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1.
J Perioper Pract ; 31(1-2): 44-50, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33292057

RESUMEN

One of the priorities at our large Operating Theatres Department is to support awareness and basic education of the multi-disciplinary teams in clinical Human Factors, to help build competence and capacity in healthcare towards a resilient system. From May 2019 until February 2020, our Human Factors Champions embarked on a project called Observation of Non-technical Skills and Teamwork in the operating theatres (ONSeT), to monitor and evaluate the benefits of local Human Factors education. In September 2020, six months after the COVID-19 pandemic hit the UK and caused a major disruption of surgical services, we decided to investigate the usefulness of the project and the impact of COVID-19 in the operating theatres, looking through the eyes of the Human Factors Champions. Results pointed to a consensus about ONSeT having helped during the pandemic, with regards to how teams worked and in enabling team leaders to be more responsive. Human Factors Champions found that feedback on performance was received in a non-threatening way and observation of performance became 'second nature'. As organisations need to develop critical thinking, we think that the ONSeT project has helped us build some capacity for this, from the front-line onwards.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Personal de Salud/normas , Control de Infecciones/métodos , Control de Infecciones/normas , Quirófanos/normas , Aisladores de Pacientes/normas , Atención Perioperativa/normas , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Guías de Práctica Clínica como Asunto
3.
Neurosurg Focus ; 49(6): E2, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33260125

RESUMEN

OBJECTIVES: Coronavirus disease (COVID-19) is a potentially severe respiratory illness that has threatened humanity globally. The pediatric neurosurgery practice differs from that of adults in that it treats children in various stages of physical and psychological development and contemplates diseases that do not exist in other areas. The aim of this study was to identify the level of knowledge and readiness of the healthcare providers, as well as to evaluate new preventive practices that have been introduced, psychological concerns, and the impact of the COVID-19 pandemic on pediatric neurosurgical units in Brazil. METHODS: Pediatric neurosurgeons were given an online questionnaire developed by the Brazilian Society of Pediatric Neurosurgery to evaluate the impact of the COVID-19 pandemic on their clinical practice. RESULTS: Of a cohort of 110 active members of the Brazilian Society of Pediatric Neurosurgery, 76 completed the survey (69%). Ninety-six percent were aware of the correct use of and indication for the types of personal protective equipment in clinical and surgical practices, but only 73.7% of them had unrestricted access to this equipment. Ninety-eight percent of participants agreed or strongly agreed that the pandemic had affected their pediatric neurosurgical practice. The COVID-19 pandemic interfered with outpatient care in 88% of the centers, it affected neurosurgical activity in 90.7%, and it led to the cancellation of elective neurosurgical procedures in 57.3%. Concerning the impact of COVID-19 on surgical activity, 9.2% of the centers had less than 25% of the clinical practice affected, 46.1% had 26%-50% of their activity reduced, 35.5% had a 51%-75% reduction, and 9.2% had more than 75% of their surgical work cancelled or postponed. Sixty-three percent affirmed that patients had been tested for COVID-19 before surgery. Regarding the impact of the COVID-19 pandemic on the mental health of those interviewed, 3.9% reported fear and anxiety with panic episodes, 7.9% had worsening of previous anxiety symptoms, 60.5% reported occasional fear, 10.5% had sadness and some depressive symptoms, and 2.6% reported depressive symptoms. CONCLUSIONS: The COVID-19 pandemic has posed unprecedented challenges to healthcare services worldwide, including neurosurgical units. Medical workers, pediatric neurosurgeons included, should be aware of safety measures and follow the recommendations of local healthcare organizations, preventing and controlling the disease. Attention should be given to the psychological burden of exposure to SARS-CoV-2 in healthcare workers, which carries a high risk of anxiety and depression.


Asunto(s)
/epidemiología , Personal de Salud/normas , Neurocirugia/normas , Pediatría/normas , Guías de Práctica Clínica como Asunto/normas , Sociedades Médicas/normas , Brasil/epidemiología , Niño , Personal de Salud/psicología , Humanos , Neurocirujanos/psicología , Neurocirujanos/normas , Procedimientos Neuroquirúrgicos/normas , Pandemias/prevención & control , Equipo de Protección Personal/normas , Encuestas y Cuestionarios
4.
Neurosurg Focus ; 49(6): E13, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33260126

