scholarly journals 114 The Patient’s Perspective: Burn Reconstructive Surgery During the Pandemic

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S76-S77
Author(s):  
Paul Won ◽  
Karel-Bart Celie ◽  
Justin Gillenwater ◽  
Haig A Yenikomshian
Keyword(s):  
Reconstructive Surgery ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Surgical Care ◽  
Quality Improvement Initiative ◽  
Burn Patients ◽  
Burn Treatment ◽  
Hospital Systems ◽  
Novel Coronavirus ◽  
Burn Patient

Abstract Introduction The novel Coronavirus disease 2019 (COVID-19) has created profound challenges in healthcare delivery. Hospital systems have delayed or shut down elective surgeries and outpatient care. These measures resulted in profound disruptions to burn treatment regarding reconstructive care from surgery to therapy. This study aims to characterize burn patients’ perspectives on elective reconstructive surgery during COVID-19. Methods As part of a quality improvement initiative, a 12-component questionnaire to burn patients awaiting reconstructive surgery at a single ABA verified Burn Center during COVID-19 was conducted. Responses regarding willingness to undergo reconstruction during COVID-19, perceived medical and personal impacts of COVID-19, and perspectives on telehealth were gathered. Surveys were administered over the phone in English and Spanish to burn patients or to primary caregivers in the case of pediatric patients. Results We surveyed 23 participants who met our inclusion criteria. Average age was 23 and 43% were male. We found 22 (96%) patients were willing to undergo reconstruction during the COVID-19 pandemic. Table 1 outlines the responses to questions regarding telehealth and being a burn patient during COVID-19. Examples of stressors experienced by patients and their families due to COVID-19 included: inability to communicate with healthcare providers in person, increased anxiety in public places, delayed surgical care, and interruption of physical or occupational therapy. Family members in 5 out of the 8 Spanish speaking households lost their job due to COVID-19, resulting in financial stress for the burn patient. Conclusions The majority of patients expressed strong desires to return to surgical and therapy care delayed by COVID-19. Patients reported feeling especially vulnerable as burn patients and cited receiving healthcare and financial stressors as a result of the COVID-19 pandemic as the main causes.

scholarly journals The Patient’s Perspective: Burn Reconstructive Surgery During the COVID-19 Pandemic

2021 ◽  
Author(s):  
Paul Won ◽  
Karel-Bart Celie ◽  
Violeta Perez ◽  
T Justin Gillenwater ◽  
Haig A Yenikomshian
Keyword(s):  
Reconstructive Surgery ◽  
Burn Patients ◽  
Inclusion Criteria ◽  
Burn Treatment ◽  
Burn Care ◽  
Postoperative Therapy ◽  
Burn Center ◽  
Increased Risk ◽  
Average Patient ◽  
Hospital Systems

Abstract During the Covid-19 pandemic, hospital systems delayed or halted elective surgeries and outpatient care, profoundly disrupting reconstructive burn treatment ranging from surgery to postoperative therapy. This study aims to characterize burn patients’ perspectives on reconstructive surgery during Covid-19. A 12-component questionnaire to burn patients awaiting reconstructive surgery at a single ABA verified Burn Center was administered. Responses regarding willingness to undergo reconstruction, perceived medical and personal impacts of Covid-19, and perspectives on telehealth were gathered. Surveys were administered to patients/caregivers over the phone in English and Spanish. Inclusion criteria consisted of burn patients who had elective reconstructive surgeries delayed or canceled as a result of the pandemic. 51 patients met our inclusion criteria. Of those, 23 patients responded to our survey (45%). Average patient age was 23, 43% were male, and a majority (52%) were pediatric. 22 (96%) patients were willing to undergo reconstruction during the Covid-19 pandemic, despite a perceived increased risk. 43% disagreed or strongly disagreed that telehealth adequately enabled communication with their burn care provider. 78% agreed or strongly agreed that they felt more susceptible to Covid-19 as burn patients. 83% agreed or strongly agreed that the Covid-19 pandemic had created stressors specifically related to their burn care. The majority of patients expressed a strong desire to return to surgical and therapeutic care delayed by Covid-19. Patients reported feeling especially vulnerable to the Covid-19 pandemic as burn patients, and cited difficulty obtaining care and financial stressors as the main causes.

