scholarly journals Simplified Strategies for COVID-19 Surge Management in Critical Care in Resource-Limited Areas – An Aide-Mémoire

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Mehraj Ud Din ◽  
Prashant Hegde
Keyword(s):  
Health Care ◽  
Critical Care ◽  
Disaster Response ◽  
Well Being ◽  
Health Care Facilities ◽  
Response Strategy ◽  
Care Staff ◽  
Organ Support ◽  
Health Care Staff ◽  
Hospital Institution

Purpose of this document Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the severe acute respiratory syndrome (SARS) coronavirus 2. We are facing an unprecedented situation globally because of the COVID-19 pandemic where extraordinary measures are needed continually on war footing. The goal being to save maximum lives while protecting health care staff. A competent emergency response system must incorporate necessary resources, relevant knowledge, attitudes and skills. Ring-fencing by clustering patients, experts and pooling of resources will go a long way in containing the pandemic locally. While detailed disaster response policies and guidelines are available from different societies and national bodies, this concise paper presents an aide-mémoire in a simplistic manner, since clarity of thought is key to effective preparation and sustained response. [1-5] Based on a review of various guidelines and literature search, key considerations are presented in a concise format to facilitate chalking out a suitable response strategy locally. [6-10] The following five key areas should be considered in the hospital/institution while planning for increasing Critical Care capacity to cope with anticipated COVID-19 surge. 1. Structure 2. Staffing 3. Space 4. Supplies and equipment 5. Sustainability and Staff Well being Structure (Management & Chain of Command) Anticipate: • There is going to be a sudden peak and surge in COVID-19 patients with many requiring Intensive Care Unit (ICU) admission requiring organ support particularly m e c h a n i c a l v e n t i l a t i o n w h i c h w i l l overwhelm existing health care facilities. Blueprint: • Establish a central/regional ICU COVID- 19 coordination center with dedicated and expert man power, which will guide and monitor all the ICU admissions and resource allocation in the entire region while maintaining continual contact with networking hospitals. • Lay down and circulate policies and guidelines

scholarly journals A Web-Delivered Acceptance and Commitment Therapy Intervention With Email Reminders to Enhance Subjective Well-Being and Encourage Engagement With Lifestyle Behavior Change in Health Care Staff: Randomized Cluster Feasibility Stud

10.2196/18586 ◽  
2020 ◽  
Vol 4 (8) ◽  
pp. e18586
Author(s):  
Menna Brown ◽  
Nic Hooper ◽  
Phillip James ◽  
Darren Scott ◽  
Owen Bodger ◽  
...  
Keyword(s):  
Health Care ◽  
Behavior Change ◽  
Controlled Trial ◽  
Well Being ◽  
Care Staff ◽  
Health Care Staff ◽  
Subjective Well Being ◽  
Web Based ◽  
Lifestyle Behavior ◽  
Acceptance And Commitment

Background Poor mental health and emotional well-being can negatively impact ability to engage in healthy lifestyle behavior change. Health care staff have higher rates of sickness and absence than other public sector staff, which has implications at both individual and societal levels. Individual efforts to self-manage health and well-being which add to the UK mental health prevention agenda need to be supported. Objective The objective of this study was to establish the feasibility and acceptability of the inclusion of a self-guided, automated, web-based acceptance and commitment therapy intervention in an existing health promotion program, to improve subjective well-being and encourage engagement with lifestyle behavior change. Methods For this 12-week, 4-armed, randomized controlled cluster feasibility study, we recruited participants offline and randomly allocated them to 1 of 3 intervention arms or control (no well-being intervention) using an automated web-based allocation procedure. Eligibility criteria were current health care staff in 1 Welsh health board, age≥18 years, ability to read English, and ability to provide consent. The primary researcher was blinded to cluster allocation. Feasibility outcomes were randomization procedure, acceptance of intervention, and adherence to and engagement with the wider program. We evaluated health and well-being data via self-assessment at 2 time points, registration and postintervention, using the 14-item Warwick-Edinburgh Mental Well-Being Scale, the 4-item Patient Health Questionnaire, and the 7-item Acceptance and Action Questionnaire—Revised. Results Of 124 participants who provided consent and were randomly allocated, 103 completed full registration and engaged with the program. Most participants (76/103) enrolled in at least one health behavior change module, and 43% (41/96) of those randomly allocated to an intervention arm enrolled in the well-being module. Adherence and engagement was low (7/103, 6.8%), but qualitative feedback was positive. Conclusions The procedure and randomization process proved feasible, and the addition of the well-being module proved acceptable to health care staff. However, participant engagement was limited, and no one completed the full 12-week program. User feedback should be used to develop the intervention to address poor engagement. Effectiveness should then be evaluated in a full-scale randomized controlled trial, which would be feasible with additional recruitment. Trial Registration International Standard Randomised Controlled Trial Number (ISRCTN) 50074817; http://www.isrctn.com/ISRCTN50074817

