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1.
Am J Geriatr Psychiatry ; 28(12): 1299-1307, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33004262

RESUMO

OBJECTIVE: Family visits with residents at long-term care (LTC) facilities have been restricted during the COVID-19 pandemic. The objective was to examine what communication methods, other than in-person visits, during the pandemic were associated with greater positive and lower negative emotional experiences for LTC residents and their family members and friends. DESIGN: Cross-sectional. SETTING: Nationally targeted online survey. PARTICIPANTS: One hundred sixty-one community-dwelling adults who had a family member or friend in a LTC facility. MEASUREMENTS: The Positive and Negative Affect Scale was used to assess participant's own emotions and perceived resident emotions during the pandemic. Questions were asked about nine communication methods other than physical visits (e.g., phone, video-conference, e-mail, and letters) in terms of frequency of use during the pandemic. Sociodemographics, resident health, and facility factors were assessed and used as covariates where indicated. RESULTS: During the pandemic, greater phone frequency was associated with less participant negative emotions (ß = -0.17). Greater e-mail frequency was associated with more perceived resident positive emotions (ß = 0.28). Greater frequency of letters delivered by staff was associated with more participant negative emotions (ß = 0.23). Greater frequency of letters delivered by staff and the postal service were associated with more perceived resident negative emotions (ß = 0.28; ß = 0.34, respectively). CONCLUSION: These findings highlight the importance of synchronous, familiar methods of communication like the phone and email between families and LTC residents to maintain their emotional well-being when in-person visits are restricted.


Assuntos
Atitude do Pessoal de Saúde , Comunicação , Infecções por Coronavirus , Família/psicologia , Assistência de Longa Duração , Pandemias , Pneumonia Viral , Adulto , Idoso , Atitude Frente a Saúde , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Demência/psicologia , Inteligência Emocional , Feminino , Humanos , Controle de Infecções/métodos , Relações Interpessoais , Assistência de Longa Duração/organização & administração , Assistência de Longa Duração/psicologia , Assistência de Longa Duração/tendências , Masculino , Inovação Organizacional , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Instituições de Cuidados Especializados de Enfermagem/tendências , Inquéritos e Questionários , Visitas a Pacientes/psicologia
2.
BMC Geriatr ; 20(1): 421, 2020 10 22.
Artigo em Inglês | MEDLINE | ID: mdl-33092541

RESUMO

BACKGROUND: The COVID-19 pandemic is a significant public health emergency that impacts all sectors of healthcare. The negative health outcomes for the COVID-19 infection have been most severe in the frail elderly dwelling in Canadian long-term care (LTC) homes. METHODS: An online cross-sectional survey of Ontario LTC Clinicians working in LTC homes in Ontario Canada was conducted to provide the clinician perspective on the preparedness and engagement of the LTC sector during the COVID-19 pandemic. The survey questionnaire was developed in collaboration with the Ontario Long-Term Care Clinicians organization (OLTCC) and was distributed between March 30, 2020 to May 25, 2020. All registered members of the OLTCC and Nurse-led LTC Outreach Teams were invited to participate. The primary outcomes were: 1) the descriptive report of the screening measures implemented, communication and information received, and the preparation of the respondent's LTC home to a potential COVID-19 outbreak; and 2) the level of agreement, as reported using a five-point Likert scale), to COVID-19 preparedness statements for the respondent's LTC home was also assessed. RESULTS: The overall response rate was 54% (160/294). LTC homes implemented a wide range of important interventions (e.g. instituting established respiratory isolation protocols, active screening of new LTC admissions, increasing education on infection control processes, encouraging sick staff to take time off, etc). Ample communications pertinent to the pandemic were received from provincial LTC organizations, the government and public health officials. However, the feasibility of implementing public health recommendations, as well as the engagement of the LTC sector in pandemic planning were identified as areas of concern. Medical director status was associated with an increased knowledge of local implementation of interventions to mitigate COVID-19, as well as endorsing increased access to reliable COVID-19 information and resources to manage a potential COVID-19 outbreak in their LTC home. CONCLUSIONS: This study highlights the communication and implementation of recommendations in the Ontario LTC sector, despite some concerns regarding feasibility. Importantly, LTC clinician respondents clearly indicated that better engagement with LTC leaders is needed to plan a coordinated pandemic response.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pessoal de Saúde/psicologia , Casas de Saúde/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Adulto , Idoso , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Feminino , Pesquisas sobre Serviços de Saúde , Pessoal de Saúde/estatística & dados numéricos , Humanos , Assistência de Longa Duração/organização & administração , Masculino , Pessoa de Meia-Idade , Ontário/epidemiologia , Pneumonia Viral/epidemiologia , Adulto Jovem
5.
J Am Med Dir Assoc ; 21(10): 1378-1383.e1, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32981664

