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1.
J Nepal Health Res Counc ; 18(2): 166-171, 2020 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-32969371

RESUMO

BACKGROUND: The study assesses the perspective of doctors working in government hospitals of Nepal regarding hospital preparedness for infection prevention measures, isolation services provisions, critical care service readiness, and training of staff for COVID-19 pandemic management. METHODS: This cross-sectional study was done in central, provincial, and local level health centers of the Government of Nepal to assess the perspective of medical doctors regarding COVID-19 pandemic readiness in their facility. Nonprobability sampling was used to collect 56 responses from doctors working in different hospitals of Nepal. An online survey was performed using a questionnaire tool, which was adapted from the guidelines of the World Health Organization and the Centers for Disease Control and Prevention. RESULTS: Most of the participants were medical officers with an MBBS degree (32) followed by anesthesiologists (10). Thirteen participants worked in central hospitals (23.2%), 24 in provincial hospitals (42.8%) and 19 in local health centers (33.92%). The availability of adequate facemask was 84% in central hospitals, which was higher than provincial hospitals (66.7%), and local level health centers (77.8%). There were only 53.8% trained critical care providers in central hospitals and 29.2% in provincial hospitals. Nearly 38.5% (5) of central hospitals had measures for airborne isolation in place, whereas this was only found in 8.3% (2) of provincial hospitals surveyed for critical care facilities. Overall, only 2 hospitals had the provision of a negative pressure room with air exchanges. Only 8 participants working in central hospitals (61.5%) and 14 working in provincial hospitals (58.3%) had performed hands-on training for donning and doffing personal protective equipment. CONCLUSIONS: The majority of medical doctors working in government hospitals of Nepal perceive that provision of facemask distribution, airborne isolation rooms, critical care preparedness, and hands-on training to staff were not adequate.


Assuntos
Infecções por Coronavirus/epidemiologia , Planejamento Hospitalar , Hospitais Públicos/organização & administração , Controle de Infecções/organização & administração , Capacitação em Serviço , Corpo Clínico Hospitalar/psicologia , Pneumonia Viral/epidemiologia , Adulto , Betacoronavirus , Estudos Transversais , Humanos , Nepal/epidemiologia , Pandemias , Equipamento de Proteção Individual , Inquéritos e Questionários
2.
Am J Disaster Med ; 15(2): 143-148, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804395

RESUMO

The Vancouver Convention Health Centre (VCHC) was rapidly set up as a part of the COVID-19 response in Brit-ish Columbia in order to create surge hospital capacity bed space. Multiple field hospitals were set up across the country in preparation for a possible surge and the VCHC utilized a non-traditional health care space and overlaid it with medical infrastructure. Maximum flexibility was required in planning for multiple patient populations and a novel four-box concept to plan for the requirements of the respective possible populations was developed. Key difficulties that needed to be overcome in planning COVID-19 medical care delivery in a non-traditional space included oxygen delivery, unknown future patient populations, and staffing. A clear recommendation can also now be made that healthcare provision should be considered during the design and build of new recreational or convention facilities in all communities.


Assuntos
Betacoronavirus , Infecções por Coronavirus/terapia , Planejamento em Desastres , Recursos em Saúde/provisão & distribução , Planejamento Hospitalar , Pandemias/prevenção & controle , Pneumonia Viral/terapia , Capacidade de Resposta ante Emergências/organização & administração , Colúmbia Britânica/epidemiologia , Infecções por Coronavirus/epidemiologia , Surtos de Doenças , Número de Leitos em Hospital , Humanos , Pneumonia Viral/epidemiologia , Saúde Pública , Capacidade de Resposta ante Emergências/estatística & dados numéricos
3.
Stud Health Technol Inform ; 272: 354-357, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32604675

RESUMO

In recent years, Slovenian public health has been a very prominent topic, both politically and professionally. In 2017, a one-off cash transfer to hospitals from the state budget in the total amount of EUR 136.24 million cash has been ensured to pay debts to suppliers of medical materials and medicines. At the same time, emergency legislation enacted the recovery plans to ensure operational and payment stability. The in-depth analysis of the recovery plans for 15 hospitals revealed that management boards highlight the infrastructure and financial challenges as the greatest, whereas the challenges concerning the services/products and patients/users are perceived to be less important.


