Psychological crisis and emergency intervention for frontline critical care workers during the COVID‐19 pandemic

Author(s):  
Macarena Gálvez‐Herrer ◽  
Gemma Via‐Clavero ◽  
José Antonio Ángel‐Sesmero ◽  
Gabriel Heras‐La Calle
2020 ◽  
Author(s):  
Thomas Clavier ◽  
Benjamin Popoff ◽  
Jean Selim ◽  
Marion Beuzelin ◽  
Melanie Roussel ◽  
...  

BACKGROUND Critical care teams are on the front line of managing the COVID-19 pandemic, which is stressful for members of these teams. OBJECTIVE Our objective was to assess whether the use of social networks is associated with increased anxiety related to the COVID-19 pandemic among members of critical care teams. METHODS We distributed a web-based survey to physicians, residents, registered and auxiliary nurses, and nurse anesthetists providing critical care (anesthesiology, intensive care, or emergency medicine) in several French hospitals. The survey evaluated the respondents’ use of social networks, their sources of information on COVID-19, and their levels of anxiety and information regarding COVID-19 on analog scales from 0 to 10. RESULTS We included 641 respondents in the final analysis; 553 (86.3%) used social networks, spending a median time of 60 minutes (IQR 30-90) per day on these networks. COVID-19–related anxiety was higher in social network users than in health care workers who did not use these networks (median 6, IQR 5-8 vs median 5, IQR 3-7) in univariate (<i>P</i>=.02) and multivariate (<i>P</i>&lt;.001) analyses, with an average anxiety increase of 10% in social network users. Anxiety was higher among health care workers using social networks to obtain information on COVID-19 than among those using other sources (median 6, IQR 5-8 vs median 6, IQR 4-7; <i>P</i>=.04). Social network users considered that they were less informed about COVID-19 than those who did not use social networks (median 8, IQR 7-9 vs median 7, IQR 6-8; <i>P</i>&lt;.01). CONCLUSIONS Our results suggest that social networks contribute to increased anxiety in critical care teams. To protect their mental health, critical care professionals should consider limiting their use of these networks during the COVID-19 pandemic.


2021 ◽  
Vol 7 (3) ◽  
pp. 199-210
Author(s):  
Helen E. Baxendale ◽  
David Wells ◽  
Jessica Gronlund ◽  
Angalee Nadesalingham ◽  
Mina Paloniemi ◽  
...  

Abstract Introduction: In early 2020, at first surge of the coronavirus disease 2019 (COVID-19) pandemic, many health care workers (HCW) were re-deployed to critical care environments to support intensive care teams looking after patients with severe COVID-19. There was considerable anxiety of increased risk of COVID-19 for these staff. To determine whether critical care HCW were at increased risk of hospital acquired infection, we explored the relationship between workplace, patient facing role and evidence of immune exposure to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within a quaternary hospital providing a regional critical care response. Routine viral surveillance was not available at this time. Methods: We screened over 500 HCW (25% of the total workforce) for history of clinical symptoms of possible COVID19, assigning a symptom severity score, and quantified SARS-CoV-2 serum antibodies as evidence of immune exposure to the virus. Results: Whilst 45% of the cohort reported symptoms that they consider may have represented COVID-19, 14% had evidence of immune exposure. Staffs in patient facing critical care roles were least likely to be seropositive (9%) and staff working in non-patient facing roles most likely to be seropositive (22%). Anosmia and fever were the most discriminating symptoms for seropositive status. Older males presented with more severe symptoms. Of the 12 staff screened positive by nasal swab (10 symptomatic), 3 showed no evidence of seroconversion in convalescence. Conclusions: Patient facing staff working in critical care do not appear to be at increased risk of hospital acquired infection however the risk of nosocomial infection from non-patient facing staff may be more significant than previous recognised. Most symptoms ascribed to possible COVID-19 were found to have no evidence of immune exposure however seroprevalence may underrepresent infection frequency. Older male staff were at the greatest risk of more severe symptoms.


2019 ◽  
Vol 40 (9) ◽  
pp. 943-948 ◽  
Author(s):  
Gülseren Elay ◽  
Ilhan Bahar ◽  
Hilmi Demirkiran ◽  
Hafize Oksüz
Keyword(s):  

2014 ◽  
Vol 23 (1) ◽  
pp. 70-80 ◽  
Author(s):  
Stijn Blot ◽  
Elsa Afonso ◽  
Sonia Labeau

The intensive care unit is a work environment where superior dedication is pivotal to optimize patients’ outcomes. As this demanding commitment is multidisciplinary in nature, it requires special qualities of health care workers and organizations. Thus research in the field covers a broad spectrum of activities necessary to deliver cutting-edge care. However, given the abundance of research articles and education activities available, it is difficult for modern critical care clinicians to keep up with the latest progress and innovations in the field. This article broadly summarizes new developments in multidisciplinary intensive care, providing elementary information about advanced insights in the field by briefly describing selected articles bundled in specific topics. Issues considered include cardiovascular care, monitoring, mechanical ventilation, infection and sepsis, nutrition, education, patient safety, pain assessment and control, delirium, mental health, ethics, and outcomes research.


