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1.
Front Public Health ; 9: 558565, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33791264

RESUMEN

Background: The world faced crises of prevention and control and shortage of medical resources during the COVID-19 (Corona Virus Disease 2019) outbreak. The establishment of temporary integrated isolation wards in hospitals, which is universal and representative in China, is one of the most-effective strategies in solving these problems according to China's experiences. Aim: To conduct a preliminary study on the establishment of a temporary integrated isolation ward during the outbreak of COVID-19 and to evaluate related impact. Methods: SWOT analysis was used to analyze the advantages, disadvantages, opportunities, and risks in the establishment of the temporary integrated isolation ward, and corresponding corrective measures were made according to the analysis results. Findings: The ward has formulated more than 10 related work procedures and prevention and control measures. A total of 93 patients with 18 critically ill patients were admitted for treatment and isolation. They were all evaluated based on established procedures and protocols. Twenty-four supplementary nucleic acid tests were ordered and conducted. One new patient with COVID-19 was confirmed and was successfully transferred to the designated COVID-19 infectious control hospital. There were no missed diagnosis or misdiagnosis, no cross-infection of patients, no cluster outbreak, and no infection of medical workers during the entire process. Conclusion: SWOT analysis is helpful in guiding the establishment of a temporary integrated isolation ward and the formulation of prevention and control measures in Hebei General Hospital during the COVID-19 outbreak. It provides the guidance and reference of significance for the establishment of similar types of wards in the future.


Asunto(s)
/prevención & control , Control de Infecciones , Aislamiento de Pacientes , China/epidemiología , Brotes de Enfermedades , Hospitales , Humanos
2.
J Healthc Eng ; 2021: 8872167, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33833861

RESUMEN

In the beginning of 2020, the coronavirus (COVID-19) pandemic started to spread globally, causing panic to the lives of people around the world; many countries executed lockdown of cities or even total lockdown of the entire countries. The coronavirus disease (COVID-19) is transmitted via air droplets. In medical environments that use traditional hermetic ventilation systems, medical personnel who come in contact with patients are more susceptible to infection compared to regular staff; therefore, the air flow and air quality of hermetic negative pressure isolation wards are highly critical. For this purpose, the study proposes a full-outer-air-intake natural air-conditioning system for negative pressure isolation wards. This innovative system draws in large amounts of fresh external air to greatly improve the air exchange rate in wards; negative pressure environments can be implemented depending on requirements to solve the issue of nosocomial infections in traditional negative pressure isolation wards that draw air from within the hospital. This greatly reduces the probability of nosocomial infection and infection via air droplets; furthermore, the system's intake and exhaust paths are completely isolated, solving the issue of air cross-contamination. Based on the results from the experiment site, this innovative system was designed and implemented based on the guidelines of hospital facilities and achieved air exchange per hour in excess of 12 times/hour, reaching a maximum of 54.5 times/hour. Indoor CO2 concentration was 576 ppm, negative pressure was -14 Pa, indoor temperature was 23.3°C, indoor humidity was 54.1%, and sensible heat exchange efficiency (ηs) was 105.88% which effectively reduced ventilation load. Therefore, this innovative full-outer-air-intake natural air-conditioning system can provide medical staff and patients with a safe and healthy environment that prevents cross-infection.


Asunto(s)
Aire Acondicionado , Contaminantes Atmosféricos , Control de Infecciones/instrumentación , Aislamiento de Pacientes/instrumentación , Aisladores de Pacientes , Contaminación del Aire Interior/análisis , Dióxido de Carbono/análisis , Diseño de Equipo , Guías como Asunto , Hospitales , Calor , Humanos , Humedad , Exposición Profesional/prevención & control , Ventilación
3.
Euro Surveill ; 26(14)2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33834961

