scholarly journals Does "Flattening the Curve" Affect Critical Care Services Delivery for COVID-19? A Global Health Perspective

2020 ◽  
Author(s):  
Ramiro E. Gilardino
Keyword(s):  
Critical Care ◽  
Health Systems ◽  
Essential Element ◽  
Protective Equipment ◽  
Care Providers ◽  
Care Services ◽  
Services Delivery ◽  
Medical Supplies ◽  
Global Pandemic ◽  
Care Facilities

During this coronavirus disease 2019 (COVID-19) global pandemic, nations are taking bold measures to mitigate the spread of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in order to avoid the overwhelming its critical care facilities. While these "flattening the curve" initiatives are showing signs of impeding the potential surge in COVID-19 cases, it is not known whether these measures alleviate the burden placed on intensive care units. Much has been made of the desperate need for critical care beds and medical supplies, especially personal protective equipment (PPE). But while these initiatives may provide health systems time to bolster their critical care infrastructure, they do little to protect the most essential element – the critical care providers. This article examines bolder initiatives that may be needed to both protect crucial health systems and the essential yet vulnerable providers during this global pandemic.

scholarly journals Lessons for intensive care units in COVID-19 pandemic-moving towards sustainability

2020 ◽  
Vol 7 (3) ◽  
pp. 1
Author(s):  
Prashant Nasa ◽  
Ruchi Nasa ◽  
Aanchal Singh
Keyword(s):  
Critical Care ◽  
Supply Chain ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Standard Of Care ◽  
Infrastructure Development ◽  
Care Providers ◽  
Care Services ◽  
Second Wave ◽  
And Training

The Coronavirus disease-2019 (COVID-19) pandemic has inundated critical care services globally. The intensive care units (ICUs) and critical care providers have been forefront of this pandemic, evolving continuously from experiences and emerging evidence. In this review, we discuss the key lessons from the ongoing wave of COVID-19 pandemic and preparations for a future surge or second wave. The model of sustainable critical care services should be based on 1) infrastructure development, 2) preparation and training of manpower, 3) implementing standard of care and infection control, 4) sustained supply-chain and finally, and 5) surge planning. 

scholarly journals Exploring the implementation and delivery of primary care services for transgender individuals in Ontario: case study protocol

2020 ◽  
Vol 21 ◽  
Author(s):  
Erin Ziegler ◽  
Ruta Valaitis ◽  
Nancy Carter ◽  
Cathy Risdon ◽  
Jennifer Yost
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Access To Health Care ◽  
Care Providers ◽  
Case Study Methodology ◽  
Care Services ◽  
Services Delivery ◽  
Primary Care Services ◽  
Care Models

Abstract Background: Historically transgender adults have experienced barriers in accessing primary care services. In Ontario, Canada, health care for transgender adults is accessed through primary care; however, a limited number of practitioners provide care, and patients are often waiting and/or traveling great distances to receive care. The purpose of this protocol is to understand how primary care is implemented and delivered for transgender adults. The paper presents how the case study method can be applied to explore implementation of health services delivery for the transgender population in primary care. Methods: Case study methodology will be used to explore this phenomenon in different primary care contexts. Normalization Process Theory is used as a guide. Three cases known to provide transgender primary care and represent different Ontario primary care models have been identified. Comparing transgender care implementation and delivery across different models is vital to understanding how care provision to this population can be supported. Qualitative interviews will be conducted. Participants will also complete the NoMAD (NOrmalization MeAsure Development) survey, a tool measuring implementation processes. The tool will be modified to explore the implementation of primary care services for transgender individuals. Documentary evidence will be collected. Cross-case synthesis will be completed to compare the cases. Discussion: Findings will provide an Ontario perspective on the implementation and delivery of primary care for transgender adults in different primary care models. Results may be applicable to other primary care settings in Canada and other nations with similar systems. Barriers and facilitators in delivery and implementation will be identified. Providing an understanding and increasing awareness of the implementation and delivery of primary care may help to reduce the invisibility and disparities transgender individuals experience when accessing primary care services. Understanding delivery of care could allow care providers to implement primary care services for transgender individuals, improving access to health care for this vulnerable population.