Workplace Stress and Employee Wellbeing: Case of Health Care Staff in UAE

2017 ◽  
Vol 13 (5) ◽  
pp. 217 ◽  
Author(s):  
Nasreen Khan ◽  
Sofia Khurshid
Keyword(s):  
Health Care ◽  
Organizational Support ◽  
Negative Impact ◽  
High Stress ◽  
Poor Performance ◽  
Well Being ◽  
Workplace Stress ◽  
Care Staff ◽  
Health Care Staff ◽  
The Impact

Workplace stress is a world-wide concern and has been a subject of researchers, academicians, authorities and decision makers’ interest. It has evidently been considered to be causing poor performance, reduced employee morale, lack of autonomy, job insecurity and to greater extent the employee's wellbeing. Employees in healthcare and hospitality sector work in 24*7 work schedule due to the demanding nature of the industry. Empirical evidences have indicated that employee experience high stress on account of work overload and long working hours taking a toll on their mental and physical well-being. The purpose of this study was to investigate the impact of workplace stress on employee well-being among staff employees in the health care sector and hospitals in UAE. A total of 150 employees working at staff level in health care centers and hospitals in UAE were surveyed. The results showed that workplace has negative impact on employee well-being and the impact was found to be weak. The findings of the study suggest that an increase in workplace stresses will reduce wellbeing of employees. The researchers recommend that in order to reduce the impact of stress on employee well-being organizational support, family support and social support is essential.

scholarly journals Clowning in health care settings: The point of view of adults

2016 ◽  
Vol 12 (3) ◽  
pp. 473-488 ◽  
Author(s):  
Alberto Dionigi ◽  
Carla Canestrari
Keyword(s):  
Health Care ◽  
Positive Emotions ◽  
Emotional Reactivity ◽  
Psychological Symptoms ◽  
Empirical Studies ◽  
Well Being ◽  
Care Staff ◽  
Future Research ◽  
Health Care Staff ◽  
Pilot Studies

Within the past decade, there has been a surge of interest in investigating the effects of clown intervention in a large variety of clinical settings. Many studies have focused on the effects of clown intervention on children. However, few studies have investigated clowning effects on adults. This paper presents an overview of the concept of medical clowning followed by a literature review conducted on the empirical studies drawn from three data bases (PubMed, PsycINFO, and Google Scholar), with the aim of mapping and discussing the evidence of clowning effects on non-children, namely adults. The following areas were investigated: Adult and elderly patients (mainly those with dementia), observers of clowning, namely non-hospitalized adults who are at the hospital as relatives of patients or health-care staff, and finally clowns themselves. The main results are that 1) clown intervention induces positive emotions, thereby enhancing the patient’s well-being, reduces psychological symptoms and emotional reactivity, and prompts a decrease in negative emotions, such as anxiety and stress; 2) clown doctors are also well-perceived by relatives and healthcare staff and their presence appears to be useful in creating a lighter atmosphere in the health setting; 3) few pilot studies have been conducted on clown doctors and this lacuna represents a subject for future research.

scholarly journals Development of a Web-Based Acceptance and Commitment Therapy Intervention to Support Lifestyle Behavior Change and Well-Being in Health Care Staff: Participatory Design Study

