Hospital response challenges and strategies during COVID-19 pandemic: a qualitative study.

Background: At the beginning of the COVID-19 pandemic, healthcare managers at hospitals did not have sufficient experiences to appropriately respond to the COVID-19 outbreak. Due to a lack of preparedness, many challenges arose in the healthcare system, and each country developed and implemented strategies depending on national policies. This study aimed to understand challenges during the COVID-19 pandemic and strategies used in Iranian hospitals. Methods: A qualitative research was conducted in four hospitals in an urban area of Iran. In-depth semi-structured interviews were performed with 32 participants including healthcare managers, nurses, and medical doctors. Data underwent qualitative content analysis. Results: Four categories were developed: 'capacity expansion', 'management affairs', 'diagnostic services," and therapeutic services'. Each category consisted of 2-3 subcategories. Conclusion: Hospitals should be prepared to intelligently respond to future epidemics. It is necessary to develop a comprehensive epidemic plan for the management of disasters to reduce the impact of the epidemic and minimize the risk to public health and ensure that resources are allocated in an efficient and effective manner.

Inner Lumen Tracheostomy Tube Capable of Continuous Monitoring of Cuff Pressure.

Tracheostomy is one of the most important airway management procedures in patients with respiratory problems. This procedure might be the only option for patients with airway and respiratory problems, who are not able to have an appropriate ventilation and oxygenation. For this purpose, tracheostomy tubes are used with different applications. One of these types of tubes is the cuffed tracheostomy tube, used for fixation, positive pressure ventilation and aspiration prevention. Nevertheless, there are two common problems with using these regular tracheostomy tubes. First, these tracheostomy tubes do not have a unique cuff pressure monitoring system. Although there are portable monitoring devices for such purpose in intensive care units (ICU), they are shared among several patients, increasing the risk of infection transmission. Second, due to the presence of the patient's thick secretions, the tracheostomy tube becomes obstructed and inefficient. The pathway does not get open even through suction and thus the tracheostomy tube must be replaced. In order to resolve these problems, the inner lumen tracheostomy tube capable of continuous monitoring of cuff pressure has been invented with two techniques, which set it apart from other related tools. The invented optimized tracheostomy tube has been developed with different techniques through creating a disposable monometer system attached to it as well as a removable inner lumen embedded in it.