scholarly journals Management of Outpatient Hemodialysis During the COVID-19 Pandemic: Recommendations From the Canadian Society of Nephrology COVID-19 Rapid Response Team

2020 ◽  
Vol 7 ◽  
pp. 205435812093856
Author(s):  
Rita S. Suri ◽  
John E. Antonsen ◽  
Cheryl A. Banks ◽  
David A. Clark ◽  
Sara N. Davison ◽  
...  
Keyword(s):  
Public Health ◽  
Peer Review ◽  
Review Process ◽  
Peer Review Process ◽  
Rapid Response Team ◽  
Adverse Outcomes ◽  
Rapid Response ◽  
Canadian Society ◽  
Dialysis Unit ◽  
Response Team

Purpose: To collate best practice recommendations on the management of patients receiving in-center hemodialysis during the COVID-19 pandemic, based on published reports and current public health advice, while considering ethical principles and the unique circumstances of Canadian hemodialysis units across the country. Sources of information: The workgroup members used Internet search engines to retrieve documents from provincial and local hemodialysis programs; provincial public health agencies; the Centers for Disease Control and Prevention; webinars and slides from other kidney agencies; and nonreviewed preprints. PubMed was used to search for peer-reviewed published articles. Informal input was sought from knowledge users during a webinar. Methods: Challenges in the care of hemodialysis patients during the COVID-19 pandemic were highlighted within the Canadian Senior Renal Leaders Forum discussion group. The Canadian Society of Nephrology (CSN) developed the COVID-19 rapid response team (RRT) to address these challenges. They identified a pan-Canadian team of clinicians and administrators with expertise in hemodialysis to form the workgroup. One lead was chosen who drafted the initial document. Members of the workgroup reviewed and discussed all recommendations in detail during 2 virtual meetings on April 7 and April 9. Disagreements were resolved by consensus. The document was reviewed by the CSN COVID-19 RRT, an ethicist, an infection control expert, a community nephrologist, and a patient partner. Content was presented during an interactive webinar on April 11, 2020 attended by 269 kidney health professionals, and the webinar and first draft of the document were posted online. Final revisions were made based on feedback received until April 13, 2020. CJKHD editors reviewed the parallel process peer review and edited the manuscript for clarity. Key findings: Recommendations were made under the following themes: (1) Identification of patients with COVID-19 in the dialysis unit, (2) hemodialysis of patients with confirmed COVID-19, (3) hemodialysis of patients not yet known to have COVID-19, (4) visitors; (5) testing for COVID-19 in the dialysis unit; (6) resuscitation, (6) routine hemodialysis care, (7) hemodialysis care under fixed dialysis resources. Limitations: Because of limitations of time and resources, and the large number of questions, formal systematic review was not undertaken. The recommendations are based on expert opinion and subject to bias. The parallel review process that was created may not be as robust as the standard peer review process. Implications: We hope that these recommendations provide guidance for dialysis unit directors, clinicians, and administrators on how to limit risk from infection and adverse outcomes, while providing necessary dialysis care in a setting of finite resources. We also identify a number of resource allocation priorities, which we hope will inform decisions at provincial funding agencies.

scholarly journals Challenges in Public Health Rapid Response Team Management

2020 ◽  
Vol 18 (S1) ◽  
pp. S-8-S-13 ◽  
Author(s):  
Ashley L. Greiner ◽  
Tasha Stehling-Ariza ◽  
Dante Bugli ◽  
Adela Hoffman ◽  
Coralie Giese ◽  
...  
Keyword(s):  
Public Health ◽  
Rapid Response Team ◽  
Rapid Response ◽  
Team Management ◽  
Response Team

scholarly journals Management of Canadian Pediatric Patients With Glomerular Diseases During the COVID-19 Pandemic: Recommendations From the Canadian Association of Pediatric Nephrologists COVID-19 Rapid Response Team

2020 ◽  
Vol 7 ◽  
pp. 205435812097071
Author(s):  
Cal Robinson ◽  
Michelle Ruhl ◽  
Amrit Kirpalani ◽  
Abdullah Alabbas ◽  
Damien Noone ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Peer Review ◽  
Care Delivery ◽  
Rapid Response Team ◽  
Glomerular Disease ◽  
Rapid Response ◽  
Optimal Care ◽  
Glomerular Diseases ◽  
Canadian Association ◽  
Response Team

