scholarly journals Derailed Cardiac Surgical Practice during COVID-19 Pandemic: Concerns and Proposed Solution Strategy

2021 ◽  
Author(s):  
Prateek Vaswani ◽  
Manoj Kumar Sahu
Keyword(s):  
Health Care ◽  
Critical Care ◽  
Virus Disease ◽  
Management Plan ◽  
Solution Strategy ◽  
Surgical Practice ◽  
Surgical Department ◽  
Comprehensive Management ◽  
Alternative Plan ◽  
Hospital Resources

AbstractThe current ongoing novel corona virus disease 2019 (COVID 19) pandemic has led to reallocation of substantial hospital resources and workforce depriving the institution’s ability to handle the routine caseload. The sustenance of health care would require a comprehensive management plan and focused strategy. The cardiac surgical department would consume majority of critical care resources, hence, a balance should be sought between the resumption of routine surgeries and the emergency unavoidable ones. We have proposed an alternative plan to guide the formulation of a strategic comeback.

Embodied Spatial Practices and the Power to Care

2019 ◽  
pp. 360-377
Author(s):  
Elise Paradis ◽  
Warren Mark Liew ◽  
Myles Leslie
Keyword(s):  
Health Care ◽  
Critical Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Ethnographic Study ◽  
Spatial Practices ◽  
Critical Care Units ◽  
Interprofessional Care ◽  
The Social

Drawing on an ethnographic study of teamwork in critical care units (CCUs), this chapter applies Henri Lefebvre’s ([1974] 1991) theoretical insights to an analysis of clinicians’ and patients’ embodied spatial practices. Lefebvre’s triadic framework of conceived, lived, and perceived spaces draws attention to the role of bodies in the production and negotiation of power relations among nurses, physicians, and patients within the CCU. Three ethnographic vignettes—“The Fight,” “The Parade,” and “The Plan”—explore how embodied spatial practices underlie the complexities of health care delivery, making visible the hidden narratives of conformity and resistance that characterize interprofessional care hierarchies. The social orderings of bodies in space are consequential: seeing them is the first step in redressing them.

scholarly journals Cardiac Surgery Conduct during COVID-19 Pandemic

2020 ◽  
Vol 4 (02) ◽  
pp. 091-095
Author(s):  
Manoj Kumar Sahu ◽  
Prateek Vaswani ◽  
Amitabh Satsangi ◽  
Sarvesh Pal Singh ◽  
Palleti Rajashekar ◽  
...  
Keyword(s):  
Health Care ◽  
Cardiac Surgery ◽  
Tertiary Care ◽  
Institutional Development ◽  
Resource Conservation ◽  
Conservation Strategy ◽  
Entire Study ◽  
Strict Adherence ◽  
Surgical Practice ◽  
Valvular Heart Diseases

Abstract Background Health care is seriously affected by the coronavirus disease 2019 (COVID-19) pandemic with alarming effects upon conduct of cardiac surgery. The initial resource conservation strategy has to modify for handling the surging case load due to deference of routine care in the face of pandemic. Methods The cardiac surgical practice during the lockdown period (from 25th march till 25th June) at a tertiary care centre was observed. The cardiac diagnosis of the ones operated, conduct algorithm, and working policy were analyzed. Descriptive statistics was applied to calculate the percentages of different case subsets in both adult and pediatric groups. Results A total of 93 cardiac patients were consecutively operated during the 3 months’ period in two cardiac theatres of a total eight dedicated and were rotated cyclically. A total of 37 (39.78%) adult cardiac surgeries were performed out of 93 cases, with coronary artery bypass grafting (11.83%: 11/93) and valvular heart diseases (11.83%: 11/93) constituting the majority. Pediatric cardiac surgeries constituted 56 cases (60.21%) which comprised of arterial switch operation (19.35%), total anomalous pulmonary venous connection (8.60%), and Blalock Taussig shunts (7.53%) predominantly. There was no COVID-19-related mortality and none of the health-care workers developed COVID-19 in the entire study period. Conclusions The initial phase of resource conservation has undermined the routine cardiac surgical practice. The study showed that strict adherence to management algorithm is necessary for persisting smooth continuation of cardiac surgical practice with provision of optimum critical care. The strategic comeback against COVID-19 would urge institutional development of protocols to aid the post-surge period.