RESUMEN

OBJECTIVE: Telemedicine has rapidly expanded in the recent years as technologies have afforded healthcare practitioners the ability to diagnose and treat patients remotely. Due to the COVID-19 pandemic, nonessential clinical visits were greatly limited, and much of the outpatient neurosurgical practice at the authors' institution was shifted quickly to telehealth. Although there are prior data suggesting that the use of telemedicine is satisfactory in other surgical fields, data in neurosurgery are limited. This study aimed to investigate both patient and provider satisfaction with telemedicine and its strengths and limitations in outpatient neurosurgery visits. METHODS: This quality improvement study was designed to analyze provider and patient satisfaction with telemedicine consultations in an outpatient neurosurgery clinic setting at a tertiary care, large-volume, academic center. The authors designed an 11-question survey for neurosurgical providers and a 13-question survey for patients using both closed 5-point Likert scale responses and multiple choice responses. The questionnaires were administered to patients and providers during the period when the clinic restricted in-person visits. At the conclusion of the study, the overall data were analyzed qualitatively and quantitatively. RESULTS: During the study period, 607 surveys were sent out to patients seen by telehealth at the authors' academic center, and 122 responses were received. For the provider survey, 85 surveys were sent out to providers at the authors' center and other academic centers, and 40 surveys were received. Ninety-two percent of patients agreed or strongly agreed that they were satisfied with that particular telehealth visit. Eighty-eight percent of patients agreed that their telehealth visit was more convenient for them than an in-person visit, but only 36% of patients stated they would like their future visits to be telehealth. Sixty-three percent of providers agreed that telehealth visits were more convenient for them than in-person visits, and 85% of responding providers stated that they wished to incorporate telehealth into their future practice. CONCLUSIONS: Although the authors' transition to telehealth was both rapid and unexpected, most providers and patients reported positive experiences with their telemedicine visits and found telemedicine to be an effective form of ambulatory neurosurgical care. Not all patients preferred telemedicine visits over in-person visits, but the high satisfaction with telemedicine by both providers and patients is promising to the future expansion of telehealth in ambulatory neurosurgery.


Asunto(s)
Procedimientos Quirúrgicos Ambulatorios/psicología , Personal de Salud/psicología , Procedimientos Neuroquirúrgicos/psicología , Satisfacción del Paciente , Telemedicina , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Procedimientos Quirúrgicos Ambulatorios/normas , Actitud del Personal de Salud , Femenino , Personal de Salud/normas , Humanos , Masculino , Persona de Mediana Edad , Procedimientos Neuroquirúrgicos/normas , Telemedicina/normas , Adulto Joven
5.
Neurosurg Focus ; 49(6): E9, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33260134

RESUMEN

OBJECTIVE: The purpose of this study was to analyze the effect of the coronavirus disease 2019 (COVID-19) outbreak and of the subsequent lockdown on the neurosurgical services of the Veneto region in Italy compared to the previous 4 years. METHODS: A survey was conducted in all 6 neurosurgical departments in the Veneto region to collect data about surgical, inpatient care and endovascular procedures during the month of March for each year from 2016 to 2020. Safety measures to avoid infection from SARS-CoV-2 and any COVID-19 cases reported among neurosurgical patients or staff members were considered. RESULTS: The mean number of neurosurgical admissions for the month of March over the 2016-2019 period was 663, whereas in March 2020 admissions decreased by 42%. Emergency admissions decreased by 23%. The average number of neurosurgical procedures was 697, and declined by 30% (range -10% to -51% in individual centers). Emergency procedures decreased in the same period by 23%. Subarachnoid hemorrhage and spontaneous intracerebral hemorrhage both decreased in Veneto-by 25% and 22%, respectively. Coiling for unruptured aneurysm, coiling for ruptured aneurysm, and surgery for ruptured aneurysm or arteriovenous malformation diminished by 49%, 27%, and 78%, respectively. Endovascular procedures for acute ischemic stroke (AIS) increased by 33% in 2020 (28 procedures in total). There was a slight decrease (8%) in brain tumor surgeries. Neurosurgical admissions decreased by 25% and 35% for head trauma and spinal trauma, respectively, while surgical procedures for head trauma diminished by 19% and procedures for spinal trauma declined by 26%. Admissions and surgical treatments for degenerative spine were halved. Eleven healthcare workers and 8 patients were infected in the acute phase of the pandemic. CONCLUSIONS: This multicenter study describes the effects of a COVID-19 outbreak on neurosurgical activities in a vast region in Italy. Remodulation of neurosurgical activities has resulted in a significant reduction of elective and emergency surgeries compared to previous years. Most likely this is a combined result of cancellation of elective and postponable surgeries, increase of conservative management, increase in social restrictions, and in patients' fear of accessing hospitals. Curiously, only endovascular procedures for AIS have increased, possibly due to reduced physical activity or increased thrombosis in SARS-CoV-2. The confounding effect of thrombectomy increase over time cannot be excluded. No conclusion can be drawn on AIS incidence. Active monitoring with nasopharyngeal swabs, wearing face masks, and using separate pathways for infected patients reduce the risk of infection.


