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COVID-19/prévention et contrôle , Prévention des infections/normes , Infections à staphylocoques/prévention et contrôle , Adolescent , Arkansas/épidémiologie , COVID-19/épidémiologie , Enfant , Enfant d'âge préscolaire , Femelle , Humains , Nourrisson , Prévention des infections/méthodes , Prévention des infections/tendances , Mâle , Staphylococcus aureus résistant à la méticilline/pathogénicité , Quarantaine/méthodes , Quarantaine/normes , Quarantaine/tendances , Infections à staphylocoques/épidémiologie , Jeune adulteRÉSUMÉ
Two new tools from the AHRQ help facilitate observational audits.
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COVID-19/prévention et contrôle , Personnel de santé/tendances , Prévention des infections/méthodes , Maisons de repos/normes , COVID-19/soins infirmiers , Humains , Prévention des infections/tendances , Maisons de repos/organisation et administration , Maisons de repos/tendancesRÉSUMÉ
Patients increasingly receive care from a large spectrum of different settings, placing them at risk for exposure to pathogens by many different sources. Each health care environment has its own specific challenges, and thus infection control programs must be tailored to each specific setting. High-turnover outpatient settings may require additional considerations, such as establishing patient triage and follow-up protocols, and broadened cleaning and disinfection procedures. In nursing homes, infection control programs should focus on surveillance for infections and antimicrobial resistance, outbreak investigation and control plan for epidemics, isolation precautions, hand hygiene, staff education, and employee and resident health programs.
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Prestations des soins de santé/organisation et administration , Désinfection , Hygiène des mains , Prévention des infections , Gestion responsable des antimicrobiens , Désinfection/tendances , Multirésistance bactérienne aux médicaments , Promotion de la santé , Humains , Prévention des infections/organisation et administration , Prévention des infections/tendances , Soins de longue durée/organisation et administration , Maisons de repos/organisation et administrationRÉSUMÉ
INTRODUCTION: The COVID-19 pandemic has seen the introduction of important public health measures to minimise the spread of the virus. We aim to identify the impact government restrictions and hospital-based infection control procedures on ST elevation myocardial infarction (STEMI) care during the COVID-19 pandemic. METHODS: Patients meeting ST elevation criteria and undergoing primary percutaneous coronary intervention from 27 March 2020, the day initial national lockdown measures were announced in Ireland, were included in the study. Patients presenting after the lockdown period, from 18 May to 31 June 2020, were also examined. Time from symptom onset to first medical contact (FMC), transfer time and time of wire cross was noted. Additionally, patient characteristics, left ventricular ejection fraction, mortality and biochemical parameters were documented. Outcomes and characteristics were compared against a control group of patients meeting ST elevation criteria during the month of January. RESULTS: A total of 42 patients presented with STEMI during the lockdown period. A significant increase in total ischaemic time (TIT) was noted versus controls (8.81 hours (±16.4) vs 2.99 hours (±1.39), p=0.03), with increases driven largely by delays in seeking FMC (7.13 hours (±16.4) vs 1.98 hours (±1.46), p=0.049). TIT remained significantly elevated during the postlockdown period (6.1 hours (±5.3), p=0.05), however, an improvement in patient delays was seen versus the control group (3.99 hours (±4.5), p=0.06). There was no difference seen in transfer times and door to wire cross time during lockdown, however, a significant increase in transfer times was seen postlockdown versus controls (1.81 hours (±1.0) vs 1.1 hours (±0.87), p=0.004). CONCLUSION: A significant increase in TIT was seen during the lockdown period driven mainly by patient factors highlighting the significance of public health messages on public perception. Additionally, a significant delay in transfer times to our centre was seen postlockdown.