Assuntos
Assistência à Saúde , Planejamento Hospitalar , Orçamentos , Humanos
11.
Prehosp Disaster Med ; 35(4): 431-433, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32423513

RESUMO

The rapid insurgence and spread of coronavirus disease 2019 (COVID-19) exceeded the limit of the intensive care unit (ICU) contingency plan of the Maggiore della Carità University Hospital (Novara, Italy) generating a crisis management condition. This brief report describes how a prompt response to the sudden request of invasive mechanical ventilation (IMV) was provided by addressing the key elements of health care system surge capacity from contingency to crisis. In a short time and at a relatively low cost, a structural modification of a hospital aisle allowed to convert the general ICU into a COVID-19 unit, increasing the number of COVID-19 critical care beds by 107%.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Cuidados Críticos/métodos , Arquitetura Hospitalar , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Capacidade de Resposta ante Emergências , Ventiladores Mecânicos/provisão & distribução , Betacoronavirus , Necessidades e Demandas de Serviços de Saúde , Planejamento Hospitalar , Humanos , Itália/epidemiologia , Estudos de Casos Organizacionais , Pandemias
14.
J Am Coll Radiol ; 17(7): 882-889, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32473108

RESUMO

OBJECTIVE: To meet hospital preparedness for the coronavirus disease 2019 pandemic, the Centers for Disease Control and Prevention and ACR recommended delay of all nonemergent tests and elective procedures. The purpose of this article is to report our experience for rescheduling nonemergent imaging and procedures during the pandemic at our tertiary academic institution. METHODS: We rescheduled the nonemergent imaging and procedures in our hospitals and outpatient centers from March 16 to May 4, 2020. We created a tiered priority system to reschedule patients for whom imaging could be delayed with minimal clinical impact. The radiologists performed detailed chart reviews for decision making. We conducted daily virtual huddles with discussion of rescheduling strategies and issue tracking. RESULTS: Using a snapshot during the rescheduling period, there was a 53.4% decrease in imaging volume during the period of March 16 to April 15, 2020, compared with the same time period in 2019. The total number of imaging studies decreased from 38,369 in 2019 to 17,891 in 2020 during this period. Although we saw the largest reduction in outpatient imaging (72.3%), there was also a significant decrease in inpatient (40.5%) and emergency department (48.9%) imaging volumes. DISCUSSION: The use of multiple communication channels was critical in relaying the information to all our stakeholders, patients, referring physicians, and the radiology workforce. Teamwork, quick adoption, and adaptation of changing strategies was important given the fluidity of the situation.


Assuntos
Agendamento de Consultas , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Serviço Hospitalar de Radiologia/organização & administração , Emergências , Planejamento Hospitalar , Humanos , Ohio/epidemiologia , Pandemias , Estados Unidos/epidemiologia
19.
Transfusion ; 60(5): 908-911, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32198754

RESUMO

BACKGROUND: The first coronavirus (COVID-19) case was reported in United States in the state of Washington, approximately 3 months after the outbreak in Wuhan, China. Three weeks later, the US federal government declared the pandemic a national emergency. The number of confirmed COVID-19 positive cases increased rather rapidly and changed routine daily activities of the community. STUDY DESIGN AND METHODS: This brief report describes the response from the hospital, the regional blood center, and the hospital-based transfusion services to the events that took place in the community during the initial phases of the pandemic. RESULTS: In Washington State, the first week of March started with four confirmed cases and ended with 150; by the end of the second week of March there were more than 700 cases of confirmed COVID-19. During the first week, blood donations dropped significantly. Blood units provided from blood centers of nonaffected areas of the country helped keep inventory stable and allow for routine hospital operations. The hospital-based transfusion service began prospective triaging of blood orders to monitor and prioritize blood usage. In the second week, blood donations recovered, and the hospital postponed elective procedures to ensure staff and personal protective equipment were appropriate for the care of critical patients. CONCLUSION: As community activities are disrupted and hospital activities switch from routine operations to pandemic focused and urgent care oriented, the blood supply and usage requires a number of transformations.


Assuntos
Betacoronavirus , Transfusão de Sangue , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Doadores de Sangue , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Planejamento Hospitalar , Humanos , Pneumonia Viral/epidemiologia , Pneumonia Viral/fisiopatologia , Washington/epidemiologia
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