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1.
J Nurs Adm ; 50(12): e12-e13, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33181603

RESUMO

Innovation has enabled organizations to highlight and engage during the COVID -19 pandemic. The use of virtual site visits to assess the organizations 's culture and sustainability of the Magnet components during initial designation and redesignation allows for ongoing support of nursing excellence.


Assuntos
American Nurses' Association/organização & administração , Credenciamento/organização & administração , Serviço Hospitalar de Enfermagem/normas , Inovação Organizacional , Garantia da Qualidade dos Cuidados de Saúde/normas , Infecções por Coronavirus , Humanos , Recursos Humanos de Enfermagem no Hospital , Pandemias , Pneumonia Viral , Estados Unidos
2.
BMC Med Educ ; 20(1): 400, 2020 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-33138818

RESUMO

BACKGROUND: COVID - 19 pandemic pressured medical schools globally to shift to Distance learning (DL) as an alternative way to ensure that the content delivered is satisfactory for student progression. AIM OF THE WORK: This work aims at mapping priorities for post-COVID planning for better balance between distance learning and face to face learning. METHODS: This qualitative study aimed to develop a model for utilizing DL using The Polarity Approach for Continuity and Transformation (PACT)™. A virtual mapping session was held with 79 faculty from 19 countries. They worked in small groups to determine upsides and downsides of face-to-face and DL subsequently. An initial polarity map was generated identifying five tension areas; Faculty, Students, Curriculum, Social aspects and Logistics. A 63-item assessment tool was generated based on this map, piloted and then distributed as a self-administered assessment. The outcomes of this assessment were utilized for another mapping session to discuss warning signs and action steps to maintain upsides and avoid downsides of each pole. RESULTS: Participants agreed that face-to-face teaching allows them to inspire students and have meaningful connections with them. They also agreed that DL provides a good environment for most students. However, students with financial challenges and special needs may not have equal opportunities to access technology. As regards social issues, participants agreed that face-to-face learning provides a better chance for professionalism through enhanced team-work. Cognitive, communication and clinical skills are best achieved in face-to-face. Participants agreed that logistics for conducting DL are much more complicated when compared to face-to-face learning. Participants identified around 10 warning signs for each method that need to be continuously monitored in order to minimize the drawbacks of over focusing on one pole at the expense of the other. Action steps were determined to ensure optimized use of in either method. CONCLUSION: In order to plan for the future, we need to understand the dynamics of education within the context of polarities. Educators need to understand that the choice of DL, although was imposed as a no-alternative solution during the COVID era, yet it has always existed as a possible alternative and will continue to exist after this era. The value of polarity mapping and leveraging allows us to maximize the benefit of each method and guide educators' decisions to minimize the downsides for the good of the learning process.


Assuntos
Competência Clínica , Infecções por Coronavirus/prevenção & controle , Educação a Distância/métodos , Educação a Distância/estatística & dados numéricos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Controle de Doenças Transmissíveis/organização & administração , Estudos Transversais , Currículo , Educação de Graduação em Medicina/organização & administração , Feminino , Humanos , Masculino , Inovação Organizacional , Pandemias/estatística & dados numéricos , Pesquisa Qualitativa , Faculdades de Medicina/organização & administração , Estudantes de Medicina/psicologia
3.
Can Fam Physician ; 66(10): 745-747, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33077454
5.
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
6.
BMJ Case Rep ; 13(10)2020 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-33028570

RESUMO

In March 2020, a 74-year-old man affected by end-stage renal disease and on peritoneal dialysis was referred to an emergency room in Modena, Northern Italy, due to fever and respiratory symptoms. After ruling out COVID-19 infection, a diagnosis of chronic obstructive pulmonary disease exacerbation was confirmed and he was thus transferred to the nephrology division. Physical examination and blood tests revealed a positive fluid balance and insufficient correction of the uraemic syndrome, although peritoneal dialysis prescription was maximised. After discussion with the patient and his family, the staff decided to start hybrid dialysis, consisting of once-weekly in-hospital haemodialysis and home peritoneal dialysis for the remaining days. He was discharged at the end of the antibiotic course, after an internal jugular vein central venous catheter placement and the first haemodialysis session. This strategy allowed improvement of depuration parameters and avoidance of frequent access to the hospital, which is crucial in limiting exposure to SARS-CoV-2 in an endemic setting.