Knowledge and Communication of the National Core Standards Tool

2018 ◽  
Vol 20 (2) ◽  
Author(s):  
Winnie Thembisile Maphumulo ◽  
Busisiwe Bhengu
Keyword(s):  
Pearson Correlation ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Sampling Technique ◽  
Quality Of Healthcare ◽  
Survey Study ◽  
Public Healthcare ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Professional Nurses

The National Department of Health in South Africa has introduced the National Core Standards (NCS) tool to improve the quality of healthcare delivery in all public healthcare institutions. Knowledge of the NCS tool is essential among healthcare providers. This study investigated the level of knowledge on NCS and how the NCS tool was communicated among professional nurses. This was a cross-sectional survey study. Purposive sampling technique was used to select hospitals that only offered tertiary services in KwaZulu-Natal. Six strata of departments were selected using simple stratified sampling. The population of professional nurses in the selected hospitals was 3 050. Systematic random sampling was used to recruit 543 participants. The collected data were analysed using SPSS version 25. The study showed that only 16 (3.7%) respondents had knowledge about NCS, using McDonald’s standard of learning outcome measured criteria regarding the NCS tool. The Pearson correlation coefficient between the communication and knowledge was r = 0.055. The results revealed that although the communication scores for the respondents were high their knowledge scores remained low. This study concluded that there is a lack of knowledge regarding the NCS tool and therefore healthcare institutions need to commit themselves to the training of professional nurses regarding the NCS tool. The findings suggest that healthcare institutions implement the allocation of incentives for nurses that attend the workshops for NCS.

How Research Will Adapt to HIPAA: A View from Within the Healthcare Delivery System

2002 ◽  
Vol 28 (4) ◽  
pp. 491-502
Author(s):  
Mary L. Durham
Keyword(s):  
Health Information ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
The United States ◽  
Personal Health Information ◽  
Personal Health ◽  
Business Associations ◽  
Electronic Information ◽  
Healthcare Delivery System ◽  
Institutional Review

While the new Health Insurance Privacy and Accountability Act (HIPAA) research rules governing privacy, confidentiality and personal health information will challenge the research and medical communities, history teaches us that the difficulty of this challenge pales in comparison to the potential harms that such regulations are designed to avoid. Although revised following broad commentary from researchers and healthcare providers around the country, the HIPAA privacy requirements will dramatically change the way healthcare researchers do their jobs in the United States. Given our reluctance to change, we risk overlooking potentially valid reasons why access to personal health information is restricted and regulated. In an environment of electronic information, public concern, genetic information and decline of public trust, regulations are ever-changing. Six categories of HIPAA requirements stand out as transformative: disclosure accounting/tracking, business associations, institutional review board (IRB) changes, minimum necessary requirements, data de-identification, and criminal and civil penalties.

scholarly journals Integrating Social Determinants of Health to Precision Medicine through Digital Transformation: An Exploratory Roadmap

2021 ◽  
Vol 18 (9) ◽  
pp. 5018
Author(s):  
Ik-Whan G. Kwon ◽  
Sung-Ho Kim ◽  
David Martin
Keyword(s):  
Precision Medicine ◽  
Social Determinants Of Health ◽  
Population Health ◽  
Social Determinants ◽  
Information Technologies ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Determinants Of Health ◽  
Collaborative Tools ◽  
High Level

The COVID-19 pandemic has altered healthcare delivery platforms from traditional face-to-face formats to online care through digital tools. The healthcare industry saw a rapid adoption of digital collaborative tools to provide care to patients, regardless of where patients or clinicians were located, while mitigating the risk of exposure to the coronavirus. Information technologies now allow healthcare providers to continue a high level of care for their patients through virtual visits, and to collaborate with other providers in the networks. Population health can be improved by social determinants of health and precision medicine working together. However, these two health-enhancing constructs work independently, resulting in suboptimal health results. This paper argues that artificial intelligence can provide clinical–community linkage that enhances overall population health. An exploratory roadmap is proposed.