2018 ◽  
Vol 143 (01) ◽  
pp. 21-26 ◽  
Author(s):  
Andrej Michalsen ◽  
Andreas Hillert ◽  
Andreas Schießl ◽  
Dominik Hinzmann

AbstractBoth acute crises and chronically incriminating circumstances in people’s lives may lead to their being afflicted by psychological and somatic ailments. “Burnout” has been coined and established as the term for chronic occupational strain. Many professions claim to be extraordinarily affected by burnout, amongst others physicians and nurses, especially those working in anaesthesiology and critical care. Usually assessed with the Maslach Burnout Inventary, the prevalence of moderate or severe burnout in these areas is estimated at about 30 % amongst nurses and about 40 % to 50 % amongst physicians. Both individual characteristics of those afflicted and occupational factors – as well as their interactions – are made responsible for causing burnout. The complexity of potentially stressful impingements, though, particularly within anaesthesiology and critical care, cannot be covered by the traditional burnout-paradigm. The plethora of recommendations found in popular science may be helpful in individual cases. However, there are no evidence-based preventive or therapeutic measures yet, that would endurably mitigate the sequelae of chronic occupational strain. On the one hand, occupationally burdensome factors needed to be registered more elaborately, for instance using the “Stress-Monitor” instrument. On the other hand, an in-hospital “peer-support system” has been developed and implemented in a Munich hospital recently. Anaesthetists and intensive care physicians have formed a network that supports health care workers surmounting acute occupational strain and thus helps to prevent its chronification. Ultimately, the goal of health care workers needed to consist of establishing individual work-related strategies to adequately cope with the manifold occupational stressors in a lifelong learning process.


2020 ◽  
Vol 29 (6) ◽  
pp. e116-e127
Author(s):  
Vinciya Pandian ◽  
Linda L. Morris ◽  
Martin B. Brodsky ◽  
James Lynch ◽  
Brian Walsh ◽  
...  

Purpose Critical care nurses caring for patients with a tracheostomy are at high risk because of the predilection of SARS-CoV-2 for respiratory and mucosal surfaces. This review identifies patient-centered practices that ensure safety and reduce risk of infection transmission to health care workers during the coronavirus disease 2019 (COVID-19) pandemic. Methods Consensus statements, guidelines, institutional recommendations, and scientific literature on COVID-19 and previous outbreaks were reviewed. A global interdisciplinary team analyzed and prioritized findings via electronic communications and video conferences to develop consensus recommendations. Results Aerosol-generating procedures are commonly performed by nurses and other health care workers, most notably during suctioning, tracheostomy tube changes, and stoma care. Patient repositioning, readjusting circuits, administering nebulized medications, and patient transport also present risks. Standard personal protective equipment includes an N95/FFP3 mask with or without surgical masks, gloves, goggles, and gown when performing aerosol-generating procedures for patients with known or suspected COVID-19. Viral testing of bronchial aspirate via tracheostomy may inform care providers when determining the protective equipment required. The need for protocols to reduce risk of transmission of infection to nurses and other health care workers is evident. Conclusion Critical care nurses and multidisciplinary teams often care for patients with a tracheostomy who are known or suspected to have COVID-19. Appropriate care of these patients relies on safeguarding the health care team. The practices described in this review may greatly reduce risk of infectious transmission.


2015 ◽  
Vol 24 (1) ◽  
pp. 75-86 ◽  
Author(s):  
Stijn Blot ◽  
Elsa Afonso ◽  
Sonia Labeau

The intensive care unit is a work environment where superior dedication is crucial for optimizing patients’ outcomes. As this demanding commitment is multidisciplinary in nature, it requires special qualities of health care workers and organizations. Thus research in the field covers a broad spectrum of activities necessary to deliver cutting-edge care. However, given the numerous research articles and education activities available, it is difficult for modern critical care clinicians to keep up with the latest progress and innovation in the field. This article broadly summarizes new developments in multidisciplinary intensive care. It provides elementary information about advanced insights in the field via brief descriptions of selected articles grouped by specific topics. Issues considered include care for heart patients, mechanical ventilation, delirium, nutrition, pressure ulcers, early mobility, infection prevention, transplantation and organ donation, care for caregivers, and family matters.


2020 ◽  
Author(s):  
H.E. Baxendale ◽  
D. Wells ◽  
J. Gronlund ◽  
A. Nadesalingam ◽  
M. Paloniemi ◽  
...  

AbstractWith the first 2020 surge of the COVID-19 pandemic, many health care workers (HCW) were re-deployed to critical care environments to support intensive care teams to look after high numbers of patients with severe COVID-19. There was considerable anxiety of increased risk of COVID19 for staff working in these environments.Using a multiplex platform to assess serum IgG responses to SARS-CoV-2 N, S and RBD proteins, and detailed symptom reporting, we screened over 500 HCW (25% of the total workforce) in a quaternary level hospital to explore the relationship between workplace and evidence of exposure to SARS-CoV-2.Whilst 45% of the cohort reported symptoms that they consider may have represented COVID-19, overall seroprevalence was 14% with anosmia and fever being the most discriminating symptoms for seropositive status. There was a significant difference in seropositive status between staff working in clinical and non-clinical roles (9% patient facing critical care, 15% patient facing non-critical care, 22% nonpatient facing). In the seropositive cohort, symptom severity increased with age for men and not for women. In contrast, there was no relationship between symptom severity and age or sex in the seronegative cohort reporting possible COVID-19 symptoms. Of the 12 staff screened PCR positive (10 symptomatic), 3 showed no evidence of seroconversion in convalescence.ConclusionThe current approach to Personal Protective Equipment (PPE) appears highly effective in protecting staff from patient acquired infection in the critical care environment including protecting staff managing interhospital transfers of COVID-19 patients. The relationship between seroconversion and disease severity in different demographics warrants further investigation. Longitudinally paired virological and serological surveillance, with symptom reporting are urgently required to better understand the role of antibody in the outcome of HCW exposure during subsequent waves of COVID-19 in health care environments.


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