RESUMEN

IntroductionStandard testing for infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is based on RT-PCR tests, but detection of viral genetic material alone does not indicate ongoing infectious potential. The ability to isolate whole virus represents a better proxy for infectivity.AimThe objective of this study was to gain an understanding of the current literature and compare the reported periods of positive SARS-CoV-2 detection from studies that conducted RT-PCR testing in addition to experiments isolating whole virus.MethodsUsing a rapid review approach, studies reporting empirical data on the duration of positive RT-PCR results and/or successful viral isolation following SARS-CoV-2 infection in humans were identified through searches of peer-reviewed and pre-print health sciences literature. Articles were screened for relevance, then data were extracted, analysed, and synthesised.ResultsOf the 160 studies included for qualitative analysis, 84% (n = 135) investigated duration of positive RT-PCR tests only, 5% (n = 8) investigated duration of successful viral isolations, while 11% (n = 17) included measurements on both. There was significant heterogeneity in reported data. There was a prolonged time to viral clearance when deduced from RT-PCR tests compared with viral isolations (median: 26 vs 9 days).DiscussionFindings from this review support a minimum 10-day period of isolation but certain cases where virus was isolated after 10 days were identified. Given the extended time to viral clearance from RT-PCR tests, future research should ensure standard reporting of RT-PCR protocols and results to help inform testing policies aimed at clearance from isolation.


Asunto(s)
/prevención & control , /virología , Humanos , Aislamiento de Pacientes , /aislamiento & purificación , Factores de Tiempo
4.
G Ital Nefrol ; 38(2)2021 Apr 14.
Artículo en Inglés | MEDLINE | ID: mdl-33852220

RESUMEN

The new coronavirus disease (Covid-19) pandemic in Italy formally started on 21st February 2020, when a 38-years old man was established as the first Italian citizen with Covid-19 in Codogno, Lombardy region. In a few days, the deadly coronavirus swept beyond expectations across the city of Bergamo and its province, claiming thousands of lives and putting the hospital in Treviglio under considerable strain. Since designated Covid-dialysis hospitals to centrally manage infected hemodialysis patients were not set up in the epidemic areas, we arranged to treat all our patients. We describe the multiple strategies we had to implement fast to prevent/control Covid-19 infection and spread resources in our Dialysis Unit during the first surge of the pandemic in one of the worst-hit areas in Italy. The recommendations provided by existing guidelines and colleagues with significant experience in dealing with Covid-19 were combined with the practical judgement of our dialysis clinicians, nurses and nurse's aides.


Asunto(s)
/prevención & control , Fallo Renal Crónico/terapia , Pandemias , Diálisis Renal , Adulto , Anciano , Anciano de 80 o más Años , /epidemiología , Femenino , Administración Hospitalaria , Humanos , Italia/epidemiología , Fallo Renal Crónico/complicaciones , Masculino , Persona de Mediana Edad , Aislamiento de Pacientes/organización & administración , Administración de Personal en Hospitales/métodos , Guías de Práctica Clínica como Asunto , Evaluación de Síntomas/métodos , Triaje/organización & administración
6.
Sci Prog ; 104(2): 368504211009670, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33878962

RESUMEN

As the coronavirus disease 2019 (COVID-19) spreads globally, hospital departments will need take steps to manage their treatment procedures and wards. The preparations of high-risk departments (infection, respiratory, emergency, and intensive care unit) were relatively well within this pandemic, while low-risk departments may be unprepared. The spine surgery department in The First Affiliated Hospital of Anhui Medical University in Hefei, China, was used as an example in this study. The spine surgery department took measures to manage the patients, medical staff and wards to avoid the cross-infection within hospital. During the outbreak, no patients or healthcare workers were infected, and no treatment was delayed due to these measures. The prevention and control measures effectively reduced the risk of nosocomial transmission between health workers and patients while providing optimum care. It was a feasible management approach that was applicable to most low-risk and even high-risk departments.


