scholarly journals COVID-19 Pandemic and the Impact on the Cardiovascular Disease Patient Care

2020 ◽  
Vol 16 (3) ◽  
pp. 173-177 ◽  
Author(s):  
Prashanth Kulkarni ◽  
Manjappa Mahadevappa ◽  
Srinivas Alluri

: The COVID-19 pandemic has emerged as a serious global threat causing a large number of fatalities and putting enormous strain on the health care resources across the world. This has resulted in preferentially triaging the coronavirus infected patients and placing others, especially cardiovascular patients at increased risk for adverse complications. The effective management of cardiac patients in the hospital environment during this COVID-19 pandemic has emerged as a real challenge. We try to address this issue and also highlight the interplay between COVID-19 and cardiovascular diseases. We hereby review the available literature and emerging guidelines about cardiovascular implications related to COVID-19 which will have a bearing on the patient care, health care professionals and cardiac centres.


2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Agnes T. Black ◽  
Marla Steinberg ◽  
Amanda E. Chisholm ◽  
Kristi Coldwell ◽  
Alison M. Hoens ◽  
...  

Abstract Background The KT Challenge program supports health care professionals to effectively implement evidence-based practices. Unlike other knowledge translation (KT) programs, this program is grounded in capacity building, focuses on health care professionals (HCPs), and uses a multi-component intervention. This study presents the evaluation of the KT Challenge program to assess the impact on uptake, KT capacity, and practice change. Methods The evaluation used a mixed-methods retrospective pre-post design involving surveys and review of documents such as teams’ final reports. Online surveys collecting both quantitative and qualitative data were deployed at four time points (after both workshops, 6 months into implementation, and at the end of the 2-year funded projects) to measure KT capacity (knowledge, skills, and confidence) and impact on practice change. Qualitative data was analyzed using a general inductive approach and quantitative data was analyzed using non-parametric statistics. Results Participants reported statistically significant increases in knowledge and confidence across both workshops, at the 6-month mark of their projects, and at the end of their projects. In addition, at the 6-month check-in, practitioners reported statistically significant improvements in their ability to implement practice changes. In the first cohort of the program, of the teams who were able to complete their projects, half were able to show demonstrable practice changes. Conclusions The KT Challenge was successful in improving the capacity of HCPs to implement evidence-based practice changes and has begun to show demonstrable improvements in a number of practice areas. The program is relevant to a variety of HCPs working in diverse practice settings and is relatively inexpensive to implement. Like all practice improvement programs in health care settings, a number of challenges emerged stemming from the high turnover of staff and the limited capacity of some practitioners to take on anything beyond direct patient care. Efforts to address these challenges have been added to subsequent cohorts of the program and ongoing evaluation will examine if they are successful. The KT Challenge program has continued to garner great interest among practitioners, even in the midst of dealing with the COVID-19 pandemic, and shows promise for organizations looking for better ways to mobilize knowledge to improve patient care and empower staff. This study contributes to the implementation science literature by providing a description and evaluation of a new model for embedding KT practice skills in health care settings.



2020 ◽  
Vol 34 (1) ◽  
pp. 12-23
Author(s):  
Joseph D Z ◽  
Aminu B ◽  
Halilu S ◽  
Mark A D ◽  
Kayode O ◽  
...  

Introduction: Interdisciplinary collaboration (IDC) is important in health care settings as the complex nature and demands of the health care work environment requires the expertise and knowledge of different individuals or specialists working together to solve multifaceted and complex patient care problems. Objective: To assess the health professionals' attitude towards the development of an interdisciplinary collaborative approach to patient care in health institutions and to systematically review the impact of IDC as a panacea for effective health outcomes in Nigeria. Methodology: The research is a systematic review that provides various approaches for studying interdisciplinary teams. Fifty articles were selected from different search engines such as Google, google scholar, science direct and research gate with the search term Interdisciplinary collaboration among health care professionals. Articles were arranged based on most relevant, relevant and closely related articles. Result: The study revealed that IDC is pivotal in evidence-based care and contributes immensely to effective and efficient health outcomes. It puts the patient at the centre of the healthcare team's focus and allows all health professionals, with the patient, to collaboratively provide input, be part of the decision making, and improve outcomes. Although there are several obstacles to IDC, adopting this team-based culture of mutual respect and understanding is possible and, in fact, necessary. Conclusion: This study reveals that there are many benefits to IDC. It can improve safety and healthcare delivery, as well as reduce costs. The interprofessional team supports patient and personnel engagement, organizational efficiency and innovation.



2020 ◽  
Author(s):  
Agnes Black ◽  
Marla Steinberg ◽  
Amanda Chisholm ◽  
Kristi Coldwell ◽  
Alison Hoens ◽  
...  