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COVID-19 , Évaluation des résultats et des processus en soins de santé/tendances , Intervention coronarienne percutanée/tendances , Infarctus du myocarde avec sus-décalage du segment ST/thérapie , Sujet âgé , Bases de données factuelles , Femelle , Humains , Prévention des infections/tendances , Irlande , Mâle , Adulte d'âge moyen , Acceptation des soins par les patients , Transfert de patient/tendances , Intervention coronarienne percutanée/effets indésirables , Intervention coronarienne percutanée/mortalité , Études rétrospectives , Infarctus du myocarde avec sus-décalage du segment ST/imagerie diagnostique , Infarctus du myocarde avec sus-décalage du segment ST/mortalité , Facteurs temps , Délai jusqu'au traitement/tendances , Résultat thérapeutiqueSujet(s)
COVID-19/prévention et contrôle , Interventions chirurgicales non urgentes/tendances , Hernie inguinale/chirurgie , Herniorraphie/tendances , Types de pratiques des médecins/tendances , Interventions chirurgicales non urgentes/méthodes , Santé mondiale , Accessibilité des services de santé/tendances , Herniorraphie/méthodes , Humains , Prévention des infections/méthodes , Prévention des infections/tendances , Soins périopératoires/méthodes , Soins périopératoires/tendances , Enquêtes et questionnairesRÉSUMÉ
BACKGROUND: COVID-19 is an emerging disease of global public health concern. AIMS: To evaluate the epidemiological, clinical, laboratory, and radiologic findings and the clinical outcomes of children who were diagnosed with SARS-CoV-2 by polymerase chain reaction (PCR), and to evaluate the effect of the trends in intervention measures. STUDY DESIGN: Between April 2, 2020 and January 16, 2021, children aged 0-18 years who had presented at the pediatric emergency department and were diagnosed with confirmed SARS-CoV-2 by PCR were enrolled. METHODS: Details on demographics, epidemiologic characteristics, clinical findings, laboratory data, and radiologic investigations, hospital admissions, and prognosis were recorded. According to clinical severity, patients were divided into 5 groups as asymptomatic, mild, moderate, severe, or critical. We classified the outbreak into 3 periods. The first was between April 2, 2020, the date when the first pediatric case of our hospital was detected, and June 1, 2020, when restrictive measures were relaxed. The second period was between June 1, 2020 and November 15, 2020, when restrictive measures were reimplemented. The third period was between November 15, 2020 and January 16, 2021. RESULTS: A total of 600 patients [median age: 10.3 years (IQR: 4.4-15.1); 304 females] were enrolled. Among them, 25.0% were asymptomatic, while the 3 most common symptoms among symptomatic cases were fever, cough, and fatigue. There was contact with a COVID-19 PCRpositive individual in 73.5% of the cases, with 76.6% of those being a household contact. There were 23 (3.9%) moderate, severe, or critical cases in terms of clinical severity. The presence of chronic disease, a pathological physical chest examination, and procalcitonin levels of >0.05 ng/mL were identified as predictors of being moderate, severe, or critical. Twenty-four (4.0%) patients were admitted to the hospital; 14 (2.3%) to the ward and 10 (1.6%) to the pediatric intensive care unit. In the second intervention period, we observed a rapidly increasing number of new cases daily, especially in August. From September, an increase was observed, being particularly marked from October to November 18. Since then, there was a decrease in the daily number of cases. CONCLUSION: The majority of the cases were asymptomatic or had a mild clinical presentation. The presence of chronic disease, a pathological physical chest examination, and procalcitonin levels of >0.05 ng/mL were identified as predictors of being moderate, severe, or critical in terms of clinical severity. Strict intervention measures seem to be effective in containing the spread of COVID-19.
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COVID-19/épidémiologie , Épidémies de maladies , Prévention des infections/tendances , SARS-CoV-2 , Centres de soins tertiaires , Adolescent , COVID-19/prévention et contrôle , Enfant , Enfant d'âge préscolaire , Femelle , Humains , Nourrisson , Nouveau-né , Mâle , Turquie/épidémiologieRÉSUMÉ
BACKGROUND: The COVID-19 pandemic has transformed the delivery of medical and surgical services globally. Subsequently, all elective and aesthetic procedures have been cancelled or deferred in accordance with government-mandated quarantine measures. The Cosmetic Surgery Governance Forum (CSGF) is a network of aesthetic plastic surgery consultants which has enabled a sharing of expertise during challenging times. We conducted a cross-sectional survey to assess the impact of the COVID-19 pandemic on aesthetic plastic surgeons and their practice in the UK. METHODS: On 15 June 2020, 131 respondents from the CSGF and wider aesthetic plastic surgeons in the UK were invited to respond to an online survey. An anonymised questionnaire was created using SmartSurveyTM and distributed at the end of the quarantine period. Questions regarding their current scope of practice, willingness to recommence face-to-face consultations, financial loss and psychological impact were asked. RESULTS: A total of 101 Consultant Plastic surgeons (76%) completed the questionnaire. If strict protocols and adequate personal protective equipment were available, 50-55% of respondents would consider offering non-surgical treatments as soon as the private clinic was open. Furthermore, 51% would consider procedures under general anaesthetic, whilst 89% of respondents would offer local anaesthetic only in the initial phase. Moreover, 66% reported experiencing a psychological impact and 100% of respondents reported a significant financial impact. CONCLUSIONS: This survey aims to give an account of the current state (May-July 2020) of aesthetic plastic surgery in the UK. There is ongoing uncertainty and deliberation regarding the timing and organisational changes required for aesthetic practice to restart.