Barriers to Addressing the Spiritual and Religious Needs of Patients and Families in the Intensive Care Unit: A Qualitative Study of Critical Care Physicians

2020 ◽  
pp. 104990912097090
Author(s):  
Christian K. Alch ◽  
Christina L. Wright ◽  
Kristin M. Collier ◽  
Philip J. Choi
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Spiritual Care ◽  
Spiritual Needs ◽  
Care Providers ◽  
Structured Interviews ◽  
Care Services ◽  
Qualitative Research Design ◽  
Data Saturation

Objectives: Though critical care physicians feel responsible to address spiritual and religious needs with patients and families, and feel comfortable in doing so, they rarely address these needs in practice. We seek to explore this discrepancy through a qualitative interview process among physicians in the intensive care unit (ICU). Methods: A qualitative research design was constructed using semi-structured interviews among 11 volunteer critical care physicians at a single institution in the Midwest. The physicians discussed barriers to addressing spiritual and religious needs in the ICU. A code book of themes was created and developed through a regular and iterative process involving 4 investigators. Data saturation was reached as no new themes emerged. Results: Physicians reported feeling uncomfortable in addressing the spiritual needs of patients with different religious views. Physicians reported time limitations, and prioritized biomedical needs over spiritual needs. Many physicians delegate these conversations to more experienced spiritual care providers. Physicians cited uncertainty into how to access spiritual care services when they were desired. Additionally, physicians reported a lack of reminders to meet these needs, mentioning frequently the ICU bundle as one example. Conclusions: Barriers were identified among critical care physicians as to why spiritual and religious needs are rarely addressed. This may help inform institutions on how to better meet these needs in practice.

scholarly journals An assessment of health facility factors influencing male participation in utilization of antenatal care services among spouses in selected manufacturing industries in Nairobi County, Kenya

2021 ◽  
Vol 8 (11) ◽  
pp. 5228
Author(s):  
Kirui N. Jelagat ◽  
Keraka M. Nyanchoka ◽  
Musili F.
Keyword(s):  
Antenatal Care ◽  
Health Facility ◽  
Health Care Providers ◽  
Post Partum ◽  
Manufacturing Industries ◽  
Care Providers ◽  
Skilled Attendant ◽  
Male Participation ◽  
Care Services ◽  
Care Facilities

Background: Male participation in utilization of reproductive health is likely to promote timely and proper antenatal care, encourage women to deliver under the care of a skilled attendant, and also help identify and seek heath care in cases of post-partum complications. However, in most African societies, pregnancy, delivery and postnatal services has been erroneously classified as purely feminine issue by the society.Methods: A cross-sectional descriptive study design was adopted for the study. The target population of the study comprised of males above 18 years working in selected manufacturing industries in the area of Babadogo located in Nairobi County, Kenya. The sample size for the study was 266 respondents. Structured questionnaires were used for data collection. Data collected was quantitatively analysed using Statistical Package for Social Sciences (SPSS).Results: 56.0% (145) of the respondents had accompanied their partner to antenatal care facilities; 34.0% (88) of the respondents had ever participated in ANC services. Chi-square test statistics showed that distance to the nearest health facility (χ2=7.472 df=3, p=0.024), cost of accessing ANC services (χ2=26.253 df=4, p=0.001), attitude of healthcare providers (χ2=31.705 df=3, p=0.001) and friendliness of the waiting bay (χ2=9.718 df=2, p=0.008) significantly influenced male participation in antenatal care services’ utilization among spouses.Conclusions: Despite majority of men accompanying their wives to antenatal care facilities, most of them did not participate in the antenatal care services. Another conclusion is that facility factors such as distance, cost, health care providers’ attitude, and waiting bay friendliness influence male participation in utilization of antenatal care services.

scholarly journals An A-E assessment of post-ICU COVID-19 recovery

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Matthew Cadd ◽  
Maya Nunn
Keyword(s):  
Critical Care ◽  
Current Knowledge ◽  
Multiple Organ ◽  
Long Term Effects ◽  
Care Services ◽  
Global Pandemic ◽  
Wide Range ◽  
Assessment And Treatment ◽  
Critical Care Admission

AbstractThe COVID-19 global pandemic has placed unprecedented strain on healthcare and critical care services around the world. Whilst most resources have focused on the acute phase of the disease, there is likely to be an untold burden of patients chronically affected.A wide range of sequelae contribute to post intensive care syndrome (PICS); from our current knowledge of COVID-19, a few of these have the potential to be more prevalent following critical care admission. Follow-up assessment, diagnosis and treatment in an increasingly virtual setting will provide challenges but also opportunities to develop these services. Here, we propose an A to E approach to consider the potential long-term effects of COVID-19 following critical care admission.Anxiety and other mental health diagnosesBreathlessnessCentral nervous system impairmentDietary insufficiency and malnutritionEmbolic eventsDeveloping strategies to mitigate these during admission and providing follow-up, assessment and treatment of persistent multiple organ dysfunction will be essential to improve morbidity, mortality and patient quality of life.