RESUMO

OBJECTIVE: To describe clinical characteristics and risk factors associated with coronavirus disease 2019 (COVID-19) in long-stay nursing home residents. DESIGN AND PARTICIPANTS: Retrospective cohort study (March 16, 2020 to May 8, 2020). SETTING: Academic long-term chronic care facility (Boston, MA). PARTICIPANTS: Long-term care residents. METHODS: Patient characteristics and clinical symptoms were obtained via electronic medical records and Minimum Data Set. Staff residence was inferred by zip codes. COVID-19 infection was confirmed by polymerase chain reaction testing using nasopharyngeal swabs. Residents were followed until discharge from facility, death, or up to 21 days. Risks of COVID-19 infection were modeled by generalized estimating equation to estimate the relative risk (RR) and 95% confidence intervals (CI) of patient characteristics and staff community of residence. RESULTS: Overall 146 of 389 (37.5%) long-stay residents tested positive for COVID-19. At the time of positive test, 66 of 146 (45.5%) residents were asymptomatic. In the subsequent illness course, the most common symptom was anorexia (70.8%), followed by delirium (57.6%). During follow-up, 44 (30.1%) of residents with COVID-19 died. Mortality increased with frailty (16.7% in pre-frail, 22.2% in moderately frail, and 50.0% in frail; P < .001). The proportion of residents infected with COVID-19 varied across the long-term care units (range: 0%‒90.5%). In adjusted models, male sex (RR 1.80, 95% CI 1.07, 3.05), bowel incontinence (RR 1.97, 95% CI 1.10, 3.52), and staff residence remained significant predictors of COVID-19. For every 10% increase in the proportion of staff living in a high prevalence community, the risk of testing positive increased by 6% (95% CI 1.04, 1.08). CONCLUSIONS AND IMPLICATIONS: Among long-term care residents diagnosed with COVID-19, nearly one-half were asymptomatic at the time of diagnosis. Predictors of COVID-19 infection included male sex, bowel incontinence, and staff residence in a community with a high burden of COVID-19. Universal testing of patients and staff in communities with high COVID-19 rates is essential to mitigate outbreaks.


Assuntos
Betacoronavirus , Técnicas de Laboratório Clínico , Infecções por Coronavirus/mortalidade , Idoso Fragilizado/estatística & dados numéricos , Assistência de Longa Duração/organização & administração , Casas de Saúde/organização & administração , Pneumonia Viral/mortalidade , Fatores Etários , Idoso , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Feminino , Humanos , Masculino , Pandemias , Pneumonia Viral/terapia , Estudos Retrospectivos , Fatores de Risco
6.
Eur J Public Health ; 30(Supplement_4): iv22-iv27, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32894300

RESUMO

The present study explores the situation of migrant carers in long-term care (LTC) in European Union Member States and the disruptions caused by the COVID-19 pandemic from a public health perspective. The aim is to bring LTC migrant carers into health workforce research and highlight a need for trans-sectoral and European heath workforce governance. We apply an exploratory approach based on secondary sources, document analysis and expert information. A framework comprising four major dimensions was developed for data collection and analysis: LTC system, LTC health labour market, LTC labour migration policies and specific LTC migrant carer policies during the COVID-19 crisis March to May 2020. Material from Austria, Italy, Germany, Poland and Romania was included in the study. Results suggest that undersupply of carers coupled with cash benefits and a culture of family responsibility may result in high inflows of migrant carers, who are channelled in low-level positions or the informal care sector. COVID-19 made the fragile labour market arrangements of migrant carers visible, which may create new health risks for both the individual carer and the population. Two important policy recommendations are emerging: to include LTC migrant carers more systematically in public health and health workforce research and to develop European health workforce governance which connects health system needs, health labour markets and the individual migrant carers.