Asunto(s)
/epidemiología , Brotes de Enfermedades , Personal de Salud/normas , Procedimientos Neuroquirúrgicos/normas , Encuestas y Cuestionarios , /prevención & control , Brotes de Enfermedades/prevención & control , Personal de Salud/tendencias , Humanos , Italia/epidemiología , Procedimientos Neuroquirúrgicos/tendencias
6.
Antimicrob Resist Infect Control ; 9(1): 185, 2020 11 10.
Artículo en Inglés | MEDLINE | ID: mdl-33168097

RESUMEN

BACKGROUND: Prehospital professionals such as emergency physicians or paramedics must be able to choose and adequately don and doff personal protective equipment (PPE) in order to avoid COVID-19 infection. Our aim was to evaluate the impact of a gamified e-learning module on adequacy of PPE in student paramedics. METHODS: This was a web-based, randomized 1:1, parallel-group, triple-blind controlled trial. Student paramedics from three Swiss schools were invited to participate. They were informed they would be presented with both an e-learning module and an abridged version of the current regional prehospital COVID-19 guidelines, albeit not in which order. After a set of 22 questions designed to assess baseline knowledge, the control group was shown the guidelines before answering a set of 14 post-intervention questions. The e-learning group was shown the gamified e-learning module right after the guidelines, and before answering post-intervention questions. The primary outcome was the difference in the percentage of adequate choices of PPE before and after the intervention. RESULTS: The participation rate was of 71% (98/138). A total of 90 answer sets was analyzed. Adequate choice of PPE increased significantly both in the control (50% [33;83] vs 25% [25;50], P = .013) and in the e-learning group (67% [50;83] vs 25% [25;50], P = .001) following the intervention. Though the median of the difference was higher in the e-learning group, there was no statistically significant superiority over the control (33% [0;58] vs 17% [- 17;42], P = .087). The e-learning module was of greatest benefit in the subgroup of student paramedics who were actively working in an ambulance company (42% [8;58] vs 25% [- 17;42], P = 0.021). There was no significant effect in student paramedics who were not actively working in an ambulance service (0% [- 25;33] vs 17% [- 8;50], P = .584). CONCLUSIONS: The use of a gamified e-learning module increases the rate of adequate choice of PPE only among student paramedics actively working in an ambulance service. In this subgroup, combining this teaching modality with other interventions might help spare PPE and efficiently protect against COVID-19 infection.


Asunto(s)
Betacoronavirus/fisiología , Infecciones por Coronavirus/prevención & control , Personal de Salud/educación , Pandemias/prevención & control , Equipo de Protección Personal , Neumonía Viral/prevención & control , Adulto , Técnicos Medios en Salud/educación , Técnicos Medios en Salud/normas , Betacoronavirus/genética , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/transmisión , Infecciones por Coronavirus/virología , Educación a Distancia/estadística & datos numéricos , Europa (Continente) , Femenino , Personal de Salud/normas , Humanos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional , Internet , Conocimiento , Aprendizaje , Masculino , Equipo de Protección Personal/normas , Neumonía Viral/epidemiología , Neumonía Viral/transmisión , Neumonía Viral/virología , Estudiantes/psicología , Adulto Joven
8.
PLoS One ; 15(10): e0239853, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33057435