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Attitude du personnel soignant , COVID-19/prévention et contrôle , Techniques cosmétiques/tendances , Types de pratiques des médecins/tendances , Chirurgiens/tendances , COVID-19/économie , Techniques cosmétiques/économie , Études transversales , Politique de santé , Humains , Prévention des infections/méthodes , Prévention des infections/tendances , Types de pratiques des médecins/économie , Quarantaine , Chirurgiens/économie , Chirurgiens/psychologie , Enquêtes et questionnaires , Royaume-UniRÉSUMÉ
INTRODUCTION: The COVID-19 pandemic has had a significant impact on Spanish hospitals, which have had to allocate all available resources to treat these patients, reducing the ability to attend other common pathologies. The aim of this study is to analyze how the treatment of acute appendicitis has been affected. METHOD: A national descriptive study was carried out by an online voluntary specific questionnaire with Google Drive™ distributed by email by the Spanish Association of Surgeons (AEC) to all affiliated surgeons currently working in Spain (5203), opened from April 14th to April 24th. RESULTS: We received 337 responses from 170 centers. During the first month of the pandemic, the incidence of acute appendicitis decreased. Although conservative management increased, the surgical option has been the most used in both simple and complicated appendicitis. Despite the fact that the laparoscopic approach continues to be the most widely used in our services, the open approach has increased during this pandemic period. CONCLUSION: Highlight the contribution of this study in terms of knowledge of the status of the treatment of acute appendicitis during this first month of the pandemic, being able to serve for a better possible organization in future waves of the pandemic and a reorganization of current protocols and management of acute appendicitis in a pandemic situation.
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Appendicectomie/tendances , Appendicite/thérapie , COVID-19/thérapie , Traitement conservateur/tendances , Rationnement des services de santé/tendances , Prévention des infections/tendances , Types de pratiques des médecins/tendances , Maladie aigüe , Appendicectomie/méthodes , Appendicite/complications , Appendicite/diagnostic , Appendicite/épidémiologie , COVID-19/complications , COVID-19/diagnostic , COVID-19/épidémiologie , Enquêtes sur les soins de santé , Humains , Incidence , Prévention des infections/méthodes , Laparoscopie/tendances , Pandémies , Espagne/épidémiologieSujet(s)
COVID-19/prévention et contrôle , Prévention des infections/organisation et administration , Pandémies/prévention et contrôle , Département hospitalier de chirurgie/organisation et administration , Chirurgie plastique/organisation et administration , COVID-19/diagnostic , COVID-19/épidémiologie , COVID-19/transmission , Dépistage de la COVID-19/normes , Dépistage de la COVID-19/statistiques et données numériques , Dépistage de la COVID-19/tendances , Égypte/épidémiologie , Interventions chirurgicales non urgentes/normes , Interventions chirurgicales non urgentes/statistiques et données numériques , Interventions chirurgicales non urgentes/tendances , Politique de santé , Humains , Prévention des infections/normes , Prévention des infections/statistiques et données numériques , Prévention des infections/tendances , /normes , /statistiques et données numériques , /tendances , SARS-CoV-2/isolement et purification , Département hospitalier de chirurgie/normes , Département hospitalier de chirurgie/statistiques et données numériques , Département hospitalier de chirurgie/tendances , Chirurgie plastique/normes , Chirurgie plastique/statistiques et données numériques , Chirurgie plastique/tendances , Télémédecine/organisation et administration , Télémédecine/normes , Télémédecine/statistiques et données numériques , Centres de soins tertiaires/organisation et administration , Centres de soins tertiaires/normes , Centres de soins tertiaires/statistiques et données numériques , Centres de soins tertiaires/tendances , Triage/organisation et administration , Triage/normes , Triage/statistiques et données numériques , Triage/tendancesRÉSUMÉ