10.2196/22507 ◽  
2020 ◽  
Vol 4 (11) ◽  
pp. e22507
Author(s):  
Menna Brown ◽  
Nic Hooper ◽  
Parisa Eslambolchilar ◽  
Ann John
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Design Process ◽  
Acceptance And Commitment Therapy ◽  
Participatory Design ◽  
Well Being ◽  
Care Staff ◽  
Health Care Staff ◽  
Web Based ◽  
Acceptance And Commitment

Background Positive emotional well-being is associated with healthier lifestyle choices and overall health function, whereas poor mental health is associated with significant economic and psychological costs. Thus, the development of effective interventions that improve emotional well-being is crucial to address the worldwide burden of disease. Objective This study aims to develop a web-based emotional well-being intervention for use by health care staff using participatory design to consider adherence and engagement from a user perspective. Methods A 3-staged iterative participatory design process was followed, including multiple stakeholders: researchers, computer scientists, mental health experts, and health care staff. Stage 1 used document analyses, direct observation, and welcome interviews; stage 2 used focus group discussions, rapid prototyping, and usability tasks; and stage 3 evaluated a high-fidelity prototype. Results Different health care staff (N=38) participated during a sustained period. A structured, sequential, automated, 12-week, web-based emotional well-being intervention based on acceptance and commitment therapy was developed. Freely navigated psychoeducational resources were also included. Conclusions The iterative and collaborative participatory design process successfully met its objectives. It generated an in-depth understanding of well-being within the workplace and identified barriers to access. The 3-staged process ensured that participants had the opportunity to explore and articulate criteria relevant to their roles over time and reflect on decisions made at each stage.

scholarly journals “We are taking every precaution to do our part…”: a comparative analysis of nursing, palliative and hospice care facilities’ websites during the COVID-19 pandemic

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sabahat Ölcer ◽  
Mohamed Idris¹ ◽  
Yüce Yilmaz-Aslan ◽  
Patrick Brzoska
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Hospice Care ◽  
Qualitative Content Analysis ◽  
Health Care Facilities ◽  
Care Staff ◽  
Health Care Staff ◽  
Care Providers ◽  
Potential Health ◽  
Care Facilities

Abstract Background The COVID-19 pandemic has a significant impact on health care processes. Precautions such as restrictions imposed on visitors and social distancing have led to multiple challenges, particularly in terms of communication. Using the case of nursing, palliative and hospice care facilities in Germany and drawing on agenda-setting theory, the present study aims to shed light on how health care facilities use their websites to inform (potential) health care users about changes in regulations, new protective measures implemented and about recommendations in the context of the COVID-19 pandemic. Methods The websites of nursing, palliative and hospice care facilities in Germany were examined using qualitative document analysis and qualitative content analysis. A total of 138 websites was analysed in the study. The data gathered includes all information about COVID-19 on these websites published from the beginning of March until August 15, 2020. Results Facilities show similarities in adhering to the measures taken by the authorities to restrict the spread of SARS-CoV-2 and to protect vulnerable patients and employees. All facilities urged the public to avoid paying visits to patients in facilities unless there was an emergency; however, visiting procedures in practice varied by types of facilities. For optimal communication, telephone and especially video calls were the options preferred by health care providers and health care users. Facilities made great efforts to prevent emotional stress and to strengthen resilience among all stakeholders. Transparency was adopted by many facilities in order to build the public’s trust. Conclusions The agenda of health care facilities has been seriously affected by the COVID-19 pandemic. The study sheds light on the strategies developed by facilities, their efforts to increase emotional resilience among health care staff and health care users, the ethical guidelines they have adopted regarding privacy policies as well as how these themes are communicated via the facilities’ websites. The results can inform other health care facilities about how websites can be used as essential communication tools in times of public health crises.

scholarly journals Identifying Health Care Environment Contradictions in Terms of Infection Control during a Pandemic with a Focus on Health Workers’ Experience

2021 ◽  
Vol 13 (17) ◽  
pp. 9964
Author(s):  
Maryam Lesan ◽  
Fatemeh Khozaei ◽  
Mi-Jeong Kim ◽  
Marziyeh Shahidi Nejad
Keyword(s):  
Health Care ◽  
Infection Control ◽  
Organizational Support ◽  
Health Workers ◽  
Health Care Facilities ◽  
Care Staff ◽  
World Health ◽  
Infection Prevention And Control ◽  
Health Care Staff ◽  
Health Care Environment