scholarly journals Innovative COVID-19 Programs to Rapidly Serve New Mexico

2020 ◽  
Vol 136 (1) ◽  
pp. 39-46
Author(s):  
Joanna G. Katzman ◽  
Laura E. Tomedi ◽  
Karla Thornton ◽  
Paige Menking ◽  
Michael Stanton ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Health Care ◽  
Critical Care ◽  
New Mexico ◽  
General Education ◽  
Health Care Providers ◽  
Healthcare Outcomes ◽  
Care Providers ◽  
Project Echo

Project ECHO (Extension for Community Healthcare Outcomes) at the University of New Mexico is a telementoring program that uses videoconferencing technology to connect health care providers in underserved communities with subject matter experts. In March 2020, Project ECHO created 10 coronavirus disease 2019 (COVID-19) telementoring programs to meet the public health needs of clinicians and teachers living in underserved rural and urban regions of New Mexico. The newly created COVID-19 programs include 7 weekly sessions (Community Health Worker [in English and Spanish], Critical Care, Education, First-Responder Resiliency, Infectious Disease Office Hours, and Multi-specialty) and 3 one-day special sessions. We calculated the total number of attendees, along with the range and standard deviation, per session by program. Certain programs (Critical Care, Infectious Disease Office Hours, Multi-specialty) recorded the profession of attendees when available. The Project ECHO research team collected COVID-19 infection data by county from March 11 through May 31, 2020. During that same period, 9765 health care and general education professionals participated in the COVID-19 programs, and participants from 31 of 35 (89%) counties in New Mexico attended the sessions. Our initial evaluation of these programs demonstrates that an interprofessional clinician group and teachers used the Project ECHO network to build a community of practice and social network while meeting their educational and professional needs. Because of Project ECHO’s large reach, the results of the New Mexico COVID-19 response suggest that the rapid use of ECHO telementoring could be used for other urgent national public health problems.

Critical Care in Critical Access Hospitals

2015 ◽  
Vol 35 (5) ◽  
pp. 62-67 ◽  
Author(s):  
Teresa J. Seright ◽  
Charlene A. Winters
Keyword(s):  
Health Care ◽  
Critical Care ◽  
Rural Areas ◽  
Tertiary Care ◽  
Safety Net ◽  
The United States ◽  
Infusion Therapy ◽  
Critical Access Hospitals ◽  
Hospital System ◽  
Critical Access Hospital

What began as a grant-funded demonstration project, as a means of bridging the gap in rural health care, has developed into a critical access hospital system comprising 1328 facilities across 45 states. A critical access hospital is not just a safety net for health care in a rural community. Such hospitals may also provide specialized services such as same-day surgery, infusion therapy, and intensive care. For hospitals located near the required minimum of 35 miles from a tertiary care center, management of critically ill patients may be a matter of stabilization and transfer. Critical access hospitals in more rural areas are often much farther from tertiary care; some of these hospitals are situated within frontier areas of the United States. This article describes the development of critical access hospitals, provision of care and services, challenges to critical care in critical access hospitals, and suggestions to address gaps in research and collaborative care.