BACKGROUND: Concerns exist regarding exacerbation of existing disparities in health care access with the rapid implementation of telemedicine during the coronavirus disease 2019 (COVID-19) pandemic. However, data on pre-existing disparities in telemedicine utilization is currently lacking. OBJECTIVE: We aimed to study: (1) the prevalence of outpatient telemedicine visits before the COVID-19 pandemic by patient subgroups based on age, comorbidity burden, residence rurality, and median household income; and (2) associated diagnosis categories. RESEARCH DESIGN: This was a retrospective cohort study. SUBJECT: Commercial claims data from the Truven MarketScan database (2014-2018) representing n=846,461,609 outpatient visits. MEASURES: We studied characteristics and utilization of outpatient telemedicine services before the COVID-19 pandemic by patient subgroups based on age, comorbidity burden, residence rurality, and median household income. Disparities were assessed in unadjusted and adjusted (regression) analyses. RESULTS: With overall telemedicine uptake of 0.12% (n=1,018,092/846,461,609 outpatient visits) we found that pre-COVID-19 disparities in telemedicine use became more pronounced over time with lower use in patients who were older, had more comorbidities, were in rural areas, and had lower median household incomes (all trends and effect estimates P<0.001). CONCLUSION: These results contextualize pre-existing disparities in telemedicine use and are crucial in the monitoring of potential disparities in telemedicine access and subsequent outcomes after the rapid expansion of telemedicine during the COVID-19 pandemic.
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Soins ambulatoires/tendances , COVID-19/thérapie , Accessibilité des services de santé/tendances , Disparités d'accès aux soins/statistiques et données numériques , Télémédecine/tendances , Adulte , COVID-19/épidémiologie , Humains , Prévention des infections/tendances , Mâle , Adulte d'âge moyen , Satisfaction des patients/statistiques et données numériques , Amélioration de la qualité , Études rétrospectivesRÉSUMÉ
BACKGROUND: The COVID-19 pandemic has strained the healthcare systems across the world but its impact on acute stroke care is just being elucidated. We hypothesized a major global impact of COVID-19 not only on stroke volumes but also on various aspects of thrombectomy systems. AIMS: We conducted a convenience electronic survey with a 21-item questionnaire aimed to identify the changes in stroke admission volumes and thrombectomy treatment practices seen during a specified time period of the COVID-19 pandemic. METHODS: The survey was designed using Qualtrics software and sent to stroke and neuro-interventional physicians around the world who are part of the Global Executive Committee (GEC) of Mission Thrombectomy 2020, a global coalition under the aegis of Society of Vascular and Interventional Neurology, between April 5th and May 15th, 2020. RESULTS: There were 113 responses to the survey across 25 countries with a response rate of 31% among the GEC members. Globally there was a median 33% decrease in stroke admissions and a 25% decrease in mechanical thrombectomy (MT) procedures during the COVID-19 pandemic period until May 15th, 2020 compared to pre-pandemic months. The intubation policy for MT procedures during the pandemic was highly variable across participating centers: 44% preferred intubating all patients, including 25% of centers that changed their policy to preferred-intubation (PI) from preferred non-intubation (PNI). On the other hand, 56% centers preferred not intubating patients undergoing MT, which included 27% centers that changed their policy from PI to PNI. There was no significant difference in rate of COVID-19 infection between PI versus PNI centers (p=0.60) or if intubation policy was changed in either direction (p=1.00). Low-volume (<10 stroke/month) compared with high-volume stroke centers (>20 strokes/month) were less likely to have neurointerventional suite specific written personal protective equipment protocols (74% vs 88%) and if present, these centers were more likely to report them to be inadequate (58% vs 92%). CONCLUSION: Our data provides a comprehensive snapshot of the impact on acute stroke care observed worldwide during the pandemic. Overall, respondents reported decreased stroke admissions as well as decreased cases of MT with no clear preponderance in intubation policy during MT. DATA ACCESS STATEMENT: The corresponding author will consider requests for sharing survey data. The study was exempt from institutional review board approval as it did not involve patient level data.