Asunto(s)
/prevención & control , Control de Infecciones/métodos , Pandemias , Aislamiento de Pacientes/organización & administración , Aisladores de Pacientes/provisión & distribución , /patogenicidad , /diagnóstico , /transmisión , China/epidemiología , Infección Hospitalaria/prevención & control , Desinfección/métodos , Desinfección/organización & administración , Personal de Salud/educación , Humanos , Control de Infecciones/organización & administración , Monitoreo Fisiológico/instrumentación , Monitoreo Fisiológico/métodos , Procedimientos Ortopédicos/instrumentación , Procedimientos Ortopédicos/métodos , Aislamiento de Pacientes/métodos , Habitaciones de Pacientes/organización & administración , Equipo de Protección Personal/provisión & distribución , Columna Vertebral/cirugía
7.
Artículo en Inglés | MEDLINE | ID: mdl-33805162

RESUMEN

Long diagnostic delays (LDDs) may decrease the effectiveness of patient isolation in reducing subsequent transmission of coronavirus disease 2019 (COVID-19). This study aims to investigate the correlation between the proportion of LDD of COVID-19 patients with unknown transmission routes and the subsequent doubling time. LDD was defined as the duration between COVID-19 symptom onset and confirmation ≥6 days. We investigated the geographic correlation between the LDD proportion among 369 confirmed COVID-19 patients with symptom onset between the 9th and 11th week and the subsequent doubling time for 717 patients in the 12th-13th week among the six prefectures. The doubling time on March 29 (the end of the 13th week) ranged from 4.67 days in Chiba to 22.2 days in Aichi. Using a Pearson's product-moment correlation (p-value = 0.00182) and multiple regression analyses that were adjusted for sex and age (correlation coefficient -0.729, 95% confidence interval: -0.923--0.535, p-value = 0.0179), the proportion of LDD for unknown exposure patients was correlated inversely with the base 10 logarithm of the subsequent doubling time. The LDD for unknown exposure patients was correlated significantly and inversely with the subsequent doubling time.


Asunto(s)
Diagnóstico Tardío , Humanos , Japón/epidemiología , Aislamiento de Pacientes
8.
CMAJ Open ; 9(2): E400-E405, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33863798

RESUMEN

BACKGROUND: In March 2020, all levels of government introduced various strategies to reduce the impact of the COVID-19 pandemic. The purpose of this study was to document how the experience of providing medical assistance in dying (MAiD) changed during the COVID-19 pandemic. METHODS: We conducted a qualitative study using semistructured interviews with key informants in Canada who provided or coordinated MAiD before and during the COVID-19 pandemic. We interviewed participants from April to June 2020 by telephone or email. We collected and analyzed data in an iterative manner and reached theme saturation. Our team reached consensus on the major themes and subthemes. RESULTS: We interviewed 1 MAiD coordinator and 15 providers, including 14 physicians and 1 nurse practitioner. We identified 4 main themes. The most important theme was the perception that the pandemic increased the suffering of patients receiving MAiD by isolating them from loved ones and reducing available services. Providers were distressed by the difficulty of establishing rapport and closeness at the end of life, given the requirements for physical distancing and personal protective equipment. They were concerned about the spread of SARS-CoV-2, and found it difficult to enforce rules about distancing and the number of people present. Logistics and access to MAiD became more difficult because of the new restrictions, but there were many adaptations to solve these problems. INTERPRETATION: Providers and coordinators had many challenges in providing MAiD during the COVID-19 pandemic, including their perception that the suffering of their patients increased. Some changes in how MAiD is provided that have occurred during the pandemic, including more telemedicine assessments and virtual witnessing, are likely to remain after the pandemic and may improve service.


Asunto(s)
/psicología , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Asistencia Médica/estadística & datos numéricos , Percepción/fisiología , Adulto , Anciano , Anciano de 80 o más Años , /epidemiología , Canadá/epidemiología , Muerte , Femenino , Humanos , Entrevistas como Asunto , Masculino , Asistencia Médica/tendencias , Persona de Mediana Edad , Enfermeras Practicantes/psicología , Aislamiento de Pacientes/psicología , Equipo de Protección Personal/efectos adversos , Médicos/psicología , Investigación Cualitativa , /genética
9.
Eur J Health Law ; 28(1): 81-101, 2021 01 04.
Artículo en Inglés | MEDLINE | ID: mdl-33652383