scholarly journals 139. Impact of Pharmacist Driven Outpatient Fluoroquinolone Stewardship Initiative in Community Based Setting

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S81-S81
Author(s):  
Sarah Norman ◽  
Sara Jones ◽  
Cara Acklin ◽  
Christian Cheatham
Keyword(s):  
Antimicrobial Stewardship ◽  
Healthcare Providers ◽  
Hospital Setting ◽  
Secondary Outcome ◽  
Quality Improvement Initiative ◽  
Oral Antibiotic ◽  
Ambulatory Care Setting ◽  
Community Based ◽  
Before And After ◽  
Physician Network

Abstract Background Antimicrobial stewardship initiatives and efforts have historically had a greater emphasis in the inpatient hospital setting. There is a need for outpatient stewardship, and additionally, accreditation standards are starting to require antimicrobial stewardship efforts in the ambulatory care setting. Fluoroquinolones are a target for antimicrobial stewardship based on their broad-spectrum activity, pharmacokinetics/pharmacodynamics, safety profile, downstream resistance, and risk of super infections. The objective of this study was to compare outpatient fluoroquinolone prescribing rates before and after pharmacist led initiative. Methods This was a prospective, quality improvement initiative between October 1, 2019 to June 1, 2020 at a community-based physician network across Indiana. The pharmacist initiative incorporated a live, educational presentation with intervention 1 and an informational letter to healthcare providers across the outpatient physician network with intervention 2. Data was collected from a computer-generated, prescription report. The primary outcome was fluoroquinolone prescribing rates at Central Indiana (CI) sites before and after pharmacist led interventions. Rate of fluoroquinolone prescribing was defined as total number of fluoroquinolone prescriptions per month. The secondary outcome included percentage of fluoroquinolone use at CI sites. Percentage of fluoroquinolone use was defined as monthly number of fluoroquinolones prescriptions compared to monthly number of all oral antibiotic prescriptions. Results There was a 29.8% decrease (382 vs 268 prescriptions) in outpatient fluoroquinolone prescriptions at CI sites after intervention 1 compared to same month of previous year. There was a 43.7% decrease (428 vs 241 prescriptions) in outpatient fluoroquinolone prescriptions at CI sites after intervention 2. There was an overall 2.4% decrease (4.9% vs 2.5%) in percentage of fluoroquinolone use compared to all oral antibiotics at CI sites after intervention 2 compared to same month of previous year. Conclusion These findings suggest the pharmacist led outpatient antimicrobial stewardship initiative successfully decreased fluoroquinolone prescribing rates across the network. Disclosures Christian Cheatham, PharmD, BCIDP, Antimicrobial Resistance Solutions (Shareholder)

To err is system; a comparison of methodologies for the investigation of adverse outcomes in healthcare

2021 ◽  
pp. 251604352199026
Author(s):  
Peter Isherwood ◽  
Patrick Waterson
Keyword(s):  
Patient Safety ◽  
System Performance ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Real Life ◽  
Adverse Outcomes ◽  
System Level ◽  
Future Performance ◽  
System A ◽  
Regulatory Bodies

Patient safety, staff moral and system performance are at the heart of healthcare delivery. Investigation of adverse outcomes is one strategy that enables organisations to learn and improve. Healthcare is now understood as a complex, possibly the most complex, socio-technological system. Despite this the use of a 20th century linear investigation model is still recommended for the investigation of adverse outcomes. In this review the authors use data gathered from the investigation of a real life healthcare near incident and apply three different methodologies to the analysis of this data. They compare both the methodologies themselves and the outputs generated. This illustrates how different methodologies generate different system level recommendations. The authors conclude that system based models generate the strongest barriers to improve future performance. Healthcare providers and their regulatory bodies need to embrace system based methodologies if they are to effectively learn from, and reduce future, adverse outcomes.

scholarly journals Management challenges in patients with comorbid COVID-19 associated delirium and serious mental illness – A case series

2021 ◽  
pp. 009121742098597
Author(s):  
Saba Syed ◽  
Michael Couse ◽  
Rashi Ojha
Keyword(s):  
Mental Illness ◽  
Serious Mental Illness ◽  
Healthcare Providers ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Active Management ◽  
The Novel ◽  
Psychiatric Facility ◽  
Medical Teams ◽  
Novel Coronavirus

