Screening and managing of suspected or confirmed novel coronavirus (COVID-19) patients: experiences from a tertiary hospital outside Hubei province

ABSTRACTObjectivesTo report our experiences screening and managing patients with suspected or confirmed novel coronavirus (COVID-19) disease using a hospital-specific protocol.DesignLongitudinal cohort study.SettingA 1,200 bed tertiary care teaching hospital in Chengdu, Sichuan, China.Participants802 adults presenting to hospital with concerns of having COVID-19, 1,246 inpatients and 2,531 hospital visitors.InterventionsScreening and management of patients using a hospital-specific protocol, which included fever triage, monitoring visitors and patients, emergency response, personnel training for healthcare team members, health education for patients and family, medical materials management, disinfection and wastes disposal protocols.ResultsBetween 23 January and 28 February 2020, 73 people were identified as having fever plus respiratory signs with/without a history of exposure and were tested for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by our hospital lab using RT PCR. Forty-five of these 73 people were subsequently excluded based on one negative RT PCR result plus positive results to quick screening tests for flu or other respiratory viruses. The remaining 28 people received a second RT PCR test 24 h later. Three people were confirmed positive for COVID-19 based on two consecutive positive RT PCR tests whilst 25 people were excluded based on two consecutive negative tests. The three COVID-19 confirmed cases received non-critical care. There were no new infections of medical staff or new infections of other hospital inpatients.ConclusionsA hospital-specific protocol for screening and management is necessary for reliably identifying suspected or confirmed COVID-19 patients during an outbreak. All three cases were detected as a result of vigilant monitoring of hospital visitors. Whilst screening out-patients presenting to a fever clinic remains important, monitoring visitors must not be overlooked.Strengths and limitations of this study►We report a hospital-specific protocol used to screen and manage people presenting to our hospital fever clinic, inpatients and visitors during an outbreak of novel coronavirus (COVID-19) pneumonia in Chengdu, Sichuan province.►Key components of the protocol included: a three-level fever triage process; monitoring visitors and inpatients, formation of an emergency response team for COVID-19, personnel training for healthcare team members, health education for patients and family, medical materials management, and disinfection and wastes disposal protocols.►The ability to test nucleic acid of SARS-CoV-2 using RT PCR in the hospital greatly shortened the time from the detection of patients to diagnosis, and was beneficial to the control of the transmission of the SARS-CoV-2.►Although our process detected few patients, comparison with other processes, when they are published, will allow the identification of the optimal approach for screening and management.►We suggest that if all resources had been focused on screening people through our fever clinic, we would have missed important in-hospital risks of transmitting COVID-19: The detection of a hospital visitor with COVID-19 led to the detection of an inpatient with COVID-19.

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Evaluation of Evidence-Based Phytotherapy Applications

Journal of Academic Research in Nursing ◽

10.5222/jaren.2020.20591 ◽

2020 ◽

Author(s):

Dilek Yıldırım ◽

Dilek Baykal ◽

Gülbeyaz Can

Keyword(s):

Experimental Studies ◽

Small Sample ◽

Healthcare Team ◽

Team Members ◽

Specific Protocol ◽

Wide Range ◽

Gynecology Oncology ◽

Evaluation Of Evidence ◽

National Databases ◽

Lesion Treatment

Many patients refer to complementary methods as well as pharmacological treatments. Phytotherapy is the most used among these methods. For this reason, it is important that the members of the healthcare team and especially the nurses who spend a much longer time with the patient are knowledgeable about phytotherapy. The aim of this review is to enable healthcare team members to have knowledge about phytotherapy and to provide a basis for experimental studies. In this study, CINAHL, EBSCOHost MEDLINE, Ovid, Pubmed, Web of Science The studies which were published in the national databases of ULAKBIM between January 2010 and March 2018 were examined in Turkish or in English. In this database, "Phytotherapy", "Phytotherapy Applications", "Disease Management", "Treatment with Plants" has been reached to work using keywords in Turkish and English words. Studies have shown that phytotherapy is used in a wide range of gynecology, oncology, neuropsychiatry and cardiovascular diseases, orthopedics, lesion treatment. Although it is widely used, it is noteworthy that there is still no specific protocol in many phytotherapy applications, the studies are conducted with small sample groups, and there are uncertainties about how and how to use it in the patient group. In this respect, health personnels should have knowledge about the effects and possible side effects of phytotherapy and should take the lead in the formation of phytotherapy-related care protocols.

