scholarly journals Perceptions and experiences of healthcare providers during COVID-19 pandemic in Karachi, Pakistan: an exploratory qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e048984
Author(s):  
Anam Shahil Feroz ◽  
Nousheen Akber Pradhan ◽  
Zarak Hussain Ahmed ◽  
Mashal Murad Shah ◽  
Nargis Asad ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Low Income ◽  
Healthcare Workers ◽  
Early Stage ◽  
Tertiary Care ◽  
Healthcare Providers ◽  
Working Environment ◽  
Hospital Environment ◽  
Front Line ◽  
Enabling Factors

ObjectiveTo explore healthcare provider’s perspectives and experiences of the barriers and facilitators to treat and manage COVID-19 cases.Design and settingWe conducted an exploratory qualitative study using a purposive sampling approach, at a private tertiary care teaching hospital in Karachi, Pakistan. Study data were analysed manually using the conventional content analysis technique.ParticipantsKey-informant interviews (KIIs) were conducted with senior management and hospital leadership and in-depth interviews (IDIs) were conducted with front-line healthcare providers.ResultsA total of 31 interviews (KIIs=19; IDIs=12) were conducted, between April and May 2020. Three overarching themes emerged. The first was ‘challenges faced by front-line healthcare providers working in COVID-19 wards. Healthcare workers experienced increased anxiety due to the fear of acquiring infection and transmitting it to their family members. They felt overwhelmed due to the exhaustive donning and doffing process, intense work and stigmatisation. The second theme was ‘enablers supporting healthcare providers to deal with the COVID-19 pandemic’. Front liners pointed out several enabling factors that supported hospital staff including a safe hospital environment, adequate training, a strong system of information sharing and supportive management. The third theme was ‘recommendations to support the healthcare workforce during the COVID-19 crisis’. Healthcare workers recommended measures to mitigate current challenges including providing risk allowance to front-line healthcare providers, preparing a backup health workforce, and establishing a platform to address the mental health needs of the healthcare providers.ConclusionThis study provides an initial evidence base of healthcare providers’ experiences of managing patients with COVID-19 in the early stage of the pandemic and highlights measures needed to address the encountered challenges. It offers lessons for hospitals in low-income and middle-income countries to ensure a safe working environment for front-line workers in their fight against COVID-19.

scholarly journals Feasibility, usability and acceptability of paediatric lung ultrasound among healthcare providers and caregivers for the diagnosis of childhood pneumonia in resource-constrained settings: a qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e042547
Author(s):  
Atif Riaz ◽  
Olga Cambaco ◽  
Laura Elizabeth Ellington ◽  
Jennifer L Lenahan ◽  
Khatia Munguambe ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Low Income ◽  
Lung Ultrasound ◽  
New Technology ◽  
Healthcare Providers ◽  
Ease Of Use ◽  
Local Context ◽  
Future Research ◽  
Successful Implementation ◽  
Pneumonia Diagnosis

ObjectivesPaediatric pneumonia burden and mortality are highest in low-income and middle-income countries (LMIC). Paediatric lung ultrasound (LUS) has emerged as a promising diagnostic tool for pneumonia in LMIC. Despite a growing evidence base for LUS use in paediatric pneumonia diagnosis, little is known about its potential for successful implementation in LMIC. Our objectives were to evaluate the feasibility, usability and acceptability of LUS in the diagnosis of paediatric pneumonia.DesignProspective qualitative study using semistructured interviewsSettingTwo referral hospitals in Mozambique and PakistanParticipantsA total of 21 healthcare providers (HCPs) and 20 caregivers were enrolled.ResultsHCPs highlighted themes of limited resource availability for the feasibility of LUS implementation, including perceived high cost of equipment, maintenance demands, time constraints and limited trained staff. HCPs emphasised the importance of policymaker support and caregiver acceptance for long-term success. HCP perspectives of usability highlighted ease of use and integration into existing workflow. HCPs and caregivers had positive attitudes towards LUS with few exceptions. Both HCPs and caregivers emphasised the potential for rapid, improved diagnosis of paediatric respiratory conditions using LUS.ConclusionsThis was the first study to evaluate HCP and caregiver perspectives of paediatric LUS through qualitative analysis. Critical components impacting feasibility, usability and acceptability of LUS for paediatric pneumonia diagnosis in LMIC were identified for initial deployment. Future research should explore LUS sustainability, with a particular focus on quality control, device maintenance and functionality and adoption of the new technology within the health system. This study highlights the need to engage both users and recipients of new technology early in order to adapt future interventions to the local context for successful implementation.Trial registration numberNCT03187067.