RESUMEN

This article reflects on COVID-19 restrictions imposed on elders in Ireland through the lens of the right to private and family life (Article 8 ECHR), focusing on stay at home orders and recommendations advising elders to avoid social contact. Furthermore, we examine restrictions on visiting nursing homes given the high death toll in that setting. In our analysis, we zero in on the principles of foreseeability and proportionality, highlighting areas of concern and aspects that we submit should be considered in a proportionality assessment. Ultimately, we argue that it is a mistake to view the COVID-19 pandemic solely as an emergency. In this manner, the solutions suggested through the law - restrictions on movement and visitation bans - are too narrow and fail to address the underlying structures, such as, issues in the healthcare system, the limited home help for elderly and poor conditions in nursing homes.


Asunto(s)
/prevención & control , Brotes de Enfermedades/legislación & jurisprudencia , Familia , Aislamiento de Pacientes/legislación & jurisprudencia , Privacidad , Visitas a Pacientes/legislación & jurisprudencia , Anciano , Hogares para Ancianos/normas , Humanos , Irlanda/epidemiología , Casas de Salud/normas
10.
Radiol Oncol ; 55(2): 121-129, 2021 03 05.
Artículo en Inglés | MEDLINE | ID: mdl-33675200

RESUMEN

BACKGROUND: COVID-19 infection is particularly aggressive in frail patients, as cancer patients. Therefore, the more suitable management of the oncological patient requires a multidisciplinary assessment, to identify which patients should be treated, as inpatients or outpatients, and which treatments can be procrastinated. CONCLUSIONS: The role of radiologist is crucial, and, all cancer patients who need an imaging evaluation will need to be studied, using the most appropriate imaging tools related to the clinical question and paying a special attention to preserve public health. Guidelines are necessary in the correct organization of a radiology unit to manage patients with suspected or confirmed COVID-19 infection, and whenever possible, a satellite radiography center with dedicated equipment should be used to decrease the transmission risk.


Asunto(s)
/complicaciones , Protocolos Clínicos , Neoplasias/complicaciones , Neoplasias/diagnóstico , Servicio de Radiología en Hospital/organización & administración , /terapia , Infección Hospitalaria/prevención & control , Humanos , Hallazgos Incidentales , Neoplasias/terapia , Grupo de Atención al Paciente/organización & administración , Aislamiento de Pacientes , Equipo de Protección Personal , Triaje
12.
Bull World Health Organ ; 99(1): 62-66, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-33658735

RESUMEN

Problem: The surge in coronavirus disease 2019 (COVID-19) cases overwhelmed the health system in the Republic of Korea. Approach: To help health-care workers prioritize treatment for patients with more severe disease and to decrease the burden on health systems caused by COVID-19, the government established a system to classify disease severity. Health-care staff in city- and provincial-level patient management teams classified the patients into the different categories according to the patients' pulse, systolic blood pressure, respiratory rate, body temperature and level of consciousness. Patients categorized as having moderate, severe and very severe disease were promptly assigned to beds or negative-pressure isolation rooms for hospital treatment, while patients with mild symptoms were monitored in 16 designated facilities across the country. Local setting: The case fatality rate was higher in the city of Daegu and the Gyeongsangbuk-do province (1.6%; 124/7756) than the rest of the country (0.5%; 7/1485). Relevant changes: From 25 February to 26 March 2020, the ratio of negative-pressure isolation rooms per COVID-19 patient was below 0.15 in the city of Daegu and the Gyeongsangbuk-do province. In the rest of the country, this ratio decreased from 5.56 to 0.63 during the same period. Before the classification system was in place, eight (15.7%) out of the 51 deaths occurred at home or during transfer from home to health-care institutions. Lessons learnt: Categorizing patients according to their disease severity should be a prioritized measure to ease the burden on health systems and reduce the case fatality rate.