RESUMEN

BACKGROUND: Mobilization of intensive care patients is a multi-professional task. Aim of this study was to explore how different professions working at Intensive Care Units (ICU) estimate the mobility capacity using the ICU Mobility Score in 10 different scenarios. METHODS: Ten fictitious patient-scenarios and guideline-related knowledge were assessed using an online survey. Critical care team members in German-speaking countries were invited to participate. All datasets including professional data and at least one scenario were analyzed. Kruskal Wallis test was used for the individual scenarios, while a linear mixed-model was used over all responses. RESULTS: In total, 515 of 788 (65%) participants could be evaluated. Physicians (p = 0.001) and nurses (p = 0.002) selected a lower ICU Mobility Score (-0.7 95% CI -1.1 to -0.3 and -0.4 95% CI -0.7 to -0.2, respectively) than physical therapists, while other specialists did not (p = 0.81). Participants who classified themselves as experts or could define early mobilization in accordance to the "S2e guideline: positioning and early mobilisation in prophylaxis or therapy of pulmonary disorders" correctly selected higher mobilization levels (0.2 95% CI 0.0 to 0.4, p = 0.049 and 0.3 95% CI 0.1 to 0.5, p = 0.002, respectively). CONCLUSION: Different professions scored the mobilization capacity of patients differently, with nurses and physicians estimating significantly lower capacity than physical therapists. The exact knowledge of guidelines and recommendations, such as the definition of early mobilization, independently lead to a higher score. Interprofessional education, interprofessional rounds and mobilization activities could further enhance knowledge and practice of mobilization in the critical care team.


Asunto(s)
Ambulación Precoz/normas , Adhesión a Directriz/estadística & datos numéricos , Personal de Salud/psicología , Unidades de Cuidados Intensivos/normas , Posicionamiento del Paciente/normas , Adulto , Femenino , Conocimientos, Actitudes y Práctica en Salud , Personal de Salud/normas , Humanos , Masculino , Persona de Mediana Edad , Guías de Práctica Clínica como Asunto , Encuestas y Cuestionarios
9.
BMJ Open ; 10(10): e038390, 2020 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-33004397

RESUMEN

INTRODUCTION: In order to avoid unnecessary hospital admission and associated complications, there is an urgent need to improve the early detection of infection in nursing home residents. Monitoring signs and symptoms with checklists or aids called decision support tools may help nursing home staff to detect infection in residents, particularly during the current COVID-19 pandemic.We plan to conduct a survey exploring views and experiences of how infections are detected and managed in practice by nurses, care workers and managers in nursing homes in England and Sweden. METHODS AND ANALYSIS: An international cross-sectional descriptive survey, using a pretested questionnaire, will be used to explore nurses, care workers and managers views and experiences of how infections are detected and managed in practice in nursing homes. Data will be analysed descriptively and univariate associations between personal and organisational factors explored. This will help identify important factors related to awareness, knowledge, attitudes, belief and skills likely to affect future implementation of a decision support tool for the early detection of infection in nursing home residents. ETHICS AND DISSEMINATION: This study was approved using the self-certification process at the University of Surrey and Linköping University ethics committee (Approval 2018/514-32) in 2018. Study findings will be disseminated through community/stakeholder/service user engagement events in each country, publication in academic peer-reviewed journals and conference presentations. A LAY summary will be provided to participants who indicate they would like to receive this information.This is the first stage of a plan of work to revise and evaluate the Early Detection of Infection Scale (EDIS) tool and its effect on managing infections and reducing unplanned hospital admissions in nursing home residents. Implementation of the EDIS tool may have important implications for the healthcare economy; this will be explored in cost-benefit analyses as the work progresses.


Asunto(s)
Control de Enfermedades Transmisibles , Infecciones por Coronavirus , Uso Excesivo de los Servicios de Salud/prevención & control , Casas de Salud/estadística & datos numéricos , Pandemias , Manejo de Atención al Paciente , Neumonía Viral , Instituciones de Cuidados Especializados de Enfermería/estadística & datos numéricos , Betacoronavirus/aislamiento & purificación , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/organización & administración , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/terapia , Análisis Costo-Beneficio , Estudios Transversales , Inglaterra/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Personal de Salud/normas , Hospitalización , Humanos , Manejo de Atención al Paciente/economía , Manejo de Atención al Paciente/métodos , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Neumonía Viral/terapia , Gestión de la Práctica Profesional/economía , Proyectos de Investigación , Suecia/epidemiología
10.
PLoS One ; 15(10): e0239917, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33002086