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SARS-CoV-2 Is Not Detected in the Cerebrospinal Fluid of Encephalopathic COVID-19 Patients

Frontiers in Neurology ◽

10.3389/fneur.2020.587384 ◽

2020 ◽

Vol 11 ◽

Author(s):

Dimitris G. Placantonakis ◽

Maria Aguero-Rosenfeld ◽

Abdallah Flaifel ◽

John Colavito ◽

Kenneth Inglima ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Viral Entry ◽

Cell Types ◽

Host Cells ◽

Nasopharyngeal Swab ◽

Rt Pcr ◽

Neurologic Sequelae ◽

Show Evidence ◽

Novel Coronavirus ◽

Transmembrane Serine Protease

Neurologic manifestations of the novel coronavirus SARS-CoV-2 infection have received wide attention, but the mechanisms remain uncertain. Here, we describe computational data from public domain RNA-seq datasets and cerebrospinal fluid data from adult patients with severe COVID-19 pneumonia that suggest that SARS-CoV-2 infection of the central nervous system is unlikely. We found that the mRNAs encoding the ACE2 receptor and the TMPRSS2 transmembrane serine protease, both of which are required for viral entry into host cells, are minimally expressed in the major cell types of the brain. In addition, CSF samples from 13 adult encephalopathic COVID-19 patients diagnosed with the viral infection via nasopharyngeal swab RT-PCR did not show evidence for the virus. This particular finding is robust for two reasons. First, the RT-PCR diagnostic was validated for CSF studies using stringent criteria; and second, 61% of these patients had CSF testing within 1 week of a positive nasopharyngeal diagnostic test. We propose that neurologic sequelae of COVID-19 are not due to SARS-CoV-2 meningoencephalitis and that other etiologies are more likely mechanisms.

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A Case Series of SARS-CoV-2 RT-PCR-Positive Hospitalized Infants 60 Days of Age or Younger From 2 New York City Pediatric Emergency Departments

Clinical Pediatrics ◽

10.1177/00099228211006688 ◽

2021 ◽

Vol 60 (4-5) ◽

pp. 247-251

Author(s):

Ameer Hassoun ◽

Nessy Dahan ◽

Christopher Kelly

Keyword(s):

New York ◽

Case Reports ◽

Severe Disease ◽

Case Series ◽

Pediatric Emergency ◽

Rt Pcr ◽

Vulnerable Group ◽

Mild Disease ◽

Young Infants ◽

Novel Coronavirus

The emergence of novel coronavirus disease-2019 poses an unprecedented challenge to pediatricians. While the majority of children experience mild disease, initial case reports on young infants are conflicting. We present a case series of 8 hospitalized infants 60 days of age or younger with coronavirus disease-2019. A quarter of these patients had coinfections (viral or bacterial). None of these infants had severe disease. Continued vigilance in testing this vulnerable group of infants is warranted.

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The Role and Activities of Board-Certified Chaplains in Advance Care Planning

American Journal of Hospice and Palliative Medicine® ◽

10.1177/1049909121989996 ◽

2021 ◽

pp. 104990912198999

Author(s):

Jung Kwak ◽

Soyeon Cho ◽

George Handzo ◽

Brian P. Hughes ◽

Sami S. Hasan ◽

...

Keyword(s):

Advance Care Planning ◽

Self Report ◽

Healthcare Team ◽

Care Planning ◽

Cross Sectional ◽

Team Members ◽

Roles And Responsibilities ◽

Healthcare Settings ◽

Academic Medical ◽

Advance Care

Background: Healthcare chaplains have key roles in providing palliative support to patients and families, and they are well-suited to facilitate advance care planning (ACP). However, empirical data on the roles and responsibilities of chaplains in facilitating ACP are limited. Objectives: To examine the roles of board-certified healthcare chaplains in ACP in various healthcare settings. Methods: A cross-sectional, web-based self-report survey was conducted with 585 board-certified chaplains recruited from 3 major professional chaplains’ organizations in the U.S. The survey data included chaplains’ demographic and professional characteristics, their roles and responsibilities, and responses regarding communication and participation with other healthcare team members in facilitating ACP, including experienced barriers. Results: More participants worked in community hospital settings (42%) and academic medical centers (19.6%) than in any other setting. Over 90% viewed ACP as an important part of their work, 70% helped patients complete advance directives, and 90% helped patients discuss their preferences about end-of-life treatments. Many chaplains were not consistently included in team discussions regarding decision-making, although most chaplains reported that they could always find ways to communicate with their teams. Conclusion: Professional board-certified chaplains regularly engage in facilitating ACP discussions with patients and families in various healthcare settings. There is a need to recognize and provide systematic support for the role of chaplains in facilitating ACP conversations and to integrate chaplains into routine interdisciplinary team and family meetings.