Assuntos
Cuidadores/psicologia , Emigração e Imigração , Pessoal Profissional Estrangeiro , Mão de Obra em Saúde , Assistência de Longa Duração , Política Pública , Betacoronavirus , Infecções por Coronavirus , Europa (Continente) , União Europeia , Governo , Serviços de Saúde para Idosos/organização & administração , Humanos , Assistência de Longa Duração/organização & administração , Pandemias , Pneumonia Viral , Saúde Pública
7.
J Am Med Dir Assoc ; 21(9): 1186-1190, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32859298

RESUMO

The COVID-19 pandemic has disproportionately affected residents and staff at long-term care (LTC) and other residential facilities in the United States. The high morbidity and mortality at these facilities has been attributed to a combination of a particularly vulnerable population and a lack of resources to mitigate the risk. During the first wave of the pandemic, the federal and state governments received urgent calls for help from LTC and residential care facilities; between March and early June of 2020, policymakers responded with dozens of regulatory and policy changes. In this article, we provide an overview of these responses by first summarizing federal regulatory changes and then reviewing state-level executive orders. The policy and regulatory changes implemented at the federal and state levels can be categorized into the following 4 classes: (1) preventing virus transmission, which includes policies relating to visitation restrictions, personal protective equipment guidance, and testing requirements; (2) expanding facilities' capacities, which includes both the expansion of physical space for isolation purposes and the expansion of workforce to combat COVID-19; (3) relaxing administrative requirements, which includes measures enacted to shift the attention of caretakers and administrators from administrative requirements to residents' care; and (4) reporting COVID-19 data, which includes the reporting of cases and deaths to residents, families, and administrative bodies (such as state health departments). These policies represent a snapshot of the initial efforts to mitigate damage inflicted by the pandemic. Looking ahead, empirical evaluation of the consequences of these policies-including potential unintended effects-is urgently needed. The recent availability of publicly reported COVID-19 LTC data can be used to inform the development of evidence-based regulations, though there are concerns of reporting inaccuracies. Importantly, these data should also be used to systematically identify hot spots and help direct resources to struggling facilities.


Assuntos
Infecções por Coronavirus/prevenção & controle , Assistência de Longa Duração/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Instituições Residenciais/legislação & jurisprudência , Instituições Residenciais/organização & administração , Moradias Assistidas/organização & administração , Betacoronavirus , Governo Federal , Programas Governamentais/organização & administração , Humanos , Assistência de Longa Duração/legislação & jurisprudência , Casas de Saúde/organização & administração , Qualidade da Assistência à Saúde , Estados Unidos
8.
Front Health Serv Manage ; 37(1): 20-26, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32842085

RESUMO

COVID-19 will remain a threat to millions of older adults for the foreseeable future, challenging healthcare providers to find successful ways to address this population's special needs. Thanks to well-defined core values and an experienced and innovative team of colleagues, Trinity Health's Continuing Care division has been able to adroitly support thousands of older adults throughout the COVID-19 pandemic. Our response has also included working to maintain the safety and well-being of thousands of staff who serve in this space every day. The pandemic is less than a year old, yet we have learned lessons that an organization typically takes many years to learn, and we are pleased to share them here. One of the greatest lessons is that, to best respond to a pandemic, everyone in an organization should have a clear understanding of purpose and strategy. In other words, know why you exist and what you need to do to weather the unknown until a vaccine or cure is available for all.


Assuntos
Continuidade da Assistência ao Paciente/organização & administração , Infecções por Coronavirus/terapia , Assistência à Saúde/organização & administração , Assistência de Longa Duração/organização & administração , Pneumonia Viral/terapia , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Feminino , Humanos , Masculino , Michigan , Pessoa de Meia-Idade , Pandemias/prevenção & controle
9.
Geriatr Gerontol Int ; 20(7): 715-719, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32634849