Purpose: The goal of these recommendations is to provide guidance on the optimal care of children with glomerular diseases during the COVID-19 pandemic. Patients with glomerular diseases are known to be more susceptible to infection. Risk factors include decreased vaccine uptake, urinary loss of immunoglobulins, and treatment with immunosuppressive medications. The Canadian Society of Nephrology (CSN) recently published guidelines on the care of adult glomerulonephritis patients. This guideline aims to expand and adapt those recommendations for programs caring for children with glomerular diseases. Sources of information: We used the CSN COVID-19 Rapid Response Team adult glomerulonephritis recommendations, published in the Canadian Journal of Kidney Health and Disease, as the foundation for our guidelines. We reviewed documents published by nephrology and non-nephrology societies and health care agencies focused on kidney disease and immunocompromised populations. Finally, we conducted a formal literature review of publications relevant to pediatric and adult glomerular disease, chronic kidney disease, hypertension, and immunosuppression in the context of the COVID-19 pandemic. Methods: The leadership of the Canadian Association of Pediatric Nephrologists (CAPN), which is affiliated with the CSN, identified a team of clinicians and researchers with expertise in pediatric glomerular diseases. The aim was to adapt Canadian adult glomerulonephritis guidelines to make them applicable to children and discuss pediatric-specific considerations. The updated guidelines were peer-reviewed by senior clinicians with expertise in the care of childhood glomerular diseases. Key findings: We identified a number of key areas of glomerular disease care likely to be affected by the COVID-19 pandemic, including (1) clinic visit scheduling, (2) visit types, (3) provision of multidisciplinary care, (4) blood work and imaging, (5) home monitoring, (6) immunosuppression, (7) other medications, (8) immunizations, (9) management of children with suspected COVID-19, (10) renal biopsy, (11) patient education and support, and (12) school and child care. Limitations: There are minimal data regarding the characteristics and outcomes of COVID-19 in adult or pediatric glomerular disease patients, as well as the efficacy of strategies to prevent infection transmission within these populations. Therefore, the majority of these recommendations are based on expert opinion and consensus guidance. To expedite the publication of these guidelines, an internal peer-review process was conducted, which may not have been as rigorous as formal journal peer-review. Implications: These guidelines are intended to promote optimal care delivery for children with existing or newly diagnosed glomerular diseases during the COVID-19 pandemic. The implications of modified care delivery, altered immunosuppression strategies, and limited access to existing resources remain uncertain.

scholarly journals The limited value of journal peer review in public health: a case series of tobacco harm reduction articles.

2019 ◽  
Author(s):  
Carl V. Phillips ◽  
Igor Burstyn ◽  
Brian L. Carter
Keyword(s):  
Public Health ◽  
Harm Reduction ◽  
Peer Review ◽  
Review Process ◽  
Peer Review Process ◽  
Single Case ◽  
Journal Article ◽  
Case Series ◽  
Tobacco Harm Reduction ◽  
Almost All

Background: A widespread belief holds that the journal peer-review process ensures that published claims are correct. In public health this results in consumer, clinical, and policy decisions being based on blind faith in the accuracy of claims that appear in journals. Methods: We wrote reviews, as if we were writing journal peer reviews, of 12 consecutive articles related to tobacco harm reduction topics published in a mainstream public health journal, BMC Public Health, from 2012 to 2015. We then compared these to the reviews written by the journal’s reviewers. Additionally, we reviewed the changes made to the papers as a result of the journal reviews. Results: Almost all the papers in the dataset suffered from major flaws, most of which could have been corrected. None of these were corrected by the journal review process. In the single case where a journal reviewer identified many of the major flaws, the comments were basically ignored by the authors. Unreported conflict of interest was common among both authors and reviewers. Conclusions: The journal publishing process contributed very little value, compared to just circulating working papers, other than formatting and indexing. In public health, the phrase “according to a peer-reviewed journal article” seems to mean little more than “I read this somewhere.”

Reducing Telemetry Use Is Safe: A Retrospective Analysis of Rapid Response Team and Code Events After a Successful Intervention to Reduce Telemetry Use

2018 ◽  
Vol 34 (4) ◽  
pp. 398-401
Author(s):  
Lijia Xie ◽  
Trit Garg ◽  
David Svec ◽  
Jason Hom ◽  
Rajani Kaimal ◽  
...  
Keyword(s):  
Financial Incentives ◽  
Care Center ◽  
Tertiary Care ◽  
Rapid Response Team ◽  
Incidence Rates ◽  
Adverse Outcomes ◽  
Rapid Response ◽  
Successful Intervention ◽  
Response Team ◽  
Educational Modules

Interventions guiding appropriate telemetry utilization have successfully reduced use at many hospitals, but few studies have examined their possible adverse outcomes. The authors conducted a successful intervention to reduce telemetry use in 2013 on a hospitalist service using educational modules, routine review, and financial incentives. The association of reduced telemetry use with the incidence of rapid response team (RRT) and code activations was assessed in a retrospective cohort study of 210 patients who experienced a total of 233 RRT and code events on the inpatient internal medicine services from January 2012 through March 2015 at a tertiary care center. The incidence of adverse events for the hospitalist service was not significantly different during the intervention and postintervention period as compared to the preintervention period. Reducing inappropriate telemetry use was not associated with an increase in the incidence rates of RRT and code events.

Getting Involved in the Peer Review Process

2008 ◽  
Author(s):  
Kenya Malcolm ◽  
Allison Groenendyk ◽  
Mary Cwik ◽  
Alisa Beyer
Keyword(s):  
Peer Review ◽  
Review Process ◽  
Peer Review Process
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