scholarly journals Unraveling PBF effects beyond impact evaluation: results from a qualitative study in Cameroon

2018 ◽  
Vol 3 (2) ◽  
pp. e000693 ◽  
Author(s):  
Manuela De Allegri ◽  
Maria Paola Bertone ◽  
Shannon McMahon ◽  
Idrissou Mounpe Chare ◽  
Paul Jacob Robyn
Keyword(s):  
Qualitative Study ◽  
Health System ◽  
Low Income ◽  
Impact Evaluation ◽  
Healthcare Providers ◽  
Analytical Techniques ◽  
Demand Side ◽  
Middle Income ◽  
Implementation Processes ◽  
Heterogeneous Effects

IntroductionPerformance-based financing (PBF) has acquired increased prominence as a means of reforming health system purchasing structures in low-income and middle-income countries. A number of impact evaluations have noted that PBF often produces mixed and heterogeneous effects. Still, little systematic effort has been channelled towards understanding what causes such heterogeneity, including looking more closely at implementation processes.MethodsOur qualitative study aimed at closing this gap in knowledge by attempting to unpack the mixed and heterogeneous effects detected by the PBF impact evaluation in Cameroon to inform further implementation as the country scales up the PBF approach. We collected data at all levels of the health system (national, district, facility) and at the community level, using a mixture of in-depth interviews and focus group discussions. We combined deductive and inductive analytical techniques and applied analyst triangulation.ResultsOur findings indicate that heterogeneity in effects across facilities could be explained by pre-existing infrastructural weaknesses coupled with rigid administrative processes and implementation challenges, while heterogeneity across indicators could be explained by providers’ practices, privileging services where demand-side barriers were less substantive.ConclusionIn light of the country’s commitment to scaling up PBF, it follows that substantial efforts (particularly entrusting facilities with more financial autonomy) should be made to overcome infrastructural and demand-side barriers and to smooth implementation processes, thus, enabling healthcare providers to use PBF resources and management models to a fuller potential.

scholarly journals Perspectives on simulation-based training from paediatric healthcare providers in Nigeria: a national survey

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034029
Author(s):  
Rachel Umoren ◽  
Veronica Chinyere Ezeaka ◽  
Ireti B Fajolu ◽  
Beatrice N Ezenwa ◽  
Patricia Akintan ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Professional Training ◽  
Tertiary Care ◽  
Healthcare Providers ◽  
Secondary Outcome ◽  
Skills Acquisition ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Simulation Based

ObjectivesThe objective of this study was to explore the access to, and perceived utility of, various simulation modalities by in-service healthcare providers in a resource-scarce setting.SettingPaediatric training workshops at a national paediatric conference in Nigeria.ParticipantsAll 200 healthcare workers who attended the workshop sessions were eligible to participate. A total of 161 surveys were completed (response rate 81%).Primary and secondary outcome measuresA paper-based 25-item cross-sectional survey on simulation-based training (SBT) was administered to a convenience sample of healthcare workers from secondary and tertiary healthcare facilities.ResultsRespondents were mostly 31–40 years of age (79, 49%) and women (127, 79%). Consultant physicians (26, 16%) and nurses (56, 35%) were in both general (98, 61%) and subspecialty (56, 35%) practice. Most had 5–10 years of experience (62, 37%) in a tertiary care setting (72, 43%). Exposure to SBT varied by profession with physicians more likely to be exposed to manikin-based (29, 30% physicians vs 12, 19% nurses, p<0.001) or online training (7, 7% physician vs 3, 5% nurses, p<0.05). Despite perceived barriers to SBT, respondents thought that SBT should be expanded for continuing education (84, 88% physician vs 39, 63% nurses, p<0.001), teaching (73, 76% physicians vs 16, 26% nurses, p<0.001) and research (65, 68% physicians vs 14, 23% nurses, p<0.001). If facilities were available, nearly all respondents (92, 98% physicians; 52, 96% nurses) would recommend the use of online simulation for their centre.ConclusionsThe access of healthcare workers to SBT is limited in resource-scarce settings. While acknowledging the challenges, respondents identified many areas in which SBT may be useful, including skills acquisition, skills practice and communication training. Healthcare workers were open to the use of online SBT and expressed the need to expand SBT beyond the current scope for health professional training in Nigeria.

