of respondents experienced COVID-19 infections within their own departments.


Assuntos
Infecções por Coronavirus/epidemiologia , Departamentos Hospitalares/estatística & dados numéricos , Internacionalidade , Pneumonia Viral/epidemiologia , Inquéritos e Questionários , Humanos , Pandemias
6.
Stroke ; 51(8): 2587-2592, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32716826

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic has in some regions overwhelmed the capacity and staffing needs of healthcare systems, necessitating the provision of resources and staff from different disciplines to aid COVID treatment teams. Stroke centers have multidisciplinary clinical and procedural expertise to support COVID treatment teams. Staff safety and patient safety are essential, as are open lines of communication between stroke center leaders and hospital leadership in a pandemic where policies and procedures can change or evolve rapidly. Support needs to be allocated in a way that allows for the continued operation of a fully capable stroke center, with the ability to adjust if stroke center volume or staff attrition requires.


Assuntos
Infecções por Coronavirus/terapia , Departamentos Hospitalares/organização & administração , Pandemias , Equipe de Assistência ao Paciente/organização & administração , Pneumonia Viral/terapia , Comunicação , Assistência à Saúde , Humanos , Liderança , Saúde do Trabalhador , Política Organizacional , Admissão e Escalonamento de Pessoal
7.
Arch Ital Urol Androl ; 92(2)2020 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-32597101

RESUMO

The COVID-19 pandemic influenced the normal course of clinical practice leading to significant delays in the delivery of healthcare services for patients non affected by COVID-19. In the near future, it will be crucial to identify facilities capable of providing health care in compliance with the safety of healthcare professionals, administrative staff and patients. All the staff involved in the project of a Covid-free hospital should be subjected to a diagnostic swab for COVID-19 before the beginning of healthcare activity and then periodically in order to avoid the risk of contamination of patients during the process of care. The modifications of various activities involved in the process of care are described: outpatient care, reception of inpatients, inpatient ward and operating room. For outpatient care, modality of appointment procedure, characteristics of waiting room and personal protective equipment (PPE) for healthcare professionals and administrative staff are presented. Reception of inpatients shall be conditional on a negative swab for COVID-19 obtained with a drive-in procedure. The management of the operating room represents the most crucial step of the patient's care process. The surgical team should be restricted and monitored with periodic swabs; surgical procedures should be performed by experienced surgeons according to standard procedures; surgical training experimental treatments and research protocols should be suspended. Adequate personal protective equipment and measures to reduce aerosolization in the operating room (closed circuits, continuous cycle insufflators, fume extraction) should be adopted. Prevention of possible transmission of the virus during procedures in open, laparoscopic and endoscopic surgery is to use a multi-tactic approach, which includes correct filtration and ventilation of the operating room, the use of appropriate PPE (FFP3 plus surgical mask and protective visor for all the staff working in the operating room) and smoke evacuation devices with a suction and filter system.   on behalf of the UrOP Executive Committee Giuseppe Ludovico, Angelo Cafarelli, Ottavio De Cobelli, Ferdinando De Marco, Giovanni Ferrari, Stefano Pecoraro, Angelo Porreca, Domenico Tuzzolo.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Departamentos Hospitalares/organização & administração , Hospitalização , Controle de Infecções/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Aerossóis , Microbiologia do Ar , Poluição do Ar em Ambientes Fechados , Assistência Ambulatorial , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecção Hospitalar/prevenção & controle , Filtração , Guias como Assunto , Arquitetura Hospitalar , Humanos , Controle de Infecções/métodos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Itália , Salas Cirúrgicas , Admissão do Paciente , Equipamento de Proteção Individual , Pneumonia Viral/diagnóstico , Equipamentos de Proteção , Procedimentos Cirúrgicos Operatórios/métodos , Ventilação/instrumentação , Ventilação/métodos
12.
Rev Esp Salud Publica ; 942020 Jun 16.
Artigo em Espanhol | MEDLINE | ID: mdl-32541647