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COVID-19 , Santé mondiale/tendances , Disparités d'accès aux soins/tendances , Types de pratiques des médecins/tendances , Accident vasculaire cérébral/thérapie , Thrombectomie/tendances , Études transversales , Enquêtes sur les soins de santé , Hôpitaux à haut volume d'activité/tendances , Hôpitaux à faible volume d'activité/tendances , Humains , Prévention des infections/tendances , Intubation trachéale/tendances , Admission du patient/tendances , Accident vasculaire cérébral/diagnostic , Facteurs tempsRÉSUMÉ
BACKGROUND: Effective management of health emergencies is an important strategy to improve health worldwide. One way to manage health emergencies is to build and sustain national capacities. The Ebola epidemic of 2014 to 2015 resulted in greater infection prevention and control (IPC) capacity in Liberia, but few studies have investigated if and how that capacity was sustained. The purpose of this study was to examine the maintenance of IPC capacity in Liberia after Ebola. METHODS: For this case study, data were collected via direct observation of nurse practice, semistructured interviews, and document collection. Data were collected in two counties in Liberia. Data were analyzed using directed content and general thematic analysis using codes generated from the safety capital theoretical framework, which describes an organization's intangible occupational health resources. FINDINGS: Thirty-seven nurses from 12 facilities participated. Ebola was a seminal event in the development of safety capital in Liberia, particularly regarding nurse knowledge of IPC and facilities' investments in safety. The safety capital developed during Ebola is still being applied at the individual and organizational levels. Tangible resources, including personal protective equipment, however, have been depleted. CONCLUSIONS/APPLICATION TO PRACTICE: IPC capacity in Liberia had been sustained since Ebola but was threatened by under-investments in physical resources. Donor countries should prioritize sustained support, both financial and technical, in partnership with Liberian leaders. Occupational health nurses participating in disaster response should advocate for long-term investment by donor countries in personal protective equipment, access to water, and clinician training.
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Fièvre hémorragique à virus Ebola/prévention et contrôle , Prévention des infections/méthodes , Fièvre hémorragique à virus Ebola/transmission , Humains , Prévention des infections/normes , Prévention des infections/tendances , Entretiens comme sujet/méthodes , Liberia , Recherche qualitativeSujet(s)
COVID-19 , Accessibilité des services de santé/tendances , Transplantation pancréatique/tendances , COVID-19/épidémiologie , COVID-19/prévention et contrôle , Santé mondiale , Humains , Prévention des infections/méthodes , Prévention des infections/tendances , Transplantation pancréatique/méthodes , Pandémies , Soins périopératoires/méthodes , Soins périopératoires/tendances , Chirurgiens , Enquêtes et questionnairesRÉSUMÉ
ABSTRACT: In the last three decades, the dramatic worldwide increase in incidence and severity of Clostridioides difficile infection (CDI) (formerly Clostridium difficile infection) has made CDI a global public health challenge. Surgery is a known risk factor for development of CDI yet surgery is also a treatment option in severe cases of CDI. The World Society of Emergency Surgery guidelines for management of CDI in surgical patients were published in 2015. In 2019, the guidelines were revised and updated according to the grading of recommendations assessment, development and evaluation methodology. This executive summary is intended to consolidate knowledge on the management of CDI focusing on aspects that a general and emergency surgeon should know about the prevention and the management of CDI, by providing a practical and concise version of the original guidelines.