RESUMEN

BACKGROUND: As the field of global health expands, the recognition of structured training for field-based public health professionals has grown. Substantial effort has gone towards defining competency domains for public health professionals working globally. However, there is limited literature on how to implement competency-based training into learning curricula and evaluation strategies. OBJECTIVES: This scoping review seeks to collate the current status, degree of consensus, and best practices, as well as gaps and areas of divergence, related to the implementation of competencies in global health curricula. Specifically, we sought to examine (i) the target audience, (ii) the levels or milestones, and (iii) the pedagogy and assessment approaches. SOURCES OF EVIDENCE: A review of the published and grey literature was completed to identify published and grey literature sources that presented information on how to implement or support global health and public health competency-based education programs. In particular, we sought to capture any attempts to assign levels or milestones, any evaluation strategies, and the different pedagogical approaches. RESULTS: Out of 68 documents reviewed, 21 documents were included which contained data related to the implementation of competency-based training programs; of these, 18 were peer-reviewed and three were from the grey literature. Most of the sources focused on post-graduate public health students, professional trainees pursuing continuing education training, and clinical and allied health professionals working in global health. Two approaches were identified to defining skill level or milestones, namely: (i) defining levels of increasing ability or (ii) changing roles across career stages. Pedagogical approaches featured field experience, direct engagement, group work, and self-reflection. Assessment approaches included self-assessment surveys, evaluations by peers and supervisors, and mixed methods assessments. CONCLUSIONS: The implementation of global health competencies needs to respond to the needs of specific agencies or particular groups of learners. A milestones approach may aide these efforts while also support monitoring and evaluation. Further development is needed to understand how to assess competencies in a consistent and relevant manner.


Asunto(s)
Educación Médica/métodos , Salud Global/educación , Guías de Práctica Clínica como Asunto , Educación Médica/normas , Personal de Salud/educación , Personal de Salud/normas , Humanos
11.
J Med Internet Res ; 22(11): e22894, 2020 11 12.
Artículo en Inglés | MEDLINE | ID: mdl-33122164

RESUMEN

BACKGROUND: The COVID-19 pandemic has imposed a heavy burden on health care systems and governments. Health literacy (HL) and eHealth literacy (as measured by the eHealth Literacy Scale [eHEALS]) are recognized as strategic public health elements but they have been underestimated during the pandemic. HL, eHEALS score, practices, lifestyles, and the health status of health care workers (HCWs) play crucial roles in containing the COVID-19 pandemic. OBJECTIVE: The aim of this study is to evaluate the psychometric properties of the eHEALS and examine associations of HL and eHEALS scores with adherence to infection prevention and control (IPC) procedures, lifestyle changes, and suspected COVID-19 symptoms among HCWs during lockdown. METHODS: We conducted an online survey of 5209 HCWs from 15 hospitals and health centers across Vietnam from April 6 to April 19, 2020. Participants answered questions related to sociodemographics, HL, eHEALS, adherence to IPC procedures, behavior changes in eating, smoking, drinking, and physical activity, and suspected COVID-19 symptoms. Principal component analysis, correlation analysis, and bivariate and multivariate linear and logistic regression models were used to validate the eHEALS and examine associations. RESULTS: The eHEALS had a satisfactory construct validity with 8 items highly loaded on one component, with factor loadings ranked from 0.78 to 0.92 explaining 76.34% of variance; satisfactory criterion validity as correlated with HL (ρ=0.42); satisfactory convergent validity with high item-scale correlations (ρ=0.80-0.84); and high internal consistency (Cronbach α=.95). HL and eHEALS scores were significantly higher in men (unstandardized coefficient [B]=1.01, 95% CI 0.57-1.45, P<.001; B=0.72, 95% CI 0.43-1.00, P<.001), those with a better ability to pay for medication (B=1.65, 95% CI 1.25-2.05, P<.001; B=0.60, 95% CI 0.34-0.86, P<.001), doctors (B=1.29, 95% CI 0.73-1.84, P<.001; B 0.56, 95% CI 0.20-0.93, P=.003), and those with epidemic containment experience (B=1.96, 95% CI 1.56-2.37, P<.001; B=0.64, 95% CI 0.38-0.91, P<.001), as compared to their counterparts, respectively. HCWs with higher HL or eHEALS scores had better adherence to IPC procedures (B=0.13, 95% CI 0.10-0.15, P<.001; B=0.22, 95% CI 0.19-0.26, P<.001), had a higher likelihood of healthy eating (odds ratio [OR] 1.04, 95% CI 1.01-1.06, P=.001; OR 1.04, 95% CI 1.02-1.07, P=.002), were more physically active (OR 1.03, 95% CI 1.02-1.03, P<.001; OR 1.04, 95% CI 1.03-1.05, P<.001), and had a lower likelihood of suspected COVID-19 symptoms (OR 0.97, 95% CI 0.96-0.98, P<.001; OR 0.96, 95% CI 0.95-0.98, P<.001), respectively. CONCLUSIONS: The eHEALS is a valid and reliable survey tool. Gender, ability to pay for medication, profession, and epidemic containment experience were independent predictors of HL and eHEALS scores. HCWs with higher HL or eHEALS scores had better adherence to IPC procedures, healthier lifestyles, and a lower likelihood of suspected COVID-19 symptoms. Efforts to improve HCWs' HL and eHEALS scores can help to contain the COVID-19 pandemic and minimize its consequences.