Assuntos
Infecções por Coronavirus , Falência Renal Crônica , Pandemias , Diálise Peritoneal/métodos , Pneumonia Viral , Doença Pulmonar Obstrutiva Crônica , Diálise Renal/métodos , Idoso , Antibacterianos/administração & dosagem , Betacoronavirus , Terapia Combinada/métodos , Terapia Combinada/tendências , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Diagnóstico Diferencial , Unidades Hospitalares de Hemodiálise , Humanos , Controle de Infecções/métodos , Falência Renal Crônica/diagnóstico , Falência Renal Crônica/fisiopatologia , Falência Renal Crônica/terapia , Masculino , Inovação Organizacional , Pandemias/prevenção & controle , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Exacerbação dos Sintomas
7.
Health Aff (Millwood) ; 39(10): 1752-1761, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33017237

RESUMO

Safety-net programs improve health for low-income children over the short and long term. In September 2018 the Trump administration announced its intention to change the guidance on how to identify a potential "public charge," defined as a noncitizen primarily dependent on the government for subsistence. After this change, immigrants' applications for permanent residence could be denied for using a broader range of safety-net programs. We investigated whether the announced public charge rule affected the share of children enrolled in Medicaid, the Supplemental Nutrition Assistance Program, and the Special Supplemental Nutrition Program for Women, Infants, and Children, using county-level data. Results show that a 1-percentage-point increase in a county's noncitizen share was associated with a 0.1-percentage-point reduction in child Medicaid use. Applied nationwide, this implies a decline in coverage of 260,000 children. The public charge rule was adopted in February 2020, just before the coronavirus disease 2019 (COVID-19) pandemic began in the US. These results suggest that the Trump administration's public charge announcement could have led to many thousands of eligible, low-income children failing to receive safety-net support during a severe health and economic crisis.


Assuntos
Serviços de Saúde da Criança/organização & administração , Infecções por Coronavirus/prevenção & controle , Assistência Alimentar/estatística & dados numéricos , Disparidades em Assistência à Saúde/economia , Medicaid/economia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pobreza/estatística & dados numéricos , Adolescente , Criança , Saúde da Criança , Pré-Escolar , Estudos de Coortes , Infecções por Coronavirus/epidemiologia , Bases de Dados Factuais , Medo , Feminino , Política de Saúde/legislação & jurisprudência , Humanos , Cobertura do Seguro/estatística & dados numéricos , Masculino , Inovação Organizacional , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Formulação de Políticas , Estudos Retrospectivos , Provedores de Redes de Segurança/organização & administração , Estados Unidos
9.
Rev Bras Epidemiol ; 23: e200100, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-33053093

RESUMO

OBJECTIVE: The assessment of the degree to which health professionals, workers and organizations are ready to implement changes in health services deserves special attention, especially related to new technologies, public policies and innovation. The objectives of this study were to conduct a Brazilian Portuguese Brazil cross-cultural adaptation of the ORIC questionnaire and to initiate the study of its psychometric properties. METHODS: Through a cross-sectional study, the Organizational Readiness for Implementing Change (ORIC) questionnaire, containing 12 questions, was translated and later applied to a sample of workers from traditional primary health care units undergoing transformation to family health units. Statistical analysis included Cronbach's alpha, exploratory and confirmatory factor analysis by structural equation model using the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. RESULTS: Workers from ten health units participated in the study (n = 150). The analysis confirmed two main factors (Effectiveness and Commitment) with Eigenvalues > 1. Rotation by the orthogonal method showed that the instrument questions confirmed the factors analyzed by the original instrument. The total Cronbach's Alpha of ORIC was 0.94, showing excellent reliability. CONCLUSION: The Brazilian Portuguese Brazil version of the ORIC-Br questionnaire showed good psychometric properties and can be used in health services to measure organizational readiness, considered as an indicator of the potential success in implementing change.


Assuntos
Comparação Transcultural , Inovação Organizacional , Psicometria/estatística & dados numéricos , Inquéritos e Questionários/normas , Brasil , Estudos Transversais , Humanos , Portugal , Reprodutibilidade dos Testes
12.
Chron Respir Dis ; 17: 1479973120961843, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33000640

RESUMO

The spread of the SARS-CoV-2 infection among population has imposed a re-organization of healthcare services, aiming at stratifying patients and dedicating specific areas where patients with suspected COVID-related respiratory disease could receive the necessary health care assistance while waiting for the confirmation of the diagnosis of COVID-19 disease. In this scenario, the pathway defined as a "grey zone" is strongly advocated. We describe the application of rules and pathways in a regional context with low diffusion of the infection among the general population in the attempt to provide the best care to respiratory patients with suspected COVID-19. To date, this process has avoided the worst-case scenario of intra-hospital epidemic outbreak.


Assuntos
Infecções por Coronavirus , Procedimentos Clínicos/tendências , Controle de Infecções/métodos , Pandemias , Administração dos Cuidados ao Paciente , Pneumonia Viral , Doenças Respiratórias/diagnóstico , Idoso , Betacoronavirus , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/terapia , Diagnóstico Diferencial , Feminino , Humanos , Itália/epidemiologia , Masculino , Inovação Organizacional , Pandemias/prevenção & controle , Administração dos Cuidados ao Paciente/organização & administração , Administração dos Cuidados ao Paciente/normas , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/terapia , Prevalência
15.
Inflamm Bowel Dis ; 26(11): e134-e136, 2020 10 23.
Artigo em Inglês | MEDLINE | ID: mdl-33029612
16.
Aust J Gen Pract ; 49(11): 745-751, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33123716

RESUMO

METHOD: A national cross-sectional online survey of Australian general practitioners was conducted in April and May 2020, with 572 respondents. RESULTS: The COVID-19 pandemic in Australia has resulted in major changes to general practice business models. Most practices have experienced increased workload and reduced income. DISCUSSION: Australian general practices have undertaken major innovation and realignment to respond to staff safety and patient care challenges during the COVID-19 pandemic. Increased administration, reduced billable time, managing staffing and pivoting to telehealth service provision have negatively affected practice viability. Major sources of information for general practice are primary care-specific, but many practices turn to colleagues for support and resources.


