Telemedicine and Teleconsulting in the Era of COVID-19 Pandemic: A Useful Tool from Screening to Intensive Care Monitoring

The COVID-19 global pandemic has had striking effects on clinical practice and medical assistance and the progressive evolution of telemedicine and telehealth systems has allowed healthcare professionals to connect with patients yet respecting the striking need for social distancing. This article aims to review the possible ways to use telehealth and teleconsulting systems to guarantee an adequate level of clinical assistance starting from screening procedures up to support the management of patients admitted to intensive care units area, thus balancing the need to ensure continuity of care and at the same time limiting the possible sources of contagion expansion. Telemedicine may be a useful tool to improve clinical assistance and reduce the financial burden on the health system in a long-term view. Although it cannot completely replace patient-physician interactions, it would be desirable to implement this field and made it accessible to the largest part of the population.

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Development and Evaluation of Clinical Practice Guideline for Delirium in Long-Term Care

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17218255 ◽

2020 ◽

Vol 17 (21) ◽

pp. 8255

Author(s):

Eunhye Jeong ◽

Jinkyung Park ◽

Sung Ok Chang

Keyword(s):

Clinical Practice ◽

Development Process ◽

Healthcare Professionals ◽

Long Term Care ◽

Structured Interviews ◽

Term Care ◽

Barriers To Implementation ◽

Selection For ◽

Search Quality

Delirium is highly prevalent and leads to several bad outcomes for older long-term care (LTC) residents. For a more successful translation of delirium knowledge, Clinical Practice Guidelines (CPGs) tailored to LTC should be developed and applied based on the understanding of the barriers to implementation. This study was conducted to develop a CPG for delirium in LTC and to determine the barriers perceived by healthcare professionals related to the implementation of the CPG. We followed a structured, evidence- and theory-based procedure during the development process. After a systematic search, quality appraisal, and selection for eligible up-to-date CPGs for delirium, the recommendations applicable to the LTC were drafted, evaluated, and confirmed by an external group of experts. To evaluate the barriers to guideline uptake from the users’ perspectives, semi-structured interviews were conducted which resulted in four major themes: (1) a lack of resources, (2) a tendency to follow mindlines rather than guidelines, (3) passive attitudes, and (4) misunderstanding delirium care in LTC. To minimize adverse prognoses through prompt delirium care, the implementation of a CPG with an approach that comprehensively considers various barriers at the system, practice, healthcare professional, and patients/family levels is necessary.

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Delirium in intensive care: violence, loss and humanity

Medical Humanities ◽

10.1136/medhum-2020-011908 ◽

2020 ◽

pp. medhum-2020-011908

Author(s):

Victoria Jane Hume

Keyword(s):

Intensive Care ◽

Narrative Analysis ◽

Physical Environment ◽

Healthcare Professionals ◽

New Music ◽

Study Analysis ◽

Altered State ◽

Hospital Intensive Care Unit ◽

Audio Recordings

Delirium in intensive care is an altered state that can bring with it persecutory paranoias, and sometimes expressions of violence on the part of the patient; it can be deeply disturbing for the person experiencing it as well as for those around them. Although the impacts of delirium on patients’ recovery and long-term mental health are well documented, qualitative research in this area remains rare. This article is derived from a narrative and musical study of the experience of delirium in hospital, undertaken better to understand the perspectives of people who have experienced delirium, as well as the healthcare professionals and family members who care for them. Data were collected in South Africa between 2015 and 2017. The study took the form of interviews and focus groups with a total of 15 participants, as well as periods of observation and audio recording in a hospital intensive care unit. Thematic and narrative analysis of the data were carried out alongside the composition of new music incorporating audio recordings from the study. Analysis suggested three key themes emerging from the data. First, the violence experienced and expressed by patients, both within delirious hallucination and in observable reality. Second, the interconnected losses undergone by patients in spaces of intensive care. Third, healthcare professionals’ attempts to bring greater humanity into the potentially dehumanising space of intensive care. The results and discussion point to possible relationships between delirium and the working cultures and physical environment of intensive care, and may reinforce the need for sensitive and committed communication between healthcare professionals and patients.

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COVID-19 and Post-Acute COVID-19 Syndrome: From Pathophysiology to Novel Translational Applications

Biomedicines ◽

10.3390/biomedicines10010047 ◽

2021 ◽

Vol 10 (1) ◽

pp. 47

Author(s):

Pasquale Ambrosino ◽

Anna Lanzillo ◽

Mauro Maniscalco

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Clinical Practice ◽

Molecular Mechanisms ◽

Future Research ◽

Special Issue ◽

Lung Abnormalities ◽

Insight Into ◽

Rehabilitation Strategies

The new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was responsible for a global emergency, with the declaration of a pandemic in March 2020. SARS-CoV-2 can determine coronavirus disease 2019 (COVID-19), ranging from a mild illness to a serious condition requiring hospitalization in an intensive care unit. Furthermore, reports of persistent lung abnormalities and residual disability after a negative swab test suggest the presence of a post-acute COVID-19 syndrome, with the need for multidisciplinary rehabilitation strategies in the majority of survivors. However, the pathophysiological mechanisms of the acute and post-acute manifestations of COVID-19 have not been fully elucidated. In this Special Issue, a number of review and original articles provided a stimulating insight into the pathophysiology and diagnostics of COVID-19 and post-acute COVID-19 syndrome. Moreover, some novel prognostic and therapeutic applications were analyzed, with potential repercussions in clinical practice and future research. The need for further laboratory and translational research seems to emerge from this collection of articles, with the aim of elucidating the molecular mechanisms of COVID-19 at different stages of the disease. This could enable personalized prevention, interventional and rehabilitation strategies aimed at reducing disease progression and long-term disability.