RESUMO

AIM: To clarify the association of cluster number and size of coronavirus disease 2019 (COVID-19) in long-term care (LTC) hospitals/facilities, general medical/welfare facilities and non-medical/welfare facilities with morbidity and mortality in 47 prefectures during 16 January to 9 May 2020 in Japan. METHODS: Information on COVID-19 clusters (n ≥2), and morbidity and mortality of COVID-19 was collected. RESULTS: A total of 381 clusters with 3786 infected cases were collected, accounting for 23.9% of 15 852 cumulated cases on 9 May 2020. Although the cluster number (/107 subjects) in LTC hospitals/facilities was significantly smaller compared with those in the other two groups, the cluster size in LTC hospitals/facilities was significantly larger than that in non-medical/welfare facilities. Cluster numbers in general medical/welfare facilities and in non-medical/welfare facilities were significantly positively correlated with morbidity (/105 ), indicating relatively early identification of clusters in these facilities. Unlike in these facilities, cluster size in LTC hospitals/facilities was significantly positively correlated with morbidity, indicating that clusters in LTC hospitals/facilities were finally identified after already having grown to a large size in areas where infection was prevalent. Multivariate logistic regression analysis showed that both cluster number and cluster size only in LTC hospitals/facilities were independently associated with higher mortality (≥median 0.64/105 subjects) after adjustment. CONCLUSIONS: Preventive efforts against COVID-19 outbreaks even at the early phase of the epidemic are critically important in LTC hospitals/facilities, as both the larger number and size of clusters only in LTC hospitals/facilities were independently linked to higher mortality in prefectures in Japan. Geriatr Gerontol Int 2020; 20: 715-719.


Assuntos
Infecções por Coronavirus , Hospitais de Doenças Crônicas/estatística & dados numéricos , Assistência de Longa Duração , Pandemias , Pneumonia Viral , Instituições de Cuidados Especializados de Enfermagem/estatística & dados numéricos , Idoso , Betacoronavirus/isolamento & purificação , Análise por Conglomerados , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/prevenção & controle , Feminino , Humanos , Controle de Infecções/organização & administração , Japão/epidemiologia , Assistência de Longa Duração/métodos , Assistência de Longa Duração/organização & administração , Assistência de Longa Duração/tendências , Masculino , Mortalidade , Pandemias/prevenção & controle , Pneumonia Viral/mortalidade , Pneumonia Viral/prevenção & controle
10.
J Am Med Dir Assoc ; 21(7): 888-892, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32674814

RESUMO

To provide policy recommendations for managing Coronavirus 19 (COVID-19) in skilled nursing facilities, a group of certified medical directors from several facilities in New York state with experience managing the disease used e-mail, phone, and video conferencing to develop consensus recommendations. The resulting document provides recommendations on screening, protection of staff, screening of residents, management of Coronavirus 19 positive and presumed positive cases, communication during an outbreak, management of admissions and readmissions, and providing emotional support for staff. These consensus guidelines have been endorsed by the Executive Board of the New York Medical Directors Association and the Board of the Metropolitan Area Geriatrics Society.


Assuntos
Doenças Transmissíveis Emergentes/terapia , Infecções por Coronavirus/epidemiologia , Assistência de Longa Duração/organização & administração , Pneumonia Viral/epidemiologia , Guias de Prática Clínica como Assunto , Instituições de Cuidados Especializados de Enfermagem/organização & administração , Cuidados Semi-Intensivos/organização & administração , Idoso , Doenças Transmissíveis Emergentes/epidemiologia , Infecções por Coronavirus/terapia , Gerenciamento Clínico , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , New York , Pandemias/estatística & dados numéricos , Pneumonia Viral/terapia , Formulação de Políticas , Política Pública/legislação & jurisprudência
12.
J Am Med Dir Assoc ; 21(7): 943-947, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32674824

RESUMO

Residents in long-term care settings are particularly vulnerable to COVID-19 infections and, compared to younger adults, are at higher risk of poor outcomes and death. Given the poor prognosis of resuscitation outcomes for COVID-19 in general, the specter of COVID-19 in long-term care residents should prompt revisiting goals of care. Visitor restriction policies enacted to reduce the risk of transmission of COVID-19 to long-term care residents requires advance care planning discussions to be conducted remotely. A structured approach can help guide discussions regarding the diagnosis, expected course, and care of individuals with COVID-19 in long-term care settings. Information should be shared in a transparent and comprehensive manner to allay the increased anxiety that families may feel during this time. To achieve this, we propose an evidence-based COVID-19 Communication and Care Planning Tool that allows for an informed consent process and shared decision making between the clinician, resident, and their family.