Asunto(s)
/clasificación , Índice de Severidad de la Enfermedad , Humanos , Pandemias , Aislamiento de Pacientes , Neumonía Viral/epidemiología , República de Corea/epidemiología , Signos Vitales
13.
Sci Rep ; 11(1): 6279, 2021 03 18.
Artículo en Inglés | MEDLINE | ID: mdl-33737580

RESUMEN

The Corona virus disease has significantly affected lives of people around the world. Existing quarantine policies led to large-scale lock-downs because of the slow tracking of the infection paths, and indeed we see new waves of the disease. This can be solved by contact tracing combined with efficient testing policies. Since the number of daily tests is limited, it is crucial to exploit them efficiently to improve the outcome of contact tracing (technological or human-based epidemiological investigations). We develop a controlled testing framework to achieve this goal. The key is to test individuals with high probability of being infected to identify them before symptoms appear. These probabilities are updated based on contact tracing and test results. We demonstrate that the proposed method could reduce the quarantine and morbidity rates compared to existing methods by up to a 50%. The results clearly demonstrate the necessity of accelerating the epidemiological investigations by using technological contact tracing. Furthermore, proper use of the testing capacity using the proposed controlled testing methodology leads to significantly improved results under both small and large testing capacities. We also show that for small new outbreaks controlled testing can prevent the large spread of new waves. Author contributions statement: The authors contributed equally to this work, including conceptualization, analysis, methodology, software, and drafting the work.


Asunto(s)
/prevención & control , Trazado de Contacto/métodos , Modelos Teóricos , Algoritmos , Humanos , Aislamiento de Pacientes
15.
JAMA Netw Open ; 4(3): e210490, 2021 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-33651111

RESUMEN

Importance: Several jurisdictions in the United States have secured hotels to temporarily house people experiencing homelessness who require isolation or quarantine for confirmed or suspected coronavirus disease 2019 (COVID-19). To our knowledge, little is known about how these programs serve this vulnerable population outside the hospital setting. Objective: To assess the safety of a hotel-based isolation and quarantine (I/Q) care system and its association with inpatient hospital capacity. Design, Setting, and Participants: This retrospective cohort study of a hotel-based I/Q care system for homeless and unstably housed individuals in San Francisco, California, was conducted from March 19 to May 31, 2020. Individuals unable to safely isolate or quarantine at home with mild to moderate COVID-19, persons under investigation, or close contacts were referred from hospitals, outpatient settings, and public health surveillance to 5 I/Q hotels. Of 1009 I/Q hotel guests, 346 were transferred from a large county public hospital serving patients experiencing homelessness. Exposure: A physician-supervised team of nurses and health workers provided around-the-clock support, including symptom monitoring, wellness checks, meals, harm-reduction services, and medications for opioid use disorder. Main Outcomes and Measures: Characteristics of I/Q hotel guests, program retention, county hospital readmissions, and mean length of stay. Results: Overall, the 1009 I/Q hotel guests had a median age of 44 years (interquartile range, 33-55 years), 756 (75%) were men, 454 (45%) were Latinx, and 501 (50%) were persons experiencing sheltered (n = 295) or unsheltered (n = 206) homelessness. Overall, 463 (46%) received a diagnosis of COVID-19; 303 of 907 (33%) had comorbid medical disorders, 225 of 907 (25%) had comorbid mental health disorders, and 236 of 907 (26%) had comorbid substance use disorders. A total of 776 of 955 guests (81%) completed their I/Q hotel stay; factors most strongly associated with premature discontinuation were unsheltered homelessness (adjusted odds ratio, 4.5; 95% CI, 2.3-8.6; P < .001) and quarantine status (adjusted odds ratio, 2.6; 95% CI, 1.5-4.6; P = .001). In total, 346 of 549 patients (63%) were transferred from the county hospital; of 113 ineligible referrals, 48 patients (42%) had behavioral health needs exceeding I/Q hotel capabilities. Thirteen of the 346 patients transferred from the county hospital (4%) were readmitted for worsening COVID-19. Overall, direct transfers to I/Q hotels from emergency and outpatient departments were associated with averting many hospital admissions. There was a nonsignificant decrease in the mean hospital length of stay for inpatients with confirmed or suspected COVID-19 from 5.5 to 2.7 days from March to May 2020 (P = .11). Conclusions and Relevance: To support persons experiencing homelessness during the COVID-19 pandemic, San Francisco rapidly and safely scaled a hotel-based model of I/Q that was associated with reduced strain on inpatient capacity. Strategies to improve guest retention and address behavioral health needs not met in hotel settings are intervention priorities.