scholarly journals COVID-19 and its impact on the cancer care in tertiary care centres in India

2021 ◽  
Vol 7 (2) ◽  
pp. 74-78
Keyword(s):  
Health Care Providers ◽  
Cancer Care ◽  
Primary Care Physicians ◽  
Radiation Treatment ◽  
Tertiary Care ◽  
Care Providers ◽  
Hub And Spoke ◽  
Care Services ◽  
Global Pandemic ◽  
High Risk Cancer

COVID-19 pandemic is an ongoing global pandemic which has resulted in significant morbidity and mortality. India has been one of the worst affected nations. The second wave has gripped the country in an unforeseen way. In an effort to contain the pandemic, the measures taken have led to all other health conditions taking a back seat. Patients of chronic diseases like cancer, marked by a continuity of care, have been bearing a major brunt. Access to cancer treatment has been disrupted as a result of COVID-19. This adversely affects the outcomes of the disease. This pandemic is here to stay, so cancer services should continue to be provided with due safeguarding of the health personnel and patients against the COVID-19 infections. Due modifications of the treatment schedules for systemic therapy, surgery and radiation treatment should be incorporated as per the guidelines. Vaccination of the immunocompromised, high risk, cancer patients on priority, besides that of the health care providers should be aimed at. In the long term, capacity of primary care physicians needs to be strengthened to provide basic cancer care services using a hub-and-spoke model with tertiary care centres.

scholarly journals Critical Care Guidance for Tracheostomy Care During the COVID-19 Pandemic: A Global, Multidisciplinary Approach

2020 ◽  
Vol 29 (6) ◽  
pp. e116-e127
Author(s):  
Vinciya Pandian ◽  
Linda L. Morris ◽  
Martin B. Brodsky ◽  
James Lynch ◽  
Brian Walsh ◽  
...  
Keyword(s):  
Health Care ◽  
Critical Care ◽  
Health Care Workers ◽  
Critical Care Nurses ◽  
Multidisciplinary Teams ◽  
Protective Equipment ◽  
Care Providers ◽  
Care Workers ◽  
Consensus Statements ◽  
Reduce Risk

Purpose Critical care nurses caring for patients with a tracheostomy are at high risk because of the predilection of SARS-CoV-2 for respiratory and mucosal surfaces. This review identifies patient-centered practices that ensure safety and reduce risk of infection transmission to health care workers during the coronavirus disease 2019 (COVID-19) pandemic. Methods Consensus statements, guidelines, institutional recommendations, and scientific literature on COVID-19 and previous outbreaks were reviewed. A global interdisciplinary team analyzed and prioritized findings via electronic communications and video conferences to develop consensus recommendations. Results Aerosol-generating procedures are commonly performed by nurses and other health care workers, most notably during suctioning, tracheostomy tube changes, and stoma care. Patient repositioning, readjusting circuits, administering nebulized medications, and patient transport also present risks. Standard personal protective equipment includes an N95/FFP3 mask with or without surgical masks, gloves, goggles, and gown when performing aerosol-generating procedures for patients with known or suspected COVID-19. Viral testing of bronchial aspirate via tracheostomy may inform care providers when determining the protective equipment required. The need for protocols to reduce risk of transmission of infection to nurses and other health care workers is evident. Conclusion Critical care nurses and multidisciplinary teams often care for patients with a tracheostomy who are known or suspected to have COVID-19. Appropriate care of these patients relies on safeguarding the health care team. The practices described in this review may greatly reduce risk of infectious transmission.

scholarly journals Nursing staff’s evaluation of facilitators and barriers during implementation of wireless nurse call systems in residential care facilities. A cross-sectional study.

2020 ◽  
Author(s):  
Janne Dugstad ◽  
Vibeke Sundling ◽  
Etty R. Nilsen ◽  
Hilde Eide
Keyword(s):  
Residential Care ◽  
Measurement Instrument ◽  
Implementation Process ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Cross Sectional ◽  
Residential Care Facilities ◽  
Care Services ◽  
Care Facilities ◽  
Facilitators And Barriers