Assuntos
Infecções por Coronavirus/prevenção & controle , Tomada de Decisão Compartilhada , Planejamento em Saúde/organização & administração , Assistência de Longa Duração/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Instituições de Cuidados Especializados de Enfermagem/organização & administração , Adulto , Planejamento Antecipado de Cuidados/organização & administração , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Controle de Infecções/organização & administração , Comunicação Interdisciplinar , Masculino , Pessoa de Meia-Idade , Pandemias/estatística & dados numéricos , Equipe de Assistência ao Paciente/organização & administração , Pneumonia Viral/epidemiologia , Desenvolvimento de Programas , Análise de Sobrevida , Estados Unidos
13.
Circ Arrhythm Electrophysiol ; 13(7): e009007, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32692972
15.
Ig Sanita Pubbl ; 76(1): 9-18, 2020.
Artigo em Italiano | MEDLINE | ID: mdl-32668446

RESUMO

ClinicFolder is a multilingual web application that facilitates communication and follow-up between health workers and assisted through Tele assistance, video consultation, and sending e-mails. Allows home surveillance thanks to the integration of special low-cost self-analysis medical devices to maximize the prevention and effectiveness of clinical intervention in Long Term Care. A system that, applied on a large scale, will contribute to the reduction of hospital admissions and medical expenses, improving the quality of life of its users, allowing assisted patients, doctors and participating health structures to collect and organize in a guided, simple and inviolable way, thanks to the use of advanced cryptography systems, the citizen's clinical history: from the physiological, family, work history to all specialist examinations, from diagnostic reports to the periodic check of vital parameters (pressure, temperature, heart rate, saturation ), blood sugar, cholesterol, triglycerides, with automatic calculation of the cardiovascular risk factor index and BMI, etc. also with graphic display of the data and with the possibility of integrating medical devices for the automatic acquisition of the parameters and for monitoring the patient in his own environment.


Assuntos
Comunicação , Pessoal de Saúde/psicologia , Assistência de Longa Duração/organização & administração , Qualidade de Vida , Telemedicina , Humanos , Assistência de Longa Duração/tendências
16.
N C Med J ; 81(4): 257-258, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32641462

RESUMO

Our population is rapidly aging and increasingly identifying as transgender or non-binary (TNB). Are our health care and long-term care systems prepared to provide person-centered care to aging TNB people?


Assuntos
Envelhecimento , Equidade em Saúde , Pessoas Transgênero , Assistência à Saúde/organização & administração , Feminino , Humanos , Assistência de Longa Duração/organização & administração , Masculino , North Carolina , Assistência Centrada no Paciente
17.
J Am Med Dir Assoc ; 21(7): 885-887, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32674813

RESUMO

Our nation's nursing home industry has been in need of overhaul for decades-a situation made all the more evident by COVID-19. AMDA-The Society for Post-Acute and Long-Term Care Medicine is dedicated to quality in post-acute and long-term care process and outcomes. This special article presents 5 keys to solving the COVID-19 crisis in post-acute and long-term care, related to policy, collaboration, individualization, leadership, and reorganization. Taking action during this crisis may prevent sinking back into the complacency and habits of our pre-COVID-19 lives.


Assuntos
Infecções por Coronavirus/epidemiologia , Liderança , Assistência de Longa Duração/organização & administração , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Cuidados Semi-Intensivos/organização & administração , Idoso , Infecções por Coronavirus/terapia , Assistência à Saúde/organização & administração , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde , Casas de Saúde/organização & administração , Inovação Organizacional , Pneumonia Viral/terapia , Desenvolvimento de Programas , Instituições de Cuidados Especializados de Enfermagem/organização & administração , Estados Unidos
18.
J Clin Nurs ; 29(17-18): 3425-3434, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32562434

RESUMO

AIMS AND OBJECTIVES: To explore the relationship between personality traits, caring characteristics and abuse tendency among professional caregivers of older people with dementia in long-term care facilities in China. BACKGROUND: Elder abuse is a serious global health problem and human right violation with high incidence among older people with dementia. There are many investigations about impact factors of risk of abuse among family caregivers of older people with dementia. However, in long-term care facilities, the situation of abuse tendency needs further investigation. DESIGN: Cross-sectional study. METHODS: An observational survey was conducted according to the STROBE checklist. We investigated 156 professional caregivers of older people with dementia in three long-term care facilities in Guangzhou, China. Participants completed a demographic questionnaire, the Caregiver Abuse Screen (CASE) and the Neuroticism Extraversion Openness Five-Factor Inventory (NEO-FFI). Data were analysed using Mann-Whitney U tests, Kruskal-Wallis tests, Spearman's rank correlation and logistic regression analyses. RESULTS: Over half of the participants (51.9%) reported abuse tendency to the older people with dementia. There was a significant negative correlation between the caregivers' agreeableness scores of NEO-FFI and their CASE scores. Multivariate logistic regression analyses highlighted that protective factors of abuse tendency were caregivers' agreeableness, care recipients' source of finances and their duration of dementia while higher care difficulty and presence of older people's behavioural and psychological symptoms of dementia (BPSD) were the risk factors. CONCLUSION: Caregivers' agreeableness personality trait and the caring characteristics of older people with dementia may be relevant to abuse tendency in long-term care facilities. Further study with a larger sample size is needed to validate such a correlation. RELEVANCE TO CLINICAL PRACTICE: Older people with dementia are at high risk for abuse. Prospective caregivers could pay more attention to developing their own agreeableness. The managers might establish monitoring system for reducing the abuse.