scholarly journals The Experiences of Healthcare Providers Regarding Professional Ethics of Front Line Health Workers (A Qualitative Study)

2020 ◽  
Author(s):  
Ghasem Abedi ◽  
Ghader Momeni Rahkola ◽  
Samad Rouhani
Keyword(s):  
Qualitative Study ◽  
Health Services ◽  
Professional Ethics ◽  
Health Workers ◽  
Healthcare Providers ◽  
Health Centers ◽  
Front Line ◽  
Services Delivery ◽  
Comprehensive Health ◽  
And Behavior

Background and purpose: There is a return to rationality and ethics in the approach of current world. After several eras, humanity comes to consider rationality and ethics in addressing its physical and moral needs. From this point of view, ethics could be considered as a center of evolution in the future. This approach mainly influences those practices that are in the lead in serving people. Therefore, in this study, the aim was to investigate stakeholders’ points of view about Phenomenological ethics and professional behavior of auxiliary health workers at first level of health services delivery.  Materials and methods: This qualitative study was conducted through semi-structural interview in 2017. The study population included 9 principals of staff technical unit, 5 physicians in charge of rural comprehensive health centers, and 12 auxiliary health workers of affiliated health houses who were selected purposefully. After conducting the interviews, the data was transferred to paper and analyzed using content analysis with emphasis on core and non-core factors that influence behavior and professional ethics of auxiliary health workers from inter-organization stakeholders’ viewpoints. Findings: The results of this study included two general domains of the main elements (ethical and behavioral), and a total of 12 sub-areas of each of the two main elements, including 3 sub-domains that comprised the moral criterion: (secrecy, censorship, good behavior), as well as three behavioral criteria (accountability, expressive power, motivation), and ultimately 107 basic categories from 3 perspectives, which were all selected by institutional stakeholders: technical units, physicians of comprehensive health centers, as well as healthcare providers.Conclusion: The expressed experiences have shown that the issues surrounding the ethics and behavior of auxiliary health workers who are providing health services at the front line of health system, is inevitable in order to intervene in improving and promoting the quality of morality and behavior of this group of health professionals. 

scholarly journals Knowledge, attitudes and practices of healthcare workers during the early COVID-19 pandemic in a main, academic tertiary care centre in Saudi Arabia

2020 ◽  
Vol 148 ◽  
Author(s):  
M. H. Temsah ◽  
A. N. Alhuzaimi ◽  
N. Alamro ◽  
A. Alrabiaah ◽  
F. Al-Sohime ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Healthcare Workers ◽  
Early Stage ◽  
Tertiary Care ◽  
Knowledge Score ◽  
Tertiary Hospital ◽  
Previous Experience ◽  
Tertiary Care Centre ◽  
Awareness Campaign ◽  
Attitudes And Practices

Abstract As the Middle East respiratory syndrome coronavirus (MERS-CoV) continues to occur in small outbreaks in Saudi Arabia, we aimed to assess the knowledge, attitudes and intended practices of healthcare workers (HCWs) during the early stage of the COVID-19 pandemic and compare worry levels with previous findings during the MERS-CoV outbreak in 2015. We sent an adapted version of our previously published MERS-CoV questionnaire to the same cohort of HCWs at a tertiary hospital in Saudi Arabia. About 40% of our sample had previous experience with confirmed or suspected MERS-CoV patients, and those had a significantly higher knowledge score (13.16 ± 2.02 vs. 12.58 ± 2.27, P = 0.002) and higher adherence to protective hygienic practices (2.95 ± 0.80 vs. 2.74 ± 0.92, P = 0.003). The knowledge scores on COVID-19 were higher in the current cohort than the previous MERS-CoV outbreak cohort (68% vs. 79.7%, P < 0.001). HCWs from the current cohort who felt greater anxiety from COVID-19 compared to MERS-CoV were less likely to have been exposed to MERS-CoV infected/suspected cases (odds ratio (OR) = 0.646, P = 0.042) and were less likely to have attended the hospital awareness campaign on COVID-19 (OR = 0.654, P = 0.035). We concluded that previous experience with MERS-CoV was associated with increased knowledge and adherence to protective hygienic practices, and reduction of anxiety towards COVID-19.