Critical Care Nurses’ Physical and Mental Health, Worksite Wellness Support, and Medical Errors

2021 ◽  
Vol 30 (3) ◽  
pp. 176-184
Author(s):  
Bernadette Mazurek Melnyk ◽  
Alai Tan ◽  
Andreanna Pavan Hsieh ◽  
Kate Gawlik ◽  
Cynthia Arslanian-Engoren ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Critical Care ◽  
Physical Health ◽  
Medical Errors ◽  
Odds Ratio ◽  
Care Quality ◽  
Critical Care Nurses ◽  
Worksite Wellness ◽  
Physical And Mental Health

Background Critical care nurses experience higher rates of mental distress and poor health than other nurses, adversely affecting health care quality and safety. It is not known, however, how critical care nurses’ overall health affects the occurrence of medical errors. Objective To examine the associations among critical care nurses’ physical and mental health, perception of workplace wellness support, and self-reported medical errors. Methods This survey-based study used a cross-sectional, descriptive correlational design. A random sample of 2500 members of the American Association of Critical-Care Nurses was recruited to participate in the study. The outcomes of interest were level of overall health, symptoms of depression and anxiety, stress, burnout, perceived worksite wellness support, and medical errors. Results A total of 771 critical care nurses participated in the study. Nurses in poor physical and mental health reported significantly more medical errors than nurses in better health (odds ratio [95% CI]: 1.31 [0.96-1.78] for physical health, 1.62 [1.17-2.29] for depressive symptoms). Nurses who perceived that their worksite was very supportive of their well-being were twice as likely to have better physical health (odds ratio [95% CI], 2.16 [1.33-3.52]; 55.8%). Conclusion Hospital leaders and health care systems need to prioritize the health of their nurses by resolving system issues, building wellness cultures, and providing evidence-based wellness support and programming, which will ultimately increase the quality of patient care and reduce the incidence of preventable medical errors.

scholarly journals The Art of Surgery: Balancing Compassionate With Virtual Care (Preprint)

2020 ◽  
Author(s):  
Elisheva Tamar Anne Nemetz ◽  
David Robert Urbach ◽  
Karen Michelle Devon
Keyword(s):  
Health Care ◽  
Physical Examination ◽  
Health Care Team ◽  
Body Language ◽  
Surgical Practice ◽  
Good Communication ◽  
Academic Literature ◽  
Virtual Care ◽  
Patient Groups

UNSTRUCTURED The recent drive to include virtual care in surgical practice has been accelerated due to the COVID-19 pandemic. Many physicians feel that communicating via telehealth is unlike traditional methods of providing health care, and thus guidance on maintaining excellence in communication is necessary, especially as academic literature on virtual care in surgery is nonexistent. Challenges faced in transitioning to virtual care include the inability to utilize body language, barriers to traditional physical examination, exacerbation of existing vulnerabilities and inequities in patient groups, the declining quality of medical education, and the fragmentation of the multidisciplinary health care team. This paper seeks to resolve these challenges by focusing on the pillars of good communication, including preparation, professionalism, empathy, respect, and the virtual physical examination.

scholarly journals Additional considerations for "checklists to guide the supportive and critical care of tuberculous meningitis"

2020 ◽  
Vol 5 ◽  
pp. 64
Author(s):  
Anuradha Behl ◽  
Sumeet Dhawan
Keyword(s):  
Health Care ◽  
Critical Care ◽  
Intensive Care ◽  
Tuberculous Meningitis ◽  
Inpatient Care ◽  
Neurological Complications ◽  
Prolonged Hospital Stay ◽  
Invasive Procedures ◽  
Systematic Assessment ◽  
Prolonged Hospital

Checklists are pivotal in the systematic assessment of critically ill patients, pre-operative assessments and for patients with multisystem involvements. Management of tuberculous meningitis is challenging due to prolonged hospital stay, multiple neurological complications like seizures, stroke, raised intracranial tension, stroke, neurosurgical interventions, multiple invasive procedures, health-care-associated sepsis, and ventilation. All these complications are managed by separate checklists to avoid treatment-related errors. The current manuscript aims to ensure completeness of inpatient care addressing issues addressing diagnostic issues, supportive care, and intensive care related issues.

Sign in / Sign up

Export Citation Format

Share Document