Asunto(s)
/terapia , Personas sin Hogar , Aislamiento de Pacientes , Cuarentena , Adulto , Femenino , Hospitales Públicos , Vivienda , Humanos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Pandemias , Grupo de Atención al Paciente , Cooperación del Paciente , Readmisión del Paciente , Transferencia de Pacientes , Estudios Retrospectivos , San Francisco , Poblaciones Vulnerables
16.
PLoS One ; 16(3): e0247949, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33651851

RESUMEN

AIM: In spring 2020, the first Covid-19-related lockdown included the closing of kindergartens and schools. Home schooling, the lack of social contacts with peers and the care of the children at home posed an enormous challenge for many families. METHODS: The present study investigated the leisure behavior of 285 one- to 10-year-old German children at two time points (t1 and t2) during the Covid-19-related lockdown in spring 2020. In the subsample of primary school children (n = 102), we also explored children's attitudes towards schoolwork at home. Analyses focused on the change of behavior from t1 to t2, on differences in these changes depending on socio-economic status (SES), and on associations of behavior with SES, the number of children at home, and the frequency of receiving learning materials from school. RESULTS: While the frequency of playing outside increased significantly from t1 to t2, the frequency of handicrafts, playing board games, indoor sports, and motivation to do schoolwork decreased. The observed changes between t1 and t2 did not differ depending on SES. However, a lower SES was associated with higher media use, less outdoor activity, and (though only marginally significant) a reduced time doing schoolwork and a reduced ability to concentrate on schoolwork at t1. In households with more children, children played outside more often, but were read to less frequently and (though only marginally significant) watched movies and series less frequently. Children receiving learning materials from school on a regular basis spent significantly more time doing schoolwork at home than children receiving materials only irregularly. CONCLUSIONS: A continuing loss of childcare in day-care facilities and schools entails the danger of declining education in the form of (inter)active indoor activities and schoolwork.


Asunto(s)
Ejercicio Físico , Aprendizaje , Actividades Recreativas , /epidemiología , Niño , Cuidado del Niño , Jardines Infantiles , Salud del Niño/estadística & datos numéricos , Preescolar , Femenino , Conductas Relacionadas con la Salud/clasificación , Humanos , Lactante , Estudios Longitudinales , Masculino , Pandemias/prevención & control , Aislamiento de Pacientes , Instituciones Académicas , Clase Social , Aislamiento Social , Medios de Comunicación Sociales/estadística & datos numéricos , Deportes/estadística & datos numéricos
17.
J. healthc. qual. res ; 36(1): 12-18, ene.-feb. 2021. tab
Artículo en Español | IBECS | ID: ibc-196571