An Outbreak Due to MultiresistantAcinetobacter baumanniiin a Burn Unit: Risk Factors for Acquisition and Management

2002 ◽  
Vol 23 (5) ◽  
pp. 261-267 ◽  
Author(s):  
Andrew E. Simor ◽  
Mark Lee ◽  
Mary Vearncombe ◽  
Linda Jones-Paul ◽  
Clare Barry ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hand Hygiene ◽  
Tertiary Care ◽  
Healthcare Providers ◽  
Significant Risk ◽  
Hospital Environment ◽  
Resistant Bacteria ◽  
Environmental Cleaning ◽  
Burn Unit ◽  
Temporary Closure

Objectives:To describe the investigation and management of an outbreak due to multiresistantAcinetobacter baumanniiand to determine risk factors for acquisition of the organism.Setting:A 14-bed regional burn unit in a Canadian tertiary-care teaching hospital.Design:Case-control study with multivariate analysis of potential risk factors using logistic regression analysis. Surveillance cultures were obtained from the hospital environment, from noninfected patients, and from healthcare providers.Results:A total of 31 (13%) of 247 patients with acute burn injuries acquired multiresistantA. baumanniibetween December 1998 and March 2000; 18 (58%) of the patients were infected. The organism was recovered from the hospital environment and the hands of healthcare providers. Significant risk factors for acquisition of multiresistantA. baumanniiwere receipt of blood products (odds ratio [OR], 10.8; 95% confidence interval [CI95], 3.4 to 34.4;P< .001); procedures performed in the hydrotherapy room (OR, 4.1; CI95, 1.3 to 13.1;P= .02); and increased duration of mechanical ventilation (OR, 1.1 per day; CI95, 1.0 to 1.1;P=. 02).Interventions:Improved compliance with hand hygiene, strict patient isolation, meticulous environmental cleaning, and temporary closure of the unit to new admissions.Conclusions:Acquisition of multiresistantA. baumanniiwas likely multifactorial, related to environmental contamination and contact with transiently colonized healthcare providers. Control measures addressing these potential sources of multiresistantA. baumanniiwere successful in terminating the outbreak. Ongoing surveillance and continued attention to hand hygiene and adequate environmental cleaning are essential to prevent recurrent outbreaks due to antibiotic-resistant bacteria in burn units.

scholarly journals Surveillance on Healthcare Workers During the First Wave of SARS-CoV-2 Pandemic in Italy: The Experience of a Tertiary Care Pediatric Hospital

2021 ◽  
Vol 9 ◽  
Author(s):  
Valentina Guarnieri ◽  
Maria Moriondo ◽  
Mattia Giovannini ◽  
Lorenzo Lodi ◽  
Silvia Ricci ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Screening Program ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
University Hospital ◽  
Hospital Environment ◽  
Rt Pcr ◽  
Screening Programs ◽  
Positive Individual ◽  
Efficient Screening