Asunto(s)
/epidemiología , Alfabetización en Salud/métodos , Personal de Salud/normas , Psicometría/métodos , Telemedicina/métodos , Adulto , Femenino , Humanos , Estilo de Vida , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , Adulto Joven
14.
Med. intensiva (Madr., Ed. impr.) ; 44(6): 371-388, ago.-sept. 2020.
Artículo en Español | IBECS | ID: ibc-187189

RESUMEN

El 11 de marzo de 2020 el director general de la Organización Mundial de la Salud (OMS) declaró la enfermedad causada por el SARS-CoV-2 (COVID-19) como una pandemia. La propagación y evolución de la pandemia está poniendo a prueba los sistemas sanitarios de decenas de países y ha dado lugar a una miríada de artículos de opinión, planes de contingencia, series de casos e incipientes ensayos. Abarcar toda esta literatura es complejo. De forma breve y sintética, en la línea de las anteriores recomendaciones de los Grupos de Trabajo, la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC) ha elaborado esta serie de recomendaciones básicas para la asistencia a pacientes en el contexto de la pandemia


On March 11, 2020, the Director-General of the World Health Organization (WHO) declared the disease caused by SARS-CoV-2 (COVID-19) as a pandemic. The spread and evolution of the pandemic is overwhelming the healthcare systems of dozens of countries and has led to a myriad of opinion papers, contingency plans, case series and emerging trials. Covering all this literature is complex. Briefly and synthetically, in line with the previous recommendations of the Working Groups, the Spanish Society of Intensive, Critical Medicine and Coronary Units (SEMICYUC) has prepared this series of basic recommendations for patient care in the context of the pandemic


Asunto(s)
Humanos , Infecciones por Coronavirus/epidemiología , Betacoronavirus , Neumonía Viral , Personal de Salud/normas , Transferencia de Pacientes/normas , Cuidados Críticos/normas , España/epidemiología , Guías de Práctica Clínica como Asunto , Sociedades Médicas/normas , Seguridad del Paciente , Pandemias , Cuidados Críticos/organización & administración
15.
Gastroenterol. hepatol. (Ed. impr.) ; 43(7): 408-413, ago.-sept. 2020.
Artículo en Español | IBECS | ID: ibc-191020

RESUMEN

La COVID-19 es un síndrome respiratorio agudo grave producido por el coronavirus SARS-CoV-2 que se describió en China a finales de 2019. Actualmente hay más de tres millones de casos diagnosticados, constituyendo una situación de pandemia que ha ocasionado una crisis a nivel mundial. El efecto devastador de esta infección se debe a su alta contagiosidad y, aunque predominan las formas leves, los casos graves y la mortalidad en valores absolutos son muy elevados. La información sobre las características de la infección en la enfermedad inflamatoria intestinal tiene especial interés, y esto es debido a que estos pacientes tienen una mayor frecuentación de centros sanitarios, lo que puede incrementar el riesgo de contagio. Además, los tratamientos que se administran para el control de la actividad inflamatoria podrían modificar la evolución de la COVID-19. El Grupo Español de Trabajo en Enfermedad de Crohn y Colitis Ulcerosa, en colaboración con el Grupo Enfermero de Trabajo en EII, ha elaborado este documento que tiene como objetivo responder de forma práctica algunas dudas frecuentes en el tratamiento de estos pacientes


COVID-19 is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which was described in China in late 2019. There are currently more than three million diagnosed cases, constituting a pandemic which has caused a worldwide crisis. The devastating effects of this infection are due to its highly contagious nature and although mild forms predominate, in absolute values, the rates for severe forms and mortality are very high. The information on the characteristics of the infection in inflammatory bowel disease is of special interest, as these patients have higher attendance at health centres, which may increase their risk of infection. Furthermore, the treatments used to control the inflammatory activity may modify the disease course of COVID-19. The Spanish Working Group on Crohn’s Disease and Ulcerative Colitis and the Spanish Nurses Working Group on Inflammatory Bowel Disease have prepared this document as a practical response to some common questions about the treatment of these patients