RESUMO

OBJECTIVE: Decision making in hospitals, and especially in their own healthcare services, is hardly referenced in the literature. During the pandemic period, healthcare services have put in place contingency plans to minimize the consequences of the coronavirus on professionals and patients. However, the deployment of contingency plans and results are hardly shared, depriving other services of references to refute, compare or emulate the aforementioned plans. The objective of this work was the description of the implementation and evaluation of Contingency Plans in the Covid-19 pandemic in a unit of inflammatory bowel disease of a Digestive Service in the Sanitary Area of Pontevedra and O Salnés. METHODS: A team of managers and professionals adapted the 10 measures recommended by Deloitte to face a pandemic to the healthcare environment. The measures were then formulated as a checklist. From the Plan-Do-Check-Act improvement cycle, they were grouped into categories: risk management, organizational management and decision-making. Finally, an external team carried out a qualitative evaluation of the implementation of the contingency plan carried out. RESULTS: The Intestinal Inflammatory Disease Unit of the Digestive Service has obtained an assessment of compliance with the 10 recommended measures to confidently face a pandemic. CONCLUSIONS: Sharing the deployment of the contingency plan and its results is useful to identify good practices. This article shows a method to evaluate decision-making in pandemic situations. The outcomes faces the The Intestinal Inflammatory Disease Unit in an excelent position.


Assuntos
Infecções por Coronavirus/prevenção & controle , Administração Hospitalar , Departamentos Hospitalares/organização & administração , Doenças Inflamatórias Intestinais/terapia , Enteropatias/terapia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Betacoronavirus , Lista de Checagem , Infecções por Coronavirus/complicações , Tomada de Decisões , Assistência à Saúde , Planejamento em Desastres , Fidelidade a Diretrizes , Humanos , Doenças Inflamatórias Intestinais/complicações , Enteropatias/complicações , Pneumonia Viral/complicações , Avaliação de Programas e Projetos de Saúde , Saúde Pública , Gestão de Riscos , Espanha/epidemiologia
13.
Psychol Trauma ; 12(S1): S43-S44, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32478538

RESUMO

The present commentary describes the main care services implemented by the clinical psychology unit of an Italian hospital to cope with the COVID-19 emergency outbreak. The unit's main goal has been to support and protect health care professionals, relatives of hospitalized patients, and patients themselves from further psychological distress. Details and insights are shared. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Infecções por Coronavirus/psicologia , Emergências/psicologia , Família/psicologia , Pacientes Internados/psicologia , Serviços de Saúde Mental , Recursos Humanos em Hospital/psicologia , Pneumonia Viral/psicologia , Angústia Psicológica , Psicologia Clínica/métodos , Adulto , Departamentos Hospitalares , Humanos , Itália , Pandemias
14.
Psychol Trauma ; 12(5): 529-530, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32551767

RESUMO

The global pandemic of coronavirus disease 2019 (COVID-19) has resulted in massive societal, economic, and environmental impacts that have both short- and long-term mental health influences. This commentary serves to tie existing literature on mental health and COVID-19 to the clinical experiences of a psychologist working in the Canadian hospital sector. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Transtornos de Ansiedade , Infecções por Coronavirus , Transtorno Depressivo , Serviços de Saúde Mental , Pandemias , Pneumonia Viral , Trauma Psicológico , Exacerbação dos Sintomas , Adolescente , Adulto , Transtornos de Ansiedade/psicologia , Criança , Transtorno Depressivo/psicologia , Departamentos Hospitalares , Humanos , Ontário , Recursos Humanos em Hospital , Trauma Psicológico/psicologia , Psicologia Clínica
15.
Neurologia ; 35(6): 363-371, 2020.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32563566