Background There is still a lot unknown about the novel Coronavirus Disease 19 (COVID-19) and its effects in humans. This pandemic has posed several challenging clinical situations to healthcare providers. Objective We hope to highlight the distinctive challenges that COVID-19 presents in patients with serious mental illness and what steps primary medical teams can take to co-manage these patients with the psychiatry consultants. Methods We present a retrospective chart review of four patients who were on psychotropic polypharmacy and admitted to our hospital from the same long-term psychiatric facility with COVID-19 delirium and other associated medical complications. Results We illustrate how the primary medical teams and psychiatrists collaborated in clinical diagnosis, treatment, and management. Conclusions Patients with serious mental illness and COVID-19 infection require active collaboration between primary medical teams and psychiatrists for diagnostic clarification, reduction of psychotropic polypharmacy to avoid adverse effects and drug-drug interactions, prevention of psychiatric decompensation, and active management of agitation while balancing staff and patient safety concerns.

613Pediatric Burn Bibliotherapy - An Initial Assessment of Novels About Young Burn Survivors and Their Collective Experiences

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S160-S160
Author(s):  
Philip H Chang ◽  
Antonella Barrios ◽  
Jamie Heffernan ◽  
Angela Rabbitts ◽  
Caroline Jedlicka
Keyword(s):  
Performing Arts ◽  
English Language ◽  
Psychosocial Support ◽  
Numerical Data ◽  
Recovery Phase ◽  
Initial Assessment ◽  
Burn Patients ◽  
The Past ◽  
Burn Survivors ◽  
Burn Patient

Abstract Introduction Bibliotherapy is the use of books as a therapeutic intervention for structuring interaction between facilitator and participant based on the mutual sharing of literature. Bibliotherapy has been utilized to address childhood teasing, healthy lifestyles in children, and eating disorders. With the dramatic improvements in survival of burn patients over the past decades, biographies and novels featuring pediatric burn survivors have emerged. These patients often face significant barriers in accessing psychosocial support. Our team hypothesized that bibliotherapy could benefit pediatric burn patients. In order to test this hypothesis, as a first step, our team conducted an assessment of the available burn survivor literature. Methods WorldCat book database was queried using the terms “Burn Patient Fiction” (45 results) and “Burn Patient Biography” (53 results). The authors identified 12 books out of these 98 results likely to be appropriate for adolescent and teenage burn patients based on the brief summaries. The 12 books were then read by the research team and analyzed for burn patient demographics and relevant clinical data when available. Simple descriptive statistics were utilized for numerical data Results Out of 12 books read, 5 were biographies & 7 fictional novels. Protagonists mean age at time of injury was 8.7±5.1 years (range 2–16), with 5 males and 7 females. Average injury size was 57±21% TBSA (range: 14–85). 10 of 12 protagonists suffered facial burns; 7 of 12 suffered hand burns. Oral health/dental issues were described in 4 of 12 books. Geographically, these English language novels spanned Australia (1), Canada 92), and the U.S. (9). Average page length was 237±88 pages (range: 64–372). In 11 of 12 books, mechanism of injury involved flame from car accidents (2), house fires (4), and campfires (2). With regards to sources of positive support during the recovery phase, family was the most commonly cited source (11 novels) followed by friends (10), spiritual/religious support (5), sports (3), burn survivor groups (3), hospital psychiatrists (3), and performing arts (2). Appropriate audience group for most books were teenagers (11) with 5 books deemed also appropriate for adults (only 1 book judged appropriate only for adults), and 2 books appropriate for adolescents. Conclusions Several novels and biographies with pediatric burn survivor protagonists have been written over the past 20 years. Commonalities across these books include flame burn etiology, relatively large TBSA, and burn injuries to visible body areas (face and hand). Family and friends were the most common emotional support for these protagonists. Most books were appropriate for teenagers.

scholarly journals ‘Not just a piece of skin in front of you’—a qualitative exploration of the experiences of adolescents with eczema and psoriasis with healthcare professionals