Asunto(s)
Humanos , Consenso , Enfermedades Inflamatorias del Intestino/terapia , Neumonía Viral/prevención & control , Infecciones por Coronavirus/prevención & control , Comorbilidad , Pandemias/prevención & control , Factores de Riesgo , Higiene/normas , Enfermedades Inflamatorias del Intestino/complicaciones , Pronóstico , Tiempo de Internación , Personal de Salud/normas , Enfermedades Gastrointestinales/epidemiología , Gastroenterología/normas , Betacoronavirus
16.
PLoS One ; 15(9): e0239159, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32956378

RESUMEN

BACKGROUND: Tuberculosis infection control is a combination of measures designed to minimize the risk of tuberculosis transmission within populations. Healthcare workers are not sufficiently protected from tuberculosis infection in healthcare facilities where infection control protocols are not followed completely. Studies conducted in Ethiopia about tuberculosis infection control practices were self-report. OBJECTIVE: To assess tuberculosis infection control practices and associated factors among health care workers in hospitals of Gamo Gofa Zone, Southern Ethiopia. METHOD: A facility-based cross-sectional study was conducted from March 6 to April 2, 2019. The sample size was 422. The sample was proportionally allocated to each hospital and the respective discipline. Simple random sampling was used to select participants from each discipline. Data were entered into EpiData version 4.4.2.1 and analyzed using SPSS Version 21 software. Multicollinearity and Model goodness-of-fit was checked. A multivariate logistic regression model at 95% CI was used to identify the predictors. RESULT: The response rate was 97.4%. The proportion of good tuberculosis infection control practice was 39.9% [95% CI (35.5, 44.9)]. Knowledge on tuberculosis infection control measures [AOR = 3.65, 95% CI (2.07, 6.43)], educational level of degree and above [AOR = 2.78, 95% CI (1.7, 4.53)] and ever having tuberculosis-related training [AOR = 2.02, 95% CI (1.24, 3.31)] were significantly associated with good tuberculosis infection control practice. CONCLUSION AND RECOMMENDATION: The proportion of good tuberculosis infection control practice among healthcare workers in hospitals of the Gamo Gofa Zone was 39.9%. The good practice of tuberculosis infection control was determined by educational level, working department, knowledge on tuberculosis infection control measures, and having tuberculosis-related training. Hence, training of healthcare workers, targeting diploma-holders in upgrading educational level programs, developing knowledge on tuberculosis infection control measures, and qualitative research to explore reasons for not practicing infection control measures is recommended.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Personal de Salud/estadística & datos numéricos , Hospitales/estadística & datos numéricos , Control de Infecciones/métodos , Tuberculosis/prevención & control , Adolescente , Adulto , Estudios Transversales , Escolaridad , Etiopía/epidemiología , Femenino , Personal de Salud/normas , Hospitales/normas , Humanos , Control de Infecciones/normas , Control de Infecciones/estadística & datos numéricos , Masculino , Autoempalme del ARN Ribosómico , Autoinforme/estadística & datos numéricos , Tuberculosis/epidemiología , Tuberculosis/transmisión , Adulto Joven
18.
BMJ Open Qual ; 9(3)2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32978176

RESUMEN

INTRODUCTION: Effective implementation of standard precautions specific to COVID-19 is a challenge for hospitals within the existing constraints of time and resources. AIM: To rapidly design and operationalise personal protective equipment (PPE) donning and doffing areas required for a COVID-19 care facility. METHODS: Literature review was done to identify all issues pertaining to donning and doffing in terms of Donabedian's structure, process and outcome. Training on donning and doffing was given to hospital staff. Donning and doffing mock drills were held. 5S was used as a tool to set up donning and doffing areas. Instances of donning and doffing were observed for protocol deviations and errors. Plan-do-study-act cycles were conducted every alternate day for 4 weeks. The initiative was reported using Standards for QUality Improvement Reporting Excellence (SQUIRE) guidelines. RESULTS: Best practices in donning and doffing were described. Our study recommends a minimum area of 16 m2 each for donning and doffing rooms. Verbally assisted doffing was found most useful than visual prompts. DISCUSSION: Challenges included sustaining the structure and process of donning and doffing, varied supplies of PPE which altered sequencing of donning and/or doffing, and training non-healthcare workers such as plumbers, electricians and drivers who were required during emergencies in the facility. CONCLUSION: Our study used evidence-based literature and quality improvement (QI) tools to design and operationalise donning and doffing areas with focus on people, task and environment. Our QI will enable healthcare facilities to rapidly prototype donning and doffing areas in a systematic way.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Personal de Salud/organización & administración , Control de Infecciones/normas , Salud Laboral/normas , Pandemias/prevención & control , Equipo de Protección Personal/normas , Neumonía Viral/prevención & control , Adulto , Betacoronavirus , Infecciones por Coronavirus/transmisión , Femenino , Personal de Salud/normas , Implementación de Plan de Salud , Humanos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Masculino , Persona de Mediana Edad , Neumonía Viral/transmisión , Ropa de Protección/normas , Mejoramiento de la Calidad , Dispositivos de Protección Respiratoria/normas , Adulto Joven
19.
Artículo en Inglés | MEDLINE | ID: mdl-32785110