RESUMO

INTRODUCTION: The overload of the healthcare system and the organisational changes made in response to the COVID-19 pandemic may be having an impact on acute stroke care in the Region of Madrid. METHODS: We conducted a survey with sections addressing hospital characteristics, changes in infrastructure and resources, code stroke clinical pathways, diagnostic testing, rehabilitation, and outpatient care. We performed a descriptive analysis of results according to the level of complexity of stroke care (availability of stroke units and mechanical thrombectomy). RESULTS: The survey was completed by 22 of the 26 hospitals in the Madrid Regional Health System that attend adult emergencies, between 16 and 27 April 2020. Ninety-five percent of hospitals had reallocated neurologists to care for patients with COVID-19. The numbers of neurology ward beds were reduced in 89.4% of hospitals; emergency department stroke care pathways were modified in 81%, with specific pathways for suspected SARS-CoV2 infection established in 50% of hospitals; and SARS-CoV2-positive patients with acute stroke were not admitted to neurology wards in 42%. Twenty-four hour on-site availability of mechanical thrombectomy was improved in 10 hospitals, which resulted in a reduction in the number of secondary hospital transfers. The admission of patients with transient ischaemic attack or minor stroke was avoided in 45% of hospitals, and follow-up through telephone consultations was implemented in 100%. CONCLUSIONS: The organisational changes made in response to the SARS-Co2 pandemic in hospitals in the Region of Madrid have modified the allocation of neurology department staff and infrastructure, stroke units and stroke care pathways, diagnostic testing, hospital admissions, and outpatient follow-up.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Procedimentos Clínicos/organização & administração , Assistência à Saúde/organização & administração , Pandemias , Pneumonia Viral , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral/terapia , Doença Aguda , Assistência Ambulatorial/organização & administração , Agendamento de Consultas , Conversão de Leitos , Infecções por Coronavirus/diagnóstico , Assistência à Saúde/estatística & dados numéricos , Serviço Hospitalar de Emergência/organização & administração , Pesquisas sobre Serviços de Saúde , Acesso aos Serviços de Saúde/estatística & dados numéricos , Número de Leitos em Hospital , Departamentos Hospitalares/organização & administração , Hospitais Urbanos/organização & administração , Hospitais Urbanos/estatística & dados numéricos , Humanos , Ataque Isquêmico Transitório/epidemiologia , Ataque Isquêmico Transitório/terapia , Trombólise Mecânica/estatística & dados numéricos , Neurologia/organização & administração , Admissão do Paciente/estatística & dados numéricos , Pneumonia Viral/diagnóstico , Espanha/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Reabilitação do Acidente Vascular Cerebral/estatística & dados numéricos , Telemedicina , Terapia Trombolítica/estatística & dados numéricos
16.
Gastroenterol Hepatol ; 43(6): 332-347, 2020.
Artigo em Inglês, Espanhol | MEDLINE | ID: covidwho-612469

RESUMO

The set of measures proposed by SEPD, AEEH, GETECCU and AEG are aimed to help departments in their resumption of usual activity. We have prepared a number of practical recommendations regarding patient management and the stepwise resumption of healthcare activity. These recommendations are based on the sparse, changing evidence available, and will be updated in the future according to daily needs and the availability of expendable materials to suit them; in each department they will be implemented depending upon the cumulative incidence of SARS-CoV-2 infection in each region, and the burden the pandemic has represented for each hospital. The general objectives of these recommendations include: (a)To protect our patients against the risks of infection with SARS-CoV-2 and to provide them with high-quality care. (b)To protect all healthcare professionals against the risks of infection with SARS-CoV-2. (c)To resume normal functioning of our departments in a setting of ongoing risk for infection with SARS-CoV-2.