During the past year, health care environments have struggled to cope with the various impacts of COVID-19 around the world. Health care facilities need to help strengthen resistance to pathogen threats and provide care for patients and health workers in the safest possible way. Architectural design strategies can play a significant role in infection prevention and control. The current study aims to examine the experiences of health workers with hospital spaces during the COVID-19 pandemic. Identifying the difficulties they face, the present study attempts to shed light on the role of the health care layout configuration in combating pandemics. The authors conducted observations at four hospitals and a series of online semi-structured interviews with 162 health care staff from March to May 2020. The study indicated that space configuration and the hospitalization of patients, layout and circulation of the environment, operation services such as indoor environment conditions, maintenance of health care system, and organizational support for health care staff were the most critical factors affecting infection control in health care environments. The initial zoning and separation of patients were the most effective methods of controlling infection. Hospitals with clustered plan layouts were found to be the most effective buildings for the zoning of COVID-19 patients during the pandemic and for infection control.

scholarly journals A Web-Delivered Acceptance and Commitment Therapy Intervention With Email Reminders to Enhance Subjective Well-Being and Encourage Engagement With Lifestyle Behavior Change in Health Care Staff: Randomized Cluster Feasibility Stud (Preprint)

2020 ◽  
Author(s):  
Menna Brown ◽  
Nic Hooper ◽  
Phillip James ◽  
Darren Scott ◽  
Owen Bodger ◽  
...  
Keyword(s):  
Health Care ◽  
Behavior Change ◽  
Controlled Trial ◽  
Well Being ◽  
Care Staff ◽  
Health Care Staff ◽  
Subjective Well Being ◽  
Web Based ◽  
Lifestyle Behavior ◽  
Acceptance And Commitment

BACKGROUND Poor mental health and emotional well-being can negatively impact ability to engage in healthy lifestyle behavior change. Health care staff have higher rates of sickness and absence than other public sector staff, which has implications at both individual and societal levels. Individual efforts to self-manage health and well-being which add to the UK mental health prevention agenda need to be supported. OBJECTIVE The objective of this study was to establish the feasibility and acceptability of the inclusion of a self-guided, automated, web-based acceptance and commitment therapy intervention in an existing health promotion program, to improve subjective well-being and encourage engagement with lifestyle behavior change. METHODS For this 12-week, 4-armed, randomized controlled cluster feasibility study, we recruited participants offline and randomly allocated them to 1 of 3 intervention arms or control (no well-being intervention) using an automated web-based allocation procedure. Eligibility criteria were current health care staff in 1 Welsh health board, age≥18 years, ability to read English, and ability to provide consent. The primary researcher was blinded to cluster allocation. Feasibility outcomes were randomization procedure, acceptance of intervention, and adherence to and engagement with the wider program. We evaluated health and well-being data via self-assessment at 2 time points, registration and postintervention, using the 14-item Warwick-Edinburgh Mental Well-Being Scale, the 4-item Patient Health Questionnaire, and the 7-item Acceptance and Action Questionnaire—Revised. RESULTS Of 124 participants who provided consent and were randomly allocated, 103 completed full registration and engaged with the program. Most participants (76/103) enrolled in at least one health behavior change module, and 43% (41/96) of those randomly allocated to an intervention arm enrolled in the well-being module. Adherence and engagement was low (7/103, 6.8%), but qualitative feedback was positive. CONCLUSIONS The procedure and randomization process proved feasible, and the addition of the well-being module proved acceptable to health care staff. However, participant engagement was limited, and no one completed the full 12-week program. User feedback should be used to develop the intervention to address poor engagement. Effectiveness should then be evaluated in a full-scale randomized controlled trial, which would be feasible with additional recruitment. CLINICALTRIAL International Standard Randomised Controlled Trial Number (ISRCTN) 50074817; http://www.isrctn.com/ISRCTN50074817

Use of Thin Dressings Under N95 Respirators: Exploring Their Effect on Quantitative Fit Testing Results to Guide Hospital Practice During the COVID-19 Pandemic