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Clostridioides difficile/pathogénicité , Infections à Clostridium/thérapie , Complications postopératoires/thérapie , Guides de bonnes pratiques cliniques comme sujet , Antibactériens/usage thérapeutique , Gestion responsable des antimicrobiens , Infections à Clostridium/diagnostic , Entérocolite pseudomembraneuse/étiologie , Entérocolite pseudomembraneuse/prévention et contrôle , Transplantation de microbiote fécal/méthodes , Transplantation de microbiote fécal/tendances , Humains , Incidence , Prévention des infections/méthodes , Prévention des infections/tendances , Facteurs de risque , Sociétés médicalesRÉSUMÉ
The first wave (FW) of COVID-19 led to a rapid reduction in total emergency department (ED) visits and hospital admissions for other diseases. Whether this represented a transient "lockdown and fear" phenomenon, or a more persisting trend, is unknown. We divided acute from post-wave changes in ED flows, diagnoses, and hospital admissions, in an Italian city experiencing a FW peak followed by nadir. This multicenter, retrospective, cross-sectional study involved five general EDs of a large Italian city (January-August 2020). Percent changes were calculated versus 2019, using four 14-day periods (FW peak, early/mid/late post-wave). ED visits were 147,446 in 2020, versus 214,868 in 2019. During the FW peak, visits were reduced by 66.4% (P < 0.001). The drop was maximum during daytime (69.8%) and for pediatric patients (89.4%). Critical triage codes were unchanged. Reductions were found for all non-COVID-19 diagnoses. Non-COVID-19 hospital admissions were reduced by 39.5% (P < 0.001), involving all conditions except hematologic, metabolic/endocrine, respiratory diseases, and traumas. In the early, mid, and late post-wave periods, visits were reduced by 25.4%, 25.3% and 23.5% (all P < 0.001) respectively. In the late period, reduction was greater for female (27.9%) and pediatric patients (44.6%). Most critical triage codes were unchanged. Oncological, metabolic/endocrine, and hematological diagnoses were unchanged, while other diagnoses had persistent reductions. Non-COVID-19 hospital admissions were reduced by 12.8% (P = 0.001), 6.3% (P = 0.1) and 12.2% (P = 0.001), respectively. Reductions in ED flows, led by non-critical codes, persisted throughout the summer nadir of COVID-19. Hospital admissions for non-COVID-19 diseases had transient changes.
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COVID-19/épidémiologie , COVID-19/thérapie , Service hospitalier d'urgences/tendances , Prévention des infections/tendances , Admission du patient/tendances , Maladies cardiovasculaires/épidémiologie , Études transversales , Hospitalisation/tendances , Humains , Italie , Troubles mentaux/épidémiologie , Infarctus du myocarde/épidémiologie , Maladies de l'appareil respiratoire/épidémiologie , Études rétrospectives , Plaies et blessures/épidémiologieRÉSUMÉ
COVID-19 is a global threat with an increasing number of infections. Research on IgG seroprevalence among health care workers (HCWs) is needed to re-evaluate health policies. This study was performed in three pandemic hospitals in Istanbul and Kocaeli. Different clusters of HCWs were screened for SARS-CoV-2 infection. Seropositivity rate among participants was evaluated by chemiluminescent microparticle immunoassay. We recruited 813 non-infected and 119 PCR-confirmed infected HCWs. Of the previously undiagnosed HCWs, 22 (2.7%) were seropositive. Seropositivity rates were highest for cleaning staff (6%), physicians (4%), nurses (2.2%) and radiology technicians (1%). Non-pandemic clinic (6.4%) and ICU (4.3%) had the highest prevalence. HCWs in "high risk" group had similar seropositivity rate with "no risk" group (2.9 vs 3.5 p = 0.7). These findings might lead to the re-evaluation of infection control and transmission dynamics in hospitals.