Assuntos
Infecções por Coronavirus/prevenção & controle , Gastroenterologia/organização & administração , Departamentos Hospitalares/organização & administração , Controle de Infecções/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Agendamento de Consultas , Técnicas de Laboratório Clínico , Ensaios Clínicos como Assunto , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/transmissão , Infecção Hospitalar/prevenção & controle , Técnicas de Diagnóstico do Sistema Digestório/instrumentação , Doenças do Sistema Digestório/complicações , Doenças do Sistema Digestório/diagnóstico , Doenças do Sistema Digestório/terapia , Desinfecção , Interações Medicamentosas , Contaminação de Equipamentos/prevenção & controle , Serviços de Assistência Domiciliar/organização & administração , Humanos , Hospedeiro Imunocomprometido , Imunossupressores/efeitos adversos , Imunossupressores/uso terapêutico , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Transplante de Fígado , Programas de Rastreamento/organização & administração , Doenças Profissionais/prevenção & controle , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/transmissão , Equipamentos de Proteção , Avaliação de Sintomas , Telemedicina/organização & administração , Precauções Universais
17.
Am J Phys Med Rehabil ; 99(6): 453-458, 2020 06.
Artigo em Inglês | MEDLINE | ID: covidwho-325972

RESUMO

The coronavirus disease 2019 has and continues to overwhelm the medical establishment in New York City. It has moved faster and had rates of mortality higher than what were initially forecast. All departments within large hospital systems have had to learn lessons and adapt in real time to the crisis. We share our experience and what we have learned as it pertains to this pandemic and hope that it aides, guides, and influences other departments of physical medicine and rehabilitation regarding their potential roles and areas of growth during this time.


Assuntos
Infecções por Coronavirus/epidemiologia , Administração Hospitalar , Departamentos Hospitalares/organização & administração , Controle de Infecções/organização & administração , Medicina Física e Reabilitação , Pneumonia Viral/epidemiologia , Humanos , Cidade de Nova Iorque/epidemiologia , Pandemias
19.
J Nucl Med Technol ; 48(2): 98-101, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: covidwho-154807

RESUMO

The COVID-19 outbreak was declared a public health emergency of international concern by the World Health Organization on January 30, 2020. Since then, the virus has spread to affect more countries worldwide. During this period, our nuclear medicine department at Singapore General Hospital segregated our staff and patients by time, by space, or both, to minimize contact and prevent spread of the virus. Necessary changes to our clinical practices and stricter infection control measures were also enforced. We share our personal experience in managing a nuclear medicine department during this epidemic.


Assuntos
Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Departamentos Hospitalares , Controle de Infecções/métodos , Medicina Nuclear , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Humanos , Exposição Ocupacional/prevenção & controle , Segurança do Paciente , Singapura
20.
Neurologia ; 35(4): 252-257, 2020 May.
Artigo em Inglês, Espanhol | MEDLINE | ID: covidwho-178373

RESUMO

INTRODUCTION: The COVID-19 pandemic will give rise to long-term changes in neurological care, which are not easily predictable. MATERIAL AND METHODS: A key informant survey was used to enquire about the changes expected in the specialty over the next 5 years. The survey was completed by heads of neurology departments with broad knowledge of the situation, having been active during the pandemic. RESULTS: Despite a low level of consensus between participants, there was strong (85%) and moderate consensus (70%) about certain subjects, mainly the increase in precautions to be taken, the use of telemedicine and teleconsultations, the reduction of care provided in in-person consultations to avoid the presence of large numbers of people in waiting rooms, the development of remote training solutions, and the changes in monitoring visits during clinical trials. There was consensus that there would be no changes to the indication of complementary testing or neurological examination. CONCLUSION: The key informant survey identified the foreseeable changes in neurological care after the pandemic.


Assuntos
Infecções por Coronavirus , Pesquisas sobre Serviços de Saúde , Doenças do Sistema Nervoso/terapia , Neurologia/tendências , Pandemias , Pneumonia Viral , Pessoal Administrativo/psicologia , Técnicas de Laboratório Clínico , Ensaios Clínicos como Assunto/métodos , Consenso , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Gerenciamento Clínico , Aconselhamento à Distância , Previsões , Departamentos Hospitalares/organização & administração , Humanos , Doenças do Sistema Nervoso/diagnóstico , Exame Neurológico , Neurologia/métodos , Neurologia/organização & administração , Pandemias/prevenção & controle , Isolamento de Pacientes , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Espanha/epidemiologia
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