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The Process and Impact of Stakeholder Engagement in Developing a Pediatric Intensive Care Unit Communication and Decision-Making Intervention

Journal of Patient Experience ◽

10.1177/2374373516685950 ◽

2016 ◽

Vol 3 (4) ◽

pp. 108-118 ◽

Cited By ~ 5

Author(s):

Kelly N Michelson ◽

Joel Frader ◽

Lauren Sorce ◽

Marla L Clayman ◽

Stephen D Persell ◽

...

Keyword(s):

Intensive Care Unit ◽

Decision Making ◽

Intensive Care ◽

Pediatric Intensive Care Unit ◽

Stakeholder Engagement ◽

Pediatric Intensive Care ◽

Healthcare Team ◽

Team Members ◽

Core Elements ◽

Stakeholder Input

Stakeholder-developed interventions are needed to support pediatric intensive care unit (PICU) communication and decision-making. Few publications delineate methods and outcomes of stakeholder engagement in research. We describe the process and impact of stakeholder engagement on developing a PICU communication and decision-making support intervention. We also describe the resultant intervention. Stakeholders included parents of PICU patients, healthcare team members (HTMs), and research experts. Through a year-long iterative process, we involved 96 stakeholders in 25 meetings and 26 focus groups or interviews. Stakeholders adapted an adult navigator model by identifying core intervention elements and then determining how to operationalize those core elements in pediatrics. The stakeholder input led to PICU-specific refinements, such as supporting transitions after PICU discharge and including ancillary tools. The resultant intervention includes navigator involvement with parents and HTMs and navigator-guided use of ancillary tools. Subsequent research will test the feasibility and efficacy of our intervention.

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Canada's Health Human Resource Challenges: What is the Fate of Our Healthcare Heroes?

Healthcare Management Forum ◽

10.1016/j.hcmf.2011.04.001 ◽

2011 ◽

Vol 24 (4) ◽

pp. 179-183

Author(s):

Karim Bandali ◽

Lynn Zhu ◽

Paul A.W. Gamble

Keyword(s):

Health Education ◽

Patient Care ◽

Professional Education ◽

Healthcare Team ◽

Health Human Resource ◽

Care Experience ◽

Education And Health ◽

System Leaders ◽

Canadian Health ◽

Challenging Environment

Each year, the Canadian health education system graduates thousands of health professionals who have the best intentions of practising to their full scope of knowledge and skills to help improve the patient care experience in this country. However, a recent research study points to the fact that members of the healthcare team may be practising in a challenging environment in which only a limited number of their skills are actually being used. The Michener Institute for Applied Health Sciences believes that these issues, which include increased role specialization, limited scopes of practice, rapidly advancing technology, and challenges transitioning from hospital to community settings, have broader health education and health system implications that need to be addressed by policy makers, educators, and healthcare system leaders in order to enhance health professional education as well as patient care.

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ESTIMATION OF SARS-COV-2 SPECIFIC ANTIBODIES SEROPREVALENCE IN HEALTHCARE WORKERS IN DISTRICT UDAIPUR, INDIA

10.36106/ijar/8102221 ◽

2021 ◽

pp. 61-63

Author(s):

Shelesh Kumar Swami ◽

Nitesh Kumar Chauhan ◽

Shuchi Goyal ◽

A.K. Verma ◽

Shweta Biyani

Keyword(s):