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e041108
Author(s):  
Isabella Joy de Vere Hunt ◽  
Abigail McNiven ◽  
Amanda Roberts ◽  
Himesh Parmar ◽  
Tess McPherson
Keyword(s):  
Young People ◽  
Skin Disease ◽  
Healthcare Professionals ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Secondary Analysis ◽  
Emotional Impact ◽  
Skin Conditions ◽  
The Uk ◽  
Qualitative Exploration

BackgroundThere is little qualitative research in the UK focussing on adolescents’ experience of their healthcare providers, and inflammatory skin conditions are a common heath problem in adolescence.AimTo explore the experiences of adolescents with eczema and psoriasis with healthcare professionals, and to distil the participants’ key messages for their healthcare providers.DesignThis is a secondary thematic analysis of interviews with adolescents with eczema or psoriasis.ParticipantsThere were a total of 41 text transcripts of interviews with young people with eczema or psoriasis who had given permission for secondary analysis; 23 of the participants had eczema, and 18 psoriasis. Participants were living in the UK at time of interview, and aged 15–24 years old.ResultsWe have distilled the following key messages from young people with eczema and psoriasis for healthcare providers: (1) address the emotional impact; (2) give more information, with the subtheme and (3) appreciate patient research. We identified the following eczema-specific themes: (ECZ-4) ‘It’s not taken seriously’; (ECZ-5) offer choice in treatment and (ECZ-6) lack of structure/conflicting advice. Two psoriasis-specific themes were identified: (PSO-4) feeling dehumanised/treat me as a person; and (PSO-5) think about how treatments will affect daily life.ConclusionThis qualitative data analysis highlights the need for greater recognition of the emotional impact of skin disease in adolescence, and for more comprehensive provision of information about the conditions. We call for greater sensitivity and flexibility in our approach to adolescents with skin disease, with important implications for healthcare delivery to this group.

scholarly journals 2019 Novel Coronavirus Vaccination among Post-graduate Residents and Fellows

2021 ◽  
Vol 12 ◽  
pp. 215013272110229
Author(s):  
Mostafa Abohelwa ◽  
Mohamed Elmassry ◽  
John Abdelmalek ◽  
Drew Payne ◽  
Kenneth Nugent
Keyword(s):  
Side Effects ◽  
Healthcare Workers ◽  
Healthcare Providers ◽  
The United States ◽  
Health Sciences ◽  
Institutional Review Board ◽  
Institutional Review ◽  
Texas Tech University ◽  
Novel Coronavirus ◽  
United States Healthcare

Background Coronavirus-2 (COVID-19) has caused a worldwide pandemic since December 2019. Since then, clinical trials with vaccines have been started and completed, and at present, 3 COVID-19 vaccines have been approved for use in the United States. Healthcare providers were among the first to get vaccinated, but the precise attitudes of healthcare workers toward vaccination are uncertain. Objective To understand residents and fellows’ attitudes toward vaccination and record any side effects after vaccination. Methods We conducted an anonymous survey that was open from 3-1-2021 to 3-12-2021 using distribution lists from the Graduate Medical Education office on the Lubbock campus of the Texas Tech University Health Sciences Center after getting approval from the Institutional Review Board (L21-088). Results Eighty-one residents and fellows (26.6% out of 304) responded to our survey. Among those who responded, 63 (77.8 %) were between 25 and 35 years old, and 41 (50.6%) were males. Seventy-seven (95.1%) received the vaccine (Pfizer-BioNTech), 78 (96.3%) reported that they supported vaccination, and 3 (3.7%) reported that they did not want vaccination. Eight members (9.8%) had tested positive for COVID-19 infection before vaccination, but only 1 (1.23%) had tested positive for COVID-19 antibodies. All residents and fellows reported side effects after the vaccination, including pain at the injection site (77; 100%), local redness (9; 11.6%), local swelling (13; 16.8%), fever (25; 32.5%), fatigue (25; 32.5%), chills (34; 44.1 %), headache (38; 49.4%). Conclusions Most medical trainees have a high interest in COVID-19 vaccination; however, a few reported that they did not want vaccination.

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