Abstract Background The KT Challenge program supports health care professionals to effectively implement evidence-based practices. Unlike other knowledge translation (KT) programs, this program is grounded in capacity building, focuses on health care professionals (HCPs), and uses a multi-component intervention. This study presents the evaluation of the KT Challenge program to assess the impact on uptake, KT capacity and practice change. MethodsThe evaluation used a mixed-methods, time-series design involving surveys and review of documents such as teams’ final reports. Online surveys collecting both quantitative and qualitative data were deployed at four time points (after both workshops, six months into implementation, and at the end of the two-year funded projects) to measure KT capacity ( knowledge, skills and confidence), and impact on practice change. Qualitative data was analyzed using a general inductive approach and quantitative data was analysed using non-parametric statistics. ResultsParticipants reported statistically significant increases in knowledge and confidence across both workshops, at the 6-month mark of their projects, and at the end of their projects. In addition, at the 6-month check-in, practitioners reported statistically significant improvements in their ability to implement practice changes. In the first cohort of the program, of the teams who were able to complete their projects, half were able to show demonstrable practice changes. ConclusionsThe KT Challenge was successful in improving the capacity of HCPs to implement evidence-based practice changes and has begun to show demonstrable improvements in a number of practice areas. The program is relevant to a variety of HCPs working in diverse practice settings and is relatively inexpensive to implement. Like all practice improvement programs in health care settings, a number of challenges emerged stemming from the high turnover of staff and the limited capacity of some practitioners to take on anything beyond direct patient care. Efforts to address these challenges have been added to subsequent cohorts of the KT Challenge program and ongoing evaluation will examine if they are successful. The KT Challenge program has continued to garner great interest among practitioners, even in the midst of dealing with the COVID-19 pandemic, and shows promise for organizations looking for better ways to mobilize knowledge to improve patient care and empower staff. This study contributes to the implementation science literature by providing a description and evaluation of a new model for embedding KT practice skills in health care settings.



2021 ◽  
Author(s):  
Agnes Black ◽  
Marla Steinberg ◽  
Amanda Chisholm ◽  
Kristi Coldwell ◽  
Alison Hoens ◽  
...  

Abstract Background The KT Challenge program supports health care professionals to effectively implement evidence-based practices. Unlike other knowledge translation (KT) programs, this program is grounded in capacity building, focuses on health care professionals (HCPs), and uses a multi-component intervention. This study presents the evaluation of the KT Challenge program to assess the impact on uptake, KT capacity and practice change. MethodsThe evaluation used a mixed-methods, time-series design involving surveys and review of documents such as teams’ final reports. Online surveys collecting both quantitative and qualitative data were deployed at four time points (after both workshops, six months into implementation, and at the end of the two-year funded projects) to measure KT capacity ( knowledge, skills and confidence), and impact on practice change. Qualitative data was analyzed using a general inductive approach and quantitative data was analysed using non-parametric statistics. ResultsParticipants reported statistically significant increases in knowledge and confidence across both workshops, at the 6-month mark of their projects, and at the end of their projects. In addition, at the 6-month check-in, practitioners reported statistically significant improvements in their ability to implement practice changes. In the first cohort of the program, of the teams who were able to complete their projects, half were able to show demonstrable practice changes. ConclusionsThe KT Challenge was successful in improving the capacity of HCPs to implement evidence-based practice changes and has begun to show demonstrable improvements in a number of practice areas. The program is relevant to a variety of HCPs working in diverse practice settings and is relatively inexpensive to implement. Like all practice improvement programs in health care settings, a number of challenges emerged stemming from the high turnover of staff and the limited capacity of some practitioners to take on anything beyond direct patient care. Efforts to address these challenges have been added to subsequent cohorts of the program and ongoing evaluation will examine if they are successful. The KT Challenge program has continued to garner great interest among practitioners, even in the midst of dealing with the COVID-19 pandemic, and shows promise for organizations looking for better ways to mobilize knowledge to improve patient care and empower staff. This study contributes to the implementation science literature by providing a description and evaluation of a new model for embedding KT practice skills in health care settings.