Abstract Background: Traditional nurse call systems used in residential care facilities rely on patients to summon assistance for routine or emergency needs. Wireless nurse call systems (WNCS) offer new affordances for persons unable to actively or consciously engage with the system, allowing detection of hazardous situations, prevention and timely treatment, as well as enhanced nurse workflows. This study aimed to explore facilitators and barriers of implementation of WNCSs in residential care facilities. Methods: The study had a cross-sectional descriptive design. We collected data from care providers (n=98) based on the Measurement Instrument for Determinants of Innovation (MIDI) framework in five Norwegian residential care facilities during the first year of WNCS implementation. The self-reporting MIDI questionnaire was adapted to the contexts. Descriptive statistics were used to explore participant characteristics and MIDI item and determinant scores. MIDI items to which ≥20% of participants disagreed/totally disagreed were regarded as barriers and items to which ≥80% of participants agreed/totally agreed were regarded as facilitators for implementation. Results: More facilitators (n=22) than barriers (n=6) were identified. The greatest facilitators, reported by 98% of the care providers, were the expected outcomes: the importance and probability of achieving prompt call responses and increased safety, and the normative belief of unit managers. During the implementation process, 87% became familiar with the systems, and 86% and 90%, respectively regarded themselves and their colleagues as competent users of the WNCS. The most salient barriers, reported by 37%, were their lack of prior knowledge and that they found the WNCS difficult to learn. No features of the technology were identified as barriers. Conclusions: Overall, the care providers gave a positive evaluation of the WNCS implementation. The barriers to implementation were addressed by training and practicing technological skills, facilitated by the influence and support by the manager and the colleagues within the residential care unit. WNCSs offer a range of advanced applications and services, and further research is needed as more WNCS functionalities are implemented into residential care services.

scholarly journals A New Phase of Healthcare: COVID-19 and Medical Advancements

2020 ◽  
Author(s):  
Oshin Puri ◽  
Vyas Kumar Rathaur ◽  
Nitish Pathania ◽  
Monika Pathania
Keyword(s):  
Critical Care ◽  
Healthcare Professionals ◽  
Virus Disease ◽  
World Health Organisation ◽  
World Health ◽  
Medical Evidence ◽  
Global Pandemic ◽  
Care Facilities ◽  
Current Scenario ◽  
New Phase

Corona Virus Disease (COVID-19) was, declared a global pandemic by the World Health Organisation (WHO) on 11th March 2020, which has posed innumerable challenges for the medical fraternity. To overcome these obstacles healthcare professionals, engineers and industries like robotics, Artificial Intelligence (AI), 3 Dimension (3D) printing etc., are coming up with innovations that can assist them in administering critical care to COVID patients, restart health services for non-COVID patients, combat the spread of the disease, restart elective services and above all protect themselves while treating others. This article is a narrative review of the developments in the field of robotics and AI, improvements in ventilators and critical care facilities, measures taken to spread awareness and the need of such innovations, their benefits and effectiveness in relation to the current scenario. Articles regarding advancements during COVID months of March-May 2020 were searched on the internet and references giving medical evidence of the suitability of these innovations were added from PubMed and Google Scholar search engines, wherever necessary. Knowing the need and principles of such medical innovations which can help in improving the current practices or replace them with even better technologies are the need of the hour.

scholarly journals Grey systems in the management of demand for palliative care services in Poland

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Sylwia Nieszporska
Keyword(s):  
Palliative Care ◽  
Health Systems ◽  
Health Care Services ◽  
Long Term Care ◽  
Health Condition ◽  
Term Care ◽  
Care Services ◽  
Number Of Patients ◽  
Care Facilities

Abstract Background The concept of care for people in a critical or even terminal health condition, who are in the last stage of their life, has become the mission of palliative care facilities. Therefore, the life of a sick patient poses a number of challenges for health care services to make sure that medical services are tailored to the trajectory of the disease, as well as the various needs, preferences and resources of patients and their families. Methods Health systems financed from public funds need to adopt new methods of management to meet the high and arising demand for a long-term care. There are several ways of assessing the demand for long-term care services. The method recommended by the author and presented in more detail in this paper is the one relying on grey systems, which enables the estimation of forecasting models and, finally, actual forecasts of the number of potential future patients. Results GST can be used to make predictions about the future behaviour of the system, which is why this article aims to present the possibility of using the first-order grey model GM (1,1) in predicting the number of patients of palliative care facilities in Poland. The analysis covers the data from 2014 to 2019, whereas the prediction of the number of patients has been additionally formulated for 2020. Conclusions Health systems, particularly publicly funded ones, are characterised by a certain kind of incompleteness and uncertainty of data on the structure and behaviour of its individual components (e.g. potential patients or payers). The present study aims to prove how simple and effective grey systems models are in the decision-making process.

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