Assuntos
Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus , Medicina Geral , Pandemias , Pneumonia Viral , Gestão de Riscos , Atitude do Pessoal de Saúde , Austrália/epidemiologia , Betacoronavirus , Defesa Civil/normas , Defesa Civil/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Estudos Transversais , Medicina Geral/organização & administração , Medicina Geral/tendências , Clínicos Gerais , Pesquisas sobre Serviços de Saúde , Humanos , Mortalidade , Inovação Organizacional , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Gestão de Riscos/organização & administração , Gestão de Riscos/tendências , Telemedicina/estatística & dados numéricos
17.
Ann Cardiol Angeiol (Paris) ; 69(5): 227-232, 2020 Nov.
Artigo em Francês | MEDLINE | ID: mdl-33059875

RESUMO

The COVID-19 pandemic has swept through our hospitals which have had to adapt as a matter of urgency. We are aware that a health crisis of this magnitude is likely to generate mental disorders particularly affecting exposed healthcare workers. Being so brutal and global, this one-of the kind pandemic has been impacting the staff in their professional sphere but also within their private circle. The COV IMPACT study is an early assessment survey conducted for 2 weeks in May 2020, of the perception by all hospital workers of the changes induced in their professional activity by the pandemic. The study was carried out by a survey sent to the hospital staff of Béziers and Montfermeil. The readjusted working conditions were source of increased physical fatigue for 62 % of the respondents. Moral exhaustion was reported by 36 %. It was related to the stress of contracting the infection (72 %) but above all of transmitting it to relatives (89 %) with a broad perception of a vital risk (41 %). This stress affected all socio-professional categories (CSP) and was independent of exposure to COVID. Change in organisation, lack of information and protective gear and equipment were major factors of insecurity at the start of the epidemic. Work on supportive measures is necessary. It should focus on the spread of information, particularly towards the youngest, as well as bringing more psychological support and a larger amount of medical equipment, beyond healthcare workers and the COVID sectors.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Recursos Humanos em Hospital/psicologia , Pneumonia Viral/epidemiologia , Estresse Psicológico/etiologia , Adulto , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/transmissão , Família , Fadiga/etiologia , Fadiga/psicologia , França/epidemiologia , Inquéritos Epidemiológicos , Humanos , Disseminação de Informação , Pessoa de Meia-Idade , Moral , Doenças Profissionais/etiologia , Doenças Profissionais/psicologia , Inovação Organizacional , Pandemias , Equipamento de Proteção Individual/provisão & distribução , Pneumonia Viral/psicologia , Pneumonia Viral/transmissão , Estresse Psicológico/psicologia , Adulto Jovem
18.
J Am Dent Assoc ; 151(11): 809-810, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33121598
20.
Am J Geriatr Psychiatry ; 28(11): 1133-1145, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32863137

RESUMO

The ubiquitous coronavirus 2019 (COVID-19) pandemic has required healthcare providers across all disciplines to rapidly adapt to public health guidelines to reduce risk while maintaining quality of care. Electroconvulsive therapy (ECT), which involves an aerosol-generating procedure from manual ventilation with a bag mask valve while under anesthesia, has undergone drastic practice changes in order to minimize disruption of treatment in the midst of COVID-19. In this paper, we provide a consensus statement on the clinical practice changes in ECT specific to older adults based on expert group discussions of ECT practitioners across the country and a systematic review of the literature. There is a universal consensus that ECT is an essential treatment of severe mental illness. In addition, there is a clear consensus on what modifications are imperative to ensure continued delivery of ECT in a manner that is safe for patients and staff, while maintaining the viability of ECT services. Approaches to modifications in ECT to address infection control, altered ECT procedures, and adjusting ECT operations are almost uniform across the globe. With modified ECT procedures, it is possible to continue to meet the needs of older patients while mitigating risk of transmission to this vulnerable population.


Assuntos
Infecções por Coronavirus , Eletroconvulsoterapia , Controle de Infecções/métodos , Transtornos Mentais , Inovação Organizacional , Pandemias , Pneumonia Viral , Padrões de Prática Médica/organização & administração , Idoso , Betacoronavirus , Consenso , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Eletroconvulsoterapia/efeitos adversos , Eletroconvulsoterapia/métodos , Eletroconvulsoterapia/normas , Prova Pericial , Humanos , Controle de Infecções/organização & administração , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Guias de Prática Clínica como Assunto , Revisões Sistemáticas como Assunto
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