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COViD-19 "Long-Haulers": Caring for Older People in the Aftermath of a Global Pandemic

The Senior Care Pharmacist ◽

10.4140/tcp.n.2021.361 ◽

2021 ◽

Vol 36 (8) ◽

pp. 361-362

Author(s):

Stephanie L. Sibicky

Keyword(s):

Older People ◽

Healthcare Professionals ◽

The Past ◽

Global Pandemic ◽

Care For Older People

The coronavirus pandemic raised many questions about how to optimally care for older people as evidenced by the vulnerability of this population to the virus over the past eighteen months. Not only are older people at a higher risk for contracting the disease but also for experiencing the severest forms of COVID-19. Unfortunately, many have succumbed to this relentless and devastating virus. Those who survive may encounter added challenges including the long-term sequelae of COVID-19. In the aftermath of this pandemic, how can healthcare professionals effectively care for older people experiencing long-term complications of this disease?

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Awareness regarding safety measures to be followed during COVID 19 outbreak among dentists in Chennai - A questionnaire based survey

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11ispl1.3901 ◽

2020 ◽

Vol 11 (SPL1) ◽

pp. 1605-1614

Author(s):

Kalyani Behera A ◽

Haripriya S

Keyword(s):

Clinical Practice ◽

Statistical Analysis ◽

Respiratory Infection ◽

Healthcare Professionals ◽

High Standard ◽

Safety Measures ◽

Global Pandemic ◽

Dental Practitioners ◽

Spss Software ◽

Anxiety And Fear

SARS - COVID 2019 is a global respiratory infection that has been confirmed as a global pandemic. The life of healthcare professionals has changed while working during the corona COVID-19 outbreak. During the coronavirus disease (COVID-19) outbreak, the dentist's knowledge about various practice modifications has been evaluated in order to combat COVID-19. A well-constructed questionnaire was designed; it was a close-ended questionnaire study involving 150 participants. The responses of the survey were obtained and subjected to statistical analysis using SPSS Software. The respondents were found to have good knowledge, which is important to combat COVID -19, which would help them imply those techniques in clinical practice. In Spite of having a high standard of knowledge while working during these current situations, dental practitioners are still in a state of anxiety and fear.

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Moving treatment-free remission into mainstream clinical practice in CML

Blood ◽

10.1182/blood-2016-01-694265 ◽

2016 ◽

Vol 128 (1) ◽

pp. 17-23 ◽

Cited By ~ 181

Author(s):

Timothy P. Hughes ◽

David M. Ross

Keyword(s):

Clinical Practice ◽

Kinase Inhibitors ◽

Financial Burden ◽

Molecular Response ◽

Best Interest ◽

Deep Molecular Response ◽

Potential Risks ◽

Treatment Free Remission ◽

The Many

Abstract The dramatic success of tyrosine kinase inhibitors (TKIs) has led to the widespread perception that chronic myeloid leukemia (CML) has become another chronic disease, where lifelong commitment to pharmacologic control is the paradigm. Recent trials demonstrate that some CML patients who have achieved stable deep molecular response can safely cease their therapy without relapsing (treatment free remission [TFR]). Furthermore, those who are unsuccessful in their cessation attempt can safely re-establish remission after restarting their TKI therapy. Based on the accumulated data on TFR, we propose that it is now time to change our approach for the many CML patients who have achieved a stable deep molecular response on long-term TKI therapy. Perhaps half of these patients could successfully achieve TFR if offered the opportunity. For many of these patients ongoing therapy is impairing quality of life and imposing a heavy financial burden while arguably achieving nothing. This recommendation is based on the evident safety of cessation attempts and TFR in the clinical trial setting. We acknowledge that there are potential risks associated with cessation attempts in wider clinical practice, but this should not deter us. Instead we need to establish criteria for safe and appropriate TKI cessation. Clinical trials will enable us to define the best strategies to achieve TFR, but clinicians need guidance today about how to approach this issue with their patients. We outline circumstances in which it would be in the patient's best interest to continue TKI, as well as criteria for a safe TFR attempt.

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How to Manage Type 2 Diabetes Mellitus During the COVID-19 Pandemic: Let’s Hear the Patient’s Voice

EMJ Diabetes ◽

10.33590/emjdiabet/21-00133 ◽

2021 ◽

pp. 60-63

Author(s):

Joanne Lusher ◽

Dawn Cameron

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Intensive Care ◽

Glycaemic Control ◽

Healthcare Professionals ◽

Self Management ◽

Global Pandemic

Diabetes is one of the most significant comorbidities associated with COVID-19 susceptibility and severity, and recent statistics have identified that up to half of all individuals with COVID-19 have had diabetes. Over 90% of people with Type 2 diabetes mellitus are overweight or obese, and obesity itself increases the severity of COVID-19 and the risk of needing intensive care and ventilation. Careful glycaemic control improves outcomes for individuals with diabetes and also significantly reduces risks if they become infected with COVID-19. It is, therefore, essential that research focuses on effective ways in which to manage Type 2 diabetes mellitus during this global pandemic. What healthcare professionals focus their attention and resources on is also crucial to its niftiness and, considering that patient self-management is key to effective glycaemic control, it makes sense that healthcare practitioners call on the patient for some advice.

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