Healthcare Workers ◽

Clinical Symptoms ◽

Control Measures ◽

Rt Pcr ◽

High Seroprevalence ◽

Know How ◽

Novel Coronavirus ◽

And Control ◽

Infection Eradication ◽

Cumulative Prevalence

Background:Current pandemic caused by Novel coronavirus (COVID-19) causes clinical symptoms from fever to acute respiratory distress syndrome but may remain mild or asymptomatic. To evaluate the cumulative prevalence of SARSCoV-2 infection in a community and know how immune response develops in the population, reliable assay alongwith RT-PCR for detection of SARS-CoV 2 antibodies is needed. Healthcare workers (HCWs) represent a high-risk populat - ion for infection with SARS-CoV-2. Methods: We evaluated total antibodies recognizing the SARS CoV 2 receptor binding domain (S1-RBD) - - - or the Spike protein over a period of six months in a total of 310 healthcare workers engaged in hospital using SARS-CoV-2 Total antibody assay kit. Findings: The overall seroprevalence found in our analysis was 41.93%. In case of males the percentage positive was found to be signicantly higher at 43.91%, compared to females at 36.25%. Seroprevalence was signicantly higher in 50 years above age group in comparison to 20-50 years old aged healthcare workers. The seroprevalence was higher in doctors, nursing staff and lab technicians than other healthcare professionals as 44.6%. Conclusions: This study showed high seroprevalence of SARS-CoV-2 in healthcare workers which means remaining proportion of the healthcare workers are still susceptible to the infection. Good compliance to infection eradication and control measures, adequate PPEs, and early detection and isolation of healthcare workers infected with SARS-CoV-2 are mandatory to reduce the risk of SARS-CoV-2 infection.

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Role Network Analysis of Team Interactions and Individual Activities: Application to VTE Prophylaxis

Proceedings of the Human Factors and Ergonomics Society Annual Meeting ◽

10.1177/1541931213601703 ◽

2017 ◽

Vol 61 (1) ◽

pp. 896-900 ◽

Cited By ~ 2

Author(s):

Ann Schoofs Hundt ◽

Pascale Carayon ◽

Yushi Yang ◽

Jason Stamm ◽

Vaibhav Agrawal ◽

...

Keyword(s):

Network Analysis ◽

Flow Model ◽

Visual Representations ◽

Hospitalized Patients ◽

Healthcare Team ◽

Analysis Method ◽

Team Members ◽

Vte Prophylaxis ◽

Team Interactions ◽

Clinical Interactions

In this paper, we describe the role network analysis method to capture and visually convey healthcare team members’ clinical interactions as well as individual activities performed in light of VTE prophylaxis management for hospitalized patients. Our visual representations expand on the role network analysis work of Pasmore (1988) and flow model of Beyer and Holtzblatt (1998) and offer a deeper sociotechnical representation of the work of healthcare team members.

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Latent Profile Analysis of Perceptions and Attitudes Towards COVID-19 in a Sample of Chinese People

Frontiers in Public Health ◽

10.3389/fpubh.2021.727242 ◽

2021 ◽

Vol 9 ◽

Author(s):

Zhimin Niu ◽

Li Li ◽

Hongying Li ◽

Songli Mei ◽

Hui Jiang ◽

...

Keyword(s):

Health Education ◽

Predictive Factors ◽

Online Survey ◽

Latent Profile Analysis ◽

Profile Analysis ◽

Chinese People ◽

Place Of Residence ◽

Perceptions And Attitudes ◽

Negative Perceptions ◽

Novel Coronavirus

Background: The novel coronavirus-2019 (COVID-19) disease has spread quickly throughout China and around the world, endangering human health and life. Individuals' perceptions and attitudes as well as related health education measures may affect disease progression and prognosis during the COVID-19 outbreak. To promote and implement health education, research must focus on the perceptions and attitudes towards COVID-19 among Chinese people. The present study aimed to examine the profiles and predictive factors of the perceptions and attitudes towards COVID-19 in a sample of Chinese people.Methods: A sample of 2,663 Chinese people comprising medical staff and members of the general public completed an online survey on Wenjuanxing. The survey measured demographic variables (e.g., gender, age, education level, and place of residence) and perceptions and attitudes towards COVID-19.Results: Two profiles of perceptions and attitudes towards COVID-19 (positive and negative perceptions and attitudes) were identified in the sample. Place of residence during the COVID-19 pandemic and first response to COVID-19 were found to be independent predictive factors for COVID-19 related perceptions and attitudes.Conclusion: In addition to drug therapy and mental health services, the perceptions and attitudes of Chinese people towards COVID-19 should be considered when promoting health education during the COVID-19 pandemic.

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