scholarly journals What Is Preparedness and Capacity of Intensive Care Service in Indonesia to Response to COVID-19? A Mixed-method Study

2021 ◽  
Vol 9 (B) ◽  
pp. 1686-1694
Author(s):  
Mochamat Helmi ◽  
Djayanti Sari ◽  
Andreasta Meliala ◽  
Laksono Trisnantoro
Keyword(s):  
Intensive Care ◽  
Mixed Method ◽  
Online Survey ◽  
Care Service ◽  
Protective Equipment ◽  
Medical Team ◽  
Isolation Room ◽  
Care Services ◽  
Initial Stage ◽  
Medical Teams

BACKGROUND: Pandemics can increase disease spread, as well as unpredictable and highly in patient demand, which can have a negative impact on hospital capacity and the overall functioning of the health-care system. The preparedness and capacity of intensive care services to respond to COVID-19 in Indonesia are remain unknown. AIM: This study aimed to investigate the preparedness and capacity of intensive care services in Indonesia to respond to the initial stage of the COVID-19 pandemic. METHODS: A mixed-method research design was used in this study using in-depth interviews and an online survey. An in-depth interview was conducted with the medical team (intensive care consultant and an anesthesiologist) who is actively involved in the provision of COVID-19 services in 15 national referral hospitals. The online survey was conducted to all medical teams that provide direct care to the COVID-19 patients. A total of 459 (response rate was 95.2%) agreed to join the survey. The content analysis technique was used to analyze qualitative data and a descriptive analysis was used to describe issues encountered in providing health services to COVID-19 patients. RESULTS: The analysis preparedness and capacity of intensive care service in Indonesia to respond to the initial stage of the COVID-19 pandemic resulting in 4 themes with 12 sub-themes. The four themes were limited quality and quantity of standardized intensive care unit (ICU) isolation room (inadequate zoning systems, adequacy of the standardized ICU isolation room, the readiness of the hospital infrastructure, and telemedicine facilities are not yet widely used, including in the COVID-19 isolation room), limited medical service support (lack of personal protective equipment (personal protective equipment [PPE], re-used PPE, lack of availability of medical devices), limitations in the medical team’s quality and quantity management (lack of number and distribution of expert doctors and medical team screening for ICU), and command systems (task shifting, effective communication, and leadership). CONCLUSION: Medical team encounters several difficulties, particularly related to the quality of facilities, staff preparedness, and systems for the provision of services to COVID-19 patients with critical conditions. There is a critical need for well-defined pathways, legal protection, and occupational health for medical teams providing services in the aftermath of a pandemic.

scholarly journals Readiness of Medical Teams Caring for COVID-19 in the Intensive Care Units: A National Web-Based Survey in Indonesia

2021 ◽  
Vol 9 (B) ◽  
pp. 1785-1790
Author(s):  
Mochamat Helmi ◽  
Djayanti Sari ◽  
Andreasta Meliala ◽  
Laksono Trisnantoro
Keyword(s):  
Intensive Care ◽  
Substantial Effect ◽  
Medical Team ◽  
Cross Sectional ◽  
Web Based ◽  
Maximum Score ◽  
Five Dimensions ◽  
Number Of Patients ◽  
Referral Hospitals ◽  
Medical Teams

BACKGROUND: The coronavirus disease 2019 (COVID)-19 pandemic is a challenge for the intensive care unit (ICU) medical team. It requires management of space, stuff (medical equipment including drugs), staff, and system readiness (4S) to deal with the surge in the number of patients. AIM: This survey aims to describe the current readiness efforts among ICU medical team at the COVID-19 referral hospitals in Indonesia; space, stuff readiness, staff, and systems readiness. METHODS: We conducted a cross-sectional national web-based survey of ICUs across referral hospitals during pandemic COVID-19 in Indonesia from June to October 2020. The medical teams survey included 53 questions in multiple parts addressing five dimensions. A linear regression model was applied to determine the factors related with readiness. RESULTS: A total of 459 participants (83.6%) agreed to join in this study. The participants’ average age was 40.43 years (SD = 5.78). About 62.53% were male, 51.20% had bachelor degree, and 55.77% lived outside of Java Island. The mean of total score of medical team readiness was 2.76 (SD = 0.320) and the highest (maximum score) mean score of medical team readiness domain was stuff (2.81, SD = 7.72). Education, working experience, training, perception of risk of contracting COVID-19, and residence had a substantial effect on the readiness, with R2 values of 0.378, p < 0.05. CONCLUSIONS: This study provides an initial view of current preparedness efforts among a group of ICUs in Indonesia’s leading hospital during the first wave of pandemic. Interventions must be developed and implemented quickly to increase the medical team’s readiness to care for a future pandemic.

Mapping non-malignant respiratory palliative care services in Australia and New Zealand

2020 ◽  
Vol 44 (5) ◽  
pp. 778
Author(s):  
Jennifer Philip ◽  
Rachel Wiseman ◽  
Peter Eastman ◽  
Chi Li ◽  
Natasha Smallwood
Keyword(s):  
Palliative Care ◽  
New Zealand ◽  
Respiratory Disease ◽  
Online Survey ◽  
Care Service ◽  
Palliative Care Service ◽  
Service Level ◽  
Service Development ◽  
Care