RESUMEN

BACKGROUND: Since the beginning of SARS-CoV-2 outbreak, a large number of infections have been reported among healthcare workers (HCWs). The aim of this study was to investigate the occurrence of SARS-CoV-2 infection among HCWs involved in the first management of infected patients and to describe the measures adopted to prevent the transmission in the hospital. METHODS: This prospective observational study was conducted between February 21 and April 16, 2020, in the Padua University Hospital (north-east Italy). The infection control policy adopted consisted of the following: the creation of the "Advanced Triage" area for the evaluation of SARS-CoV-2 cases, and the implementation of an integrated infection control surveillance system directed to all the healthcare personnel involved in the Advance Triage area. HCWs were regularly tested with nasopharyngeal swabs for SARS-CoV-2; body temperature and suggestive symptoms were evaluated at each duty. Demographic and clinical data of both patients and HCWs were collected and analyzed; HCWs' personal protective equipment (PPE) consumption was also recorded. The efficiency of the control strategy among HCWs was evaluated identifying symptomatic infection (primary endpoint) and asymptomatic infection (secondary endpoint) with confirmed detection of SARS-CoV-2. RESULTS: 7595 patients were evaluated in the Advanced Triage area: 5.2% resulted positive and 72.4% was symptomatic. The HCW team was composed of 60 members. A total of 361 nasopharyngeal swabs were performed on HCWs. All the swabs resulted negative and none of the HCWs reached the primary or the secondary endpoint. CONCLUSIONS: An integrated hospital infection control strategy, consisting of dedicated areas for infected patients, strict measures for PPE use and mass surveillance, is successful to prevent infection among HCWs.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Personal de Salud/organización & administración , Control de Infecciones/organización & administración , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Adulto , Infecciones Asintomáticas/epidemiología , Betacoronavirus , Temperatura Corporal , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Brotes de Enfermedades , Femenino , Personal de Salud/normas , Humanos , Control de Infecciones/normas , Italia/epidemiología , Masculino , Grupo de Atención al Paciente/organización & administración , Equipo de Protección Personal/estadística & datos numéricos , Equipo de Protección Personal/provisión & distribución , Estudios Prospectivos , Triaje/organización & administración
20.
Indian J Pathol Microbiol ; 63(3): 350-357, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32769321

RESUMEN

Declared as a pandemic by WHO on March 11, 2020, COVID-19 has brought about a dramatic change in the working of different laboratories across the country. Diagnostic laboratories testing different types of samples play a vital role in the treatment management. Irrespective of their size, each laboratory has to follow strict biosafety guidelines. Different sections of the laboratory receive samples that are variably infectious. Each sample needs to undergo a proper and well-designed processing system so that the personnel involved are not infected and also their close contacts. It takes a huge effort so as to limit the risk of exposure of the working staff during the collection, processing, reporting or dispatching of biohazard samples. Guidelines help in preventing the laboratory staff and healthcare workers from contracting the disease which has a known human to human route of transmission and high rate of mortality. A well-knit approach is the need of the hour to combat this fast spreading disease. We anticipate that the guidelines described in this article will be useful for continuing safe work practices by all the laboratories in the country.


Asunto(s)
Contención de Riesgos Biológicos/métodos , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Exposición Profesional/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , Manejo de Especímenes/métodos , Betacoronavirus , Desinfección/métodos , Guías como Asunto , Sustancias Peligrosas , Personal de Salud/normas , Humanos , Laboratorios/normas , Patólogos/normas , Administración de Residuos/métodos
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