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COVID-19/épidémiologie , Personnel de santé/tendances , SARS-CoV-2/immunologie , COVID-19/immunologie , Hôpitaux/tendances , Humains , Prévention des infections/méthodes , Prévention des infections/tendances , Pandémies , Prévalence , Facteurs de risque , SARS-CoV-2/pathogénicité , Études séroépidémiologiques , Turquie/épidémiologieSujet(s)
COVID-19/prévention et contrôle , Endoscopie gastrointestinale/tendances , Gastroentérologie/tendances , Types de pratiques des médecins/tendances , COVID-19/épidémiologie , Endoscopie gastrointestinale/méthodes , Endoscopie gastrointestinale/normes , Prévision , Gastroentérologie/méthodes , Gastroentérologie/normes , Santé mondiale , Politique de santé , Humains , Prévention des infections/normes , Prévention des infections/tendances , Pandémies , Sécurité des patients , États-Unis/épidémiologieRÉSUMÉ
BACKGROUND: On the 19th of January, 2020, the Chief Medical Officer of Australia issued a statement about a novel coronavirus, or SARS-CoV-2. Since this date, there have been variable jurisdictional responses, including lockdowns, and restrictions on podiatry practice. This study aimed to describe impacts of the SARS-CoV-2 pandemic on the podiatry profession in Australia. METHODS: This was a cross sectional study of Australian podiatrists using demographic data collected between 2017 and 2020, and pandemic-related question responses collected between 30th March and 31st August, 2020. Data were collected online and participants described their work settings, patient funding types, business decisions and impacts, and information sources used to guide practice decisions during this time-period. Inductive thematic analysis was used to analyse open-ended questions about their practice impact of SARS-CoV-2. RESULTS: There were 732 survey responses, with 465 Australian podiatrists or podiatric surgeons providing responses describing pandemic impact. From these responses, 223 (49% of 453) podiatrists reported no supply issues, or having adequate supplies for the foreseeable future with personal protective equipment (PPE) or consumables to support effective infection prevention and control. The most frequent responses about employment, or hours of work, impact were reported in the various categories of "business as usual" (n = 312, 67%). Participants described most frequently using the local state and territory Department of Health websites (n = 347, 75%), and the Australian Podiatry Association (n = 334, 72%) to make decisions about their business. Overarching themes which resounded through open-ended comments was that working through the pandemic was likened to a marathon, and not a sprint. Themes were: (i) commitment to do this, (ii) it's all in the plan, but not everything goes to plan, (iii) my support team must be part of getting through it, (iv) road blocks happen, and (v) nothing is easy, what's next? CONCLUSION: Podiatrists in Australia reported variable pandemic impact on their business decisions, PPE stores, and their valued sources of information. Podiatrists also described their "marathon" journey through the pandemic to date, with quotes describing their challenges and highlights. Describing these experiences should provide key learnings for future workforce challenges, should further restrictions come into place.
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COVID-19/prévention et contrôle , Prévention des infections/tendances , Médecins/psychologie , Podologie/statistiques et données numériques , Types de pratiques des médecins/statistiques et données numériques , Adulte , Sujet âgé , Australie , Études transversales , Femelle , Enquêtes sur les soins de santé , Humains , Mâle , Adulte d'âge moyen , Médecins/statistiques et données numériques , SARS-CoV-2RÉSUMÉ
The Bronx, New York, is the poorest congressional district in the United States and has the highest COVID-19 infection rate in New York City. COVID-19 has led to major changes in our healthcare system, including heightened infection-control practices, novel staffing patterns and widespread social distancing. In this article, we describe how our experience with inpatient care has changed in the wake of COVID-19.
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COVID-19/prévention et contrôle , COVID-19/thérapie , Prestations des soins de santé/organisation et administration , Prévention des infections/méthodes , Prestations des soins de santé/tendances , Hospitalisation , Humains , Prévention des infections/tendances , New York (ville)RÉSUMÉ
BACKGROUND: This survey aimed to register changes determined by the COVID-19 pandemic on pancreatic surgery in a specific geographic area (Germany, Austria, and Switzerland) to evaluate the impact of the pandemic and obtain interesting cues for the future. METHODS: An online survey was designed using Google Forms focusing on the local impact of the pandemic on pancreatic surgery. The survey was conducted at 2 different time points, during and after the lockdown. RESULTS: Twenty-five respondents (25/56) completed the survey. Many aspects of oncological care have been affected with restrictions and delays: staging, tumor board, treatment selection, postoperative course, adjuvant treatments, outpatient care, and follow-up. Overall, 60% of respondents have prioritized pancreatic cancer patients according to stage, age, and comorbidities, and 40% opted not to operate high-risk patients. However, for 96% of participants, the standards of care were guaranteed. DISCUSSION/CONCLUSIONS: The first wave of the COVID-19 pandemic had an important impact on pancreatic cancer surgery in central Europe. Guidelines for prompt interventions and prevention of the spread of viral infections in the surgical environment are needed to avoid a deterioration of care in cancer patients in the event of a second wave or a new pandemic. High-volume centers for pancreatic surgery should be preferred and their activity maintained. Virtual conferences have proven to be efficient during this pandemic and should be implemented in the near future.