2021 ◽  
Vol 9 (D) ◽  
pp. 43-46
Author(s):  
Tanya Bozhkova ◽  
Nina Musurlieva

BACKGROUND: In their practice, health-care professionals are at increased risk of coronavirus disease 2019 (COVID-19) infection, which is particularly high for dentists, hygienists, dental assistants, and dental technicians due to close contact with patients and exposure to biological fluids and aerosol/droplets during dental procedures. AIM: The purpose of this study is to survey the opinion of dentists and dental technicians about the impact of the state of emergency in Bulgaria related to the COVID-19 epidemic on their practices. MATERIALS AND METHODS: A specially developed web-based survey conducted among 49 dentists and dental technicians was used. The results were processed with SPSS v. 18 at significance level of p < 0.05. RESULTS: A group of 49 dentists and dental technicians were included in the survey. Оf them (20.41 ± 5.76) reported that they did not work at all during the state of emergency. Relatively, a large number of dentists (81.82 ± 8.22) respond that they have completely changed their patient care protocols. The result is similar for dental technicians (77.77 ± 8.00). More than half of the dentists (59.09 ± 10.48) respond that they specifically disinfect the dental impressions, and of the dental technicians (29.63 ± 8.78) say that they insist on this. All of the respondents share that they use special protective equipment in their practices. CONCLUSION: Although significant progress has been made in controlling COVID-19 and dental clinics and practices are gradually resuming routine patient care, the prevention and control of severe acute respiratory syndrome coronavirus 2 transmission during dental procedures remains a serious challenge.



1995 ◽  
Vol 2 (1) ◽  
pp. 71-77 ◽  
Author(s):  
Katherine N. Moore

Noncompliance exasperates health care professionals, leaves them worrying about the effective outcome of medical care, and results in noncompliant patients being labelled as 'difficult' or 'troublesome'. It is suggested that professionals who label a patient as noncompliant are following convenient paternalistic principles rather than considering the impact of a prescribed regimen on an individual patient. In this paper, the author considers autonomy and respect to be foremost in patient care. Further, compliance does not necessarily indicate that both professional and patient have developed a collaborative understanding relationship. Noncompliance is described as a lack of recognition by the health care professional of the meaning of the regimen to the patient. Treatment interventions will be most successful when the patient participates in the prescription. Without acknowledgement of the patient as an equal partner, and listening to his or her narrative, care will be, at best, paternalistic. Les soignants peuvent devenir exasperes par les malades qui n'acquiescent pas à leur traitement. Cela laisse les soignants souciant des résultats de leurs soins et abouti à ce que les malades sont qualifiés de difficiles ou insoumis. On propose ici que le personnel qui traite les malades d'insoumis suit des principes paternalistes plutôt que de considérer les suites des regimes prescrits pour les particuliers. Dans cet article l'auteur considère l'autonomie et le respet comme primordiaux pour les soins. L'acqiescement ne veut pas toujours dire que malades et infirmiers/ères ont développés des rapports collaborateurs. Le refus d'acquiescer est aperçu comme un manque de reconnaissance par la personne soignante de la significance du traitement médical du malade. Les interventions réussissent le mieux quant les malades participent à leurs soins. Si l'on n'accepte pas les malades comme partenaires en écoutant leurs récits, les soins sont au plus du paternalisme. Die Ablehnung der verordneten Behandlung durch die Patienten kann das Pflege personal zur Verzweiflung bringen und den Ausgang der Behandlung in Frage stellen und führt dazu, die Patienten als schwierig oder problematisch einzustrafen. Hier wird die Ansicht vertreten, dass das Pflegepersonal, das Patienten als unkooperativ oder ablehnend bezeichnet, einem paternalistischen Prinzip folgt und nicht an die Wirkung denkt, die die verschriebene Behandlung auf einzelne Patienten hat. In diesem Artikel bezeichnet die Autorin die Selstbestimmung der Patienten und den Respekt ihnen gegenüber als das Wichtigste in der Krankenpflege. Fügsamkeit deutet nicht unbedingt auf eine Zusammenarbeit zwischen Patienten und Pflegenden hin. Zuwiderhandlung der Patienten wird als Mangel an Verständnis von Seiten des Pflegepersonals gesehen, das die Bedeutung, die die Behandlung für Patienten hat, nicht einzuschatzen weiss. Die Behandlung wird nur dann den grösstmöglichen Erfolg bringen, wenn die Patienten daran teilnehmen. Wenn Patienten nicht als gleichberechtigte Partner angesehen werden, deren Meinungen gehört und respektiert werden, ist die Pflege höchstens patemalistisch.