Assuntos
Cuidadores/psicologia , Demência/terapia , Maus-Tratos ao Idoso/psicologia , Personalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Cuidadores/estatística & dados numéricos , China , Estudos Transversais , Maus-Tratos ao Idoso/estatística & dados numéricos , Feminino , Humanos , Assistência de Longa Duração/organização & administração , Masculino , Pessoa de Meia-Idade , Testes de Personalidade , Fatores de Risco , Instituições de Cuidados Especializados de Enfermagem/organização & administração , Inquéritos e Questionários
19.
J Am Med Dir Assoc ; 21(7): 939-942, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32563752

RESUMO

The COVID-19 pandemic is devastating post-acute and long-term care (PA/LTC). As geriatricians practicing in PA/LTC and a regional academic medical center, we created this program for collaboration between academic medical centers and regional PA/LTC facilities. The mission of the Geriatric Engagement and Resource Integration in Post-Acute and Long-Term Care Facilities (GERI-PaL) program is to support optimal care of residents in PA/LTC facilities during the COVID-19 pandemic. There are 5 main components of our program: (1) Project ECHO; (2) nursing liaisons; (3) infection advisory consultation; (4) telemedicine consultation; and (5) resident social contact remote connections. Implementation of this program has had positive response from our local PA/LTC facilities. A key component of our program is our interprofessional team, which includes physicians and nursing, emergency response, and public health experts. With diverse professional backgrounds, our team members have created a new model for academic medical centers to collaborate with local PA/LTC facilities.


Assuntos
Centros Médicos Acadêmicos/organização & administração , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Instituições de Cuidados Especializados de Enfermagem/organização & administração , Idoso , Feminino , Geriatras/organização & administração , Geriatria/organização & administração , Humanos , Comunicação Interdisciplinar , Assistência de Longa Duração/organização & administração , Masculino , Casas de Saúde/organização & administração , Avaliação de Resultados em Cuidados de Saúde , Pandemias , Equipe de Assistência ao Paciente/organização & administração , Avaliação de Programas e Projetos de Saúde , Consulta Remota/organização & administração , Medição de Risco , Telemedicina/organização & administração , Estados Unidos
20.
J Am Coll Surg ; 231(3): 316-324.e1, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32561446

RESUMO

BACKGROUND: Washington State experienced the first major outbreak of COVID-19 in the US and despite a significant number of cases, has seen a relatively low death rate per million population compared with other states with major outbreaks, and has seen a substantial decrease in the projections for healthcare use, that is, "flattening the curve." This consensus report seeks to identify the key factors contributing to the effective health system disaster response in western WA. METHODS: A multidisciplinary, expert panel including individuals and organizations who were integral to managing the public health and emergency healthcare system response were engaged in a consensus process to identify the key themes and lessons learned and develop recommendations for ongoing management of the COVID-19 pandemic. RESULTS: Six key themes were identified, including early communication and coordination among stakeholders; regional coordination of the healthcare system response; rapid development and access to viral testing; proactive management of long-term care and skilled nursing facilities; proactive management of vulnerable populations; and effective physical distancing in the community. CONCLUSIONS: Based on the lessons learned in each of the areas identified by the panel, 11 recommendations are provided to support the healthcare system disaster response in managing future outbreaks.


Assuntos
Betacoronavirus , Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Assistência à Saúde/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Comunicação , Infecções por Coronavirus/diagnóstico , Serviços Médicos de Emergência/organização & administração , Humanos , Assistência de Longa Duração/organização & administração , Pneumonia Viral/diagnóstico , Participação dos Interessados , Washington/epidemiologia
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