RESUMEN

ANTECEDENTES Y OBJETIVO: La calidad asistencial se ha podido ver afectada por las dimensiones de la pandemia de COVID-19 y el estricto aislamiento hospitalario al que han sido sometidos los pacientes. Por ello, se plantea describir el proceso diseñado para facilitar la comunicación de los pacientes aislados con sus familias, detectar sus necesidades y realizar intervenciones individualizadas. MÉTODO: Estudio cualitativo con metodología de investigación acción, respondiendo al siguiente algoritmo: planificar la acción, diagnóstico de la necesidad e hipótesis-acción; aplicar la acción, creación del grupo de gestores de casos y formación de los miembros; observar la acción, recoger y analizar la información. Durante el mes de abril del 2020. RESULTADOS: Se realizaron 1.754 interacciones que afectaron a 490 pacientes. Los gestores de casos realizaron 767 llamadas dirigidas principalmente a facilitar información sobre el ingreso (71,45%) y cambios de ubicación o funcionamiento de las unidades (18,84%). Recibieron un total de 1.098 llamadas de familiares solicitando: información médica (43,8%), comunicación con los pacientes (18,48%), entrega de enseres personales o gestión de objetos extraviados (12,84%) e información sobre la ubicación del paciente o gestión del alta (10,20%). En el 66% de los casos las llamadas fueron resueltas por los gestores, el 30% fueron derivadas y el 4% fallidas. CONCLUSIONES: La puesta en funcionamiento del grupo de gestores de casos ha contribuido a mejorar la comunicación de los pacientes ingresados y aislados por COVID-19 con sus familias, dando respuesta a las necesidades planteadas, mejorando la calidad asistencial y favoreciendo la humanización en los cuidados


BACKGROUND AND GOAL: Quality of healthcare has been affected by the current dimensions of the COVID-19 pandemic and the strict hospital isolation to which some inpatients have been subjected. Therefore, we propose to describe the process designed to facilitate the communication of inpatients with their families to detect their needs and perform individualized treatments in each case. METHOD: Qualitative study with action research methodology, responding to the following algorithm: plan the action, diagnosis of the need and hypothesis-action; apply the action, creation of the group of case managers and training of the members; observe the action, collect and analyse the information. During the month of April 2020. RESULTS: 1,754 interactions were undertaken, that affected 490 inpatients. Case Managers made 767 calls, to provide information about admissions (71.45%), changes in inpatient location or operation of units (18.84%), among others. One thousand and ninety-eight calls from family members were received requesting medical information (43.8%), to talk to inpatients (18.48%), to deliver personal articles or manage lost objects (12.84%), and seeking information about patient location or medical discharge (10.20%). Sixty-six percent of the requests were solved by Case Managers, 30% were referred on and 4% could not be solved. CONCLUSIONS: Implementation of the Case Manager Group contributed to encourage communication of inpatients isolated due to COVID-19 with their families, responding to needs raised, improving quality of care and promoting humanization of care


Asunto(s)
Humanos , Infecciones por Coronavirus , Neumonía Viral , Pandemias , Comunicación , Sistemas de Comunicación en Hospital , Familia , Aislamiento de Pacientes , Humanización de la Atención
18.
J Med Syst ; 45(4): 42, 2021 Feb 19.
Artículo en Inglés | MEDLINE | ID: mdl-33608811

RESUMEN

In confronting the sudden epidemic of COVID-19, China and other countries have been under great deal of pressure to block virus transmission and reduce death cases. Fangcang shelter hospital, which is converted from large-scale public venue, is proposed and proven to be an effective way for administering medical care and social isolation. This paper presents the practice in information technology support for a Fangcang shelter hospital in Wuhan, China. The experiences include the deployment strategy of IT infrastructure, the redesign of function modules in the hospital information system (HIS), equipment maintenance and medical staff training. The deployment strategy and HIS modules have ensured smoothness and efficiency of clinical work. The team established a quick response mechanism and adhered to the principle of nosocomial infection control. Deployment of network and modification of HIS was finished in the 48 hours before patient admittance. A repair hotline and remote support for equipment and software were available whenever medical workers met with any questions. No engineer ever entered the contaminated areas and no one was infected by the coronavirus during the hospital operation. Up to now, Fangcang shelter hospital is adopted by many regions around the world facing the collapse of their medical systems. This valuable experience in informatization construction and service in Wuhan may help participators involving in Fangcang shelter hospital get better information technology support, and find more practical interventions to fight the epidemic.