2021 ◽  
Vol 9 (3) ◽  
pp. 7-18
Author(s):  
Helen L. Millar

Background: Burnout, as a global phenomenon, has probably always existed and been present in all cultures but more recently has been increasingly identified in the public health sector work place. The UK National Health Service (NHS) is the largest employer in Europe with over 1.3 million workers. It therefore reflects many of the challenges common to global health care systems. The escalation of burnout in the UK NHS (National Health Service) is now recognized given the impact on workforce sustainability and the health care delivery. Objectives: This article aims to highlight the current epidemic of burnout in the UK NHS, its causes, and impact on the workforce and quality of care provided. Strategies developed to improve the health of the NHS workforce will be reviewed and appraised in terms of their impact and limitations to date. Methods: The methodology includes a broad overview of selected articles/publications focusing on the concept of burnout and the impact on the workforce and patient care and is not intended to be a systematic review. Publications include peer reviewed articles, governmental strategic documents, recent surveys, and relevant responses by health care professionals and other relevant independent bodies. Results: The current literature highlights that burnout in the NHS is a major concern. It is clear that recognition of the extent of the problem and its impact are crucial for the sustainability of the NHS. The alarming rate of work force attrition is evident and unless immediate drastic steps are taken to address the root causes, the pressure on remaining staff will escalate to breaking point resulting in an inability to sustain services due to further staff losses. Evidence demonstrates that staff burnout adversely affects patient care and increases errors. Conclusion: It is vital that burnout is addressed as a matter of urgency in order to ensure a healthy and productive workforce and to ensure patients are treated safely and effectively. The NHS’s very survival depends on direct and urgent action to remedy this situation.



1991 ◽  
Vol 2 (1) ◽  
pp. 82-89
Author(s):  
Joanne Moreland

Health care professionals are committed to the continual improvement of the quality of patient care. The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) has launched a major research and development project intended to improve its ability to evaluate health care organizations and encourage greater attention to the quality of daily patient care. This chapter describes JCAHO’s challenge to evaluate capability and performance of health care organizations and practitioners. The intent of JCAHO’s agenda for change is to focus on patient outcomes and quality improvement through a more precise and objective evaluation of both clinical and managerial performance. Through the agenda for change, JCAHO and the health care organization will participate in a continuous-flow monitoring system in which clinical and organizational data are transmitted from the field to JCAHO, analyzed, and fed back to the health care organization



2007 ◽  
Vol 13 (3) ◽  
pp. 29 ◽  
Author(s):  
Emily Mauldon

This paper reports on the attitudes of a sample of health care providers towards the use of telehealth to support rural patients and integrate rural primary health and urban hospital care. Telehealth and other information technologies hold the promise of improving the quality of care for people in rural and remote areas and for supporting rural primary health care providers. While seemingly beneficial for rural patients, study participants believed that telehealth remains underused and poorly integrated into their practice. In general, participants thought that telehealth is potentially beneficial but places constraints on their activities, and few actually used it. Published literature usually reports either on the success of telehealth pilot projects or initiatives that are well resourced and do not reflect the constraints of routine practice, or has an international focus limiting its relevance to the Australian context. Because of the paucity of systematic and generalisable research into the effects of the routine use of telehealth to support rural patients, it is unclear why health care professionals choose to provide such services or the costs and benefits they incur in doing so. Research and policy initiatives continue to be needed to identify the impact of telehealth within the context of Australian primary health care and to develop strategies to support its use.



CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S102
Author(s):  
S.W. Kirkland ◽  
A. Soleimani ◽  
B.H. Rowe ◽  
A.S. Newton

Introduction: Diverting patients away from the emergency department (ED) has been proposed as a solution for reducing ED overcrowding. The objective of this systematic review is to examine the effectiveness of diversion strategies designed to either direct patients seeking care at an ED to an alternative source of care. Methods: Seven electronic databases and grey literature were searched. Randomized/controlled clinical trials and cohort studies assessing the effectiveness of pre-hospital and ED-based diversion interventions with a comparator were eligible for inclusion. Two reviewers independently screened the studies for relevance, inclusion, and risk of bias. Intervention effects are reported as proportions (%) or relative risks (RR) with 95% confidence intervals (CI). Methodological and clinical heterogeneity prohibited pooling of study data. Results: From 7,306 citations, ten studies were included. Seven studies evaluated a pre-hospital diversion strategy and three studies evaluated an ED-based diversion strategy. The impact of diversion on subsequent health services was mixed. One study of paramedic practitioners reported increased ED attendance within 7 days (11.9% vs. 9.5%; p=0.049) but no differences in return visits for similar conditions (75.2% vs. 72.1%; p=0.64). The use of paramedic practitioners was associated with an increased risk of subsequent contact with health care services (RR=1.21, 95% CI 1.06, 1.38), while the use of deferred care was associated with no increase in risk of subsequently seeking physician care (RR=1.09, 95% CI 0.23, 5.26). While two studies reported that diverted patients were at significantly reduced risk for hospitalization, two other studies reported no significant differences between diverted or standard care patients. Conclusion: The evidence regarding the impact of pre-hospital and ED-based diversion on ED utilization and subsequent health care utilization is mixed. Additional high-quality comparative effectiveness studies of diversion strategies are required prior to widespread implementation.



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