2020 ◽  
Vol 66 (11) ◽  
pp. 13-17
Author(s):  
Susan Guschel ◽  
Karen Chmiel ◽  
Jennifer Rosenstein
Keyword(s):  
Health Care ◽  
Nurse Practitioners ◽  
Skin Barrier ◽  
Hospital Staff ◽  
Health Care Facilities ◽  
Care Staff ◽  
Health Care Staff ◽  
Hydrocolloid Dressing ◽  
Effective Seal ◽  
N95 Respirators

At the beginning of the coronavirus disease-19 pandemic, health care staff at a level 1 trauma center in the state of New York experienced facial irritation and skin breakdown under their N95 respirators due to increased and prolonged use. PURPOSE: Members of the Certified Wound and Ostomy Nurse, Nurse Practitioners staff were charged with developing recommendations within 48 hours to help prevent and manage facial skin issues using available products that would not compromise the seal of the respirators. METHOD: With the assistance of a health care safety specialist from the Environmental Health and Safety Department of the hospital, an ambient particle counting device was used to measure the N95 fit factor following application of a liquid skin barrier, transparent film dressing, light silicone-based adhesive dressing, or an extra-thin hydrocolloid dressing on the bridge of the nose and the cheekbones underneath an N95 respirator of 2 hospital staff members who volunteered to test the dressings. RESULTS: All thin dressings tested showed a fit factor over 100, reflecting an effective seal. The highest fit factors were seen with the liquid skin barrier in the 2 volunteers (200 and 198, respectively). Thin dressing usage information was included in the hospital guidelines for N95 respirators and shared with staff. Subsequent feedback suggests that the light silicone-based adhesive dressing and the extra-thin hydrocolloid dressing were preferred. CONCLUSION: Thin dressing use may help reduce skin complications among hospital staff during periods of extended N95 respirator wear time. Because use of the dressings did not result in failure of the quantitative fit test, they were permitted for use by health care staff under their N95 respirators. Studies are needed to help health care facilities optimize N95 respirator use to protect staff from coronavirus disease-19 and respirator-related skin complications while supply shortages remain.

Empowerment, environment and person-centred care: A qualitative study exploring the hospital experience for adults with cognitive impairment

Dementia ◽  
2018 ◽  
Vol 18 (7-8) ◽  
pp. 2710-2730 ◽  
Author(s):  
Laura Prato ◽  
Lyndsay Lindley ◽  
Miriam Boyles ◽  
Louise Robinson ◽  
Clare Abley
Keyword(s):  
Health Care ◽  
Cognitive Impairment ◽  
Hospital Care ◽  
Well Being ◽  
Care Staff ◽  
Health Care Staff ◽  
Ward Staff ◽  
Structured Interviews ◽  
Case Study Methodology ◽  
Hospital Experience

It is acknowledged that there are many challenges to ensuring a positive hospital experience for patients with cognitive impairment. The study (‘Improving hospital care for adults with cognitive impairment’) aimed to explore the positive and negative experiences of older adults with cognitive impairment (dementia and delirium) and their relatives and/or carers, during an acute hospital stay, from admission to discharge, using a qualitative, case study methodology. Six participants with cognitive impairment, eight relatives and 59 members of the health care team were recruited. Data was collected via ethnographic, observational periods at each stage of the hospital journey and through the use of semi-structured interviews with relatives, carers and health care staff including: medical staff; nursing staff; physiotherapists and ward managers. Interpretive phenomenological analysis was used to facilitate data analysis. 52 hours 55 minutes of ethnographic observations and 18 interviews with ward staff and relatives were undertaken. Three superordinate themes emerged from the data as crucial in determining the quality of the hospital experience: valuing the person; activities of empowerment and disempowerment and the interaction of environment with patient well-being. Whether the patient’s hospital experience was positive or negative was powerfully influenced by family involvement and ward staff actions and communication. Participants identified a requirement for a ward based activity service for patients with cognitive impairment. Further research must be undertaken focusing on the development of ward based activities for patients with cognitive impairment, alongside a move towards care which explores measures to improve and expand relative involvement in hospital care.

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