Asunto(s)
/terapia , Refugio de Emergencia/organización & administración , Hospitales Especializados/organización & administración , Unidades Móviles de Salud/organización & administración , Aislamiento de Pacientes/estadística & datos numéricos , /epidemiología , China , Urgencias Médicas , Arquitectura y Construcción de Instituciones de Salud , Hospitales de Aislamiento , Humanos , Tecnología de la Información , Factores de Riesgo
19.
BMC Psychiatry ; 21(1): 82, 2021 02 08.
Artículo en Inglés | MEDLINE | ID: mdl-33557780

RESUMEN

BACKGROUND AND OBJECTIVES: Coercion in psychiatry is legally tolerated as a last resort. The reduction of the use of coercion is a shared goal of hospital administrators, medical and nursing staff and representatives of patients and families but requires the identification of risk factors for coercion. These risk factors in geriatric psychiatric inpatient settings are not well known, especially regarding seclusion. Through examining the prevalence of coercion and patients' characteristics, this study aims to identify risk factors for coercion in elderly people. METHODS: The use of coercion in the geriatric psychiatry division of Geneva University Hospital in 2017 was retrospectively analyzed. The incidence rate ratios were estimated with multivariable Poisson regressions to assess risk factors for coercion. RESULTS: Eighty-one of 494 patients (16.4%) experienced at least one coercive measure during their stay (mainly seclusion). The risk factors for coercion were younger age, male gender, being divorced or married, cognitive disorders, high item 1 of the Health of the Nation Outcome Scales (HoNOS) score (overactive, aggressive, disruptive or agitated behavior) at admission, previous psychiatric hospitalizations and involuntary referrals from the emergency department. Other disorders and global HoNOS scores were not associated with the use of coercion. CONCLUSION: Higher risks of coercion were outlined in men with cognitive disorders, agitated behaviors, and previous psychiatric hospitalizations. They differed from those observed in younger adults in terms of age, civil status, disorders, global HoNOS scores and referrals. Therefore, geriatric psychiatric populations should be specifically investigated for the development of interventions aiming coercion reduction.


Asunto(s)
Trastornos Mentales , Psiquiatría , Adulto , Anciano , Coerción , Psiquiatría Geriátrica , Hospitales Psiquiátricos , Humanos , Pacientes Internos , Masculino , Trastornos Mentales/epidemiología , Trastornos Mentales/terapia , Aislamiento de Pacientes , Prevalencia , Restricción Física , Estudios Retrospectivos , Factores de Riesgo
20.
J Psychosom Res ; 143: 110365, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33581399

RESUMEN

OBJECTIVE: This study aimed to evaluate the impact of isolation form on the recovery of psychological distress in patients with coronavirus disease 2019 (COVID-19) after being discharged from hospital. METHODS: Baseline survey was conducted from February 10, 2020 to February 25, 2020 in patients with COVID-19 in a designated hospital on the discharge day. After discharge, patients were free to choose whether isolate in a centralized isolation site (i.e. designated hotel) or their own home for another two weeks. A follow-up survey was conducted at the end of the 2-week post-discharge isolation. Depression, anxiety as well as self-rated health were assessed at both time points using the 9-item patient health questionnaire, 7-item generalized anxiety disorder scale and self-rated health scores, respectively. RESULTS: Fifty centrally isolated and 45 home isolated patients completed both the baseline and the follow-up assessments. Significant effects of time and time by isolation form were found on depression and anxiety levels, with a significant decrease in depression and anxiety shown in home isolated but not in centrally isolated patients. Besides, a significant time effect was identified on self-rated health with significant improvement found in home isolated but not in centrally isolated patients. CONCLUSIONS: Home isolation is superior to centralized isolation in the recovery of COVID-19-associated depression, anxiety as well as self-rated health. More attention needs to be paid to the psychological well-being of centrally isolated patients. A sustained and integrated rehabilitation plan is warranted for patients with COVID-19 to achieve both physical and psychological recovery.


Asunto(s)
Ansiedad/complicaciones , /terapia , Depresión/complicaciones , Alta del Paciente , Aislamiento de Pacientes/psicología , Distrés Psicológico , Adulto , Cuidados Posteriores , China/epidemiología , Continuidad de la Atención al Paciente , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Cuestionario de Salud del Paciente , Características de la Residencia , Estrés Psicológico , Encuestas y Cuestionarios
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