Healthcare workers (HCWs) play a central role in handling the ongoing coronavirus disease 2019 (COVID-19) pandemic. Monitoring HCWs, both symptomatic and asymptomatic, through screening programs, are critical to avoid the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the hospital environment to rapidly identify and isolate infected individuals and to allow their prompt return to work as soon as necessary. We aim to describe our healthcare surveillance experience (April 2–May 6, 2020) based on a combined screening consisting of real-time PCR (RT-PCR) on nasopharyngeal (NP) swabs and rapid serologic tests (RST) for SARS-CoV-2 in all HCWs of Meyer Children's University Hospital in Florence. Among the analyzed workers, 13/1690 (0.8%), all of them without clinical manifestations, was found positive for SARS-CoV-2 by using RT-PCR on NP swab: 8/1472 (0.5%) were found positive during the screening, 1/188 (0.5%) during contact with a positive individual (p &gt; 0.05 vs. screening group), while 4/30 (13.3%) were found positive on the day of re-admission at work after an influenza-like-illness (p &lt; 0.05). Concerning working areas, the majority of RT-PCR positivity (12/13) and serologic positivity (34/42) was found in non-COVID-19 dedicated areas (p &gt; 0.05 vs. COVID-19 dedicated areas). No cases were registered among non-patients-facing workers (p = 0.04 vs. patient-facing group). Nurses and residents represented, respectively, the working role with the highest and lowest percentage of RT-PCR positivity. In conclusion, accurate surveillance is essential to reduce virus spread among HCWs, patients, and the community and to limit the shortage of skilled professionals. The implementation of the surveillance system through an efficient screening program was offered to all professionals, regardless of the presence of clinical manifestations and the level of working exposure risk, maybe wise and relevant.

scholarly journals Allocation of the “Already” Limited Medical Resources Amid the COVID-19 Pandemic, an Iterative Ethical Encounter Including Suggested Solutions From a Real Life Encounter

2021 ◽  
Vol 7 ◽  
Author(s):  
Yazan Nedal Alhalaseh ◽  
Hatem A. Elshabrawy ◽  
Madiha Erashdi ◽  
Mohammed Shahait ◽  
Abdulrahman Mohammad Abu-Humdan ◽  
...  
Keyword(s):  
Low Income ◽  
Healthcare Workers ◽  
Healthcare Providers ◽  
Real Life ◽  
Developed Countries ◽  
Low Income Countries ◽  
Health Issues ◽  
The Face ◽  
Automated Screening ◽  
Comprehensive Programs

The shortage of healthcare providers is well-documented in low-income countries (LIC) prior to COVID-19, due to various causes including the migration to developed countries, scarcity of supplies, poor healthcare infrastructure, limited ICU facilities, and lack of access to guidelines and protocols. One of the important hitches in LIC is the insufficient testing capacity that precluded accurate assessment of disease burden and subsequently resource allocations. Trying to adhere to the principles of bioethics including respect to others, beneficence, and justice should be applied on the ground in the particular setting of the LIC. Solutions should be tailored to the tangible needs and possibility of implementation in real life in the face of the “already” limited resources by making use of simple, yet plausible, measures. Implementing guidelines and frameworks that were set to work in the better-resourced nations is a call for futility. The adoption of novel solutions to overcome the unique challenges in the LIC is exigent. These include the use of automated screening algorithms and virtual video clinics. Moreover, integrating electronic intensive care unit (e-ICU) software may allow for remote monitoring of multiple patients simultaneously. Telemedicine could help in getting consultations worldwide. It can also enhance healthcare workers' knowledge and introduce new skills through teleconferences, e-workshops, and free webinars. Healthcare workers can be remotely trained to enhance their skills. Agencies, such as the WHO, should develop comprehensive programs to tackle different health issues in LIC in collaboration with major institutions and experts around the world.

scholarly journals Consensus for prevention and management of coronavirus disease 2019 (COVID-19) for neurologists

2020 ◽  
Vol 5 (2) ◽  
pp. 146-151 ◽  
Author(s):  
Huijuan Jin ◽  
Candong Hong ◽  
Shengcai Chen ◽  
Yifan Zhou ◽  
Yong Wang ◽  
...  
Keyword(s):  
Nervous System ◽  
Early Stage ◽  
Healthcare Providers ◽  
Hospital Environment ◽  
System Involvement ◽  
Presenting Symptoms

Coronavirus disease 2019 (COVID‐19) has become a pandemic disease globally. Although COVID-19 directly invades lungs, it also involves the nervous system. Therefore, patients with nervous system involvement as the presenting symptoms in the early stage of infection may easily be misdiagnosed and their treatment delayed. They become silent contagious sources or ‘virus spreaders’. In order to help neurologists to better understand the occurrence, development and prognosis, we have developed this consensus of prevention and management of COVID‐19. It can also assist other healthcare providers to be familiar with and recognise COVID-19 in their evaluation of patients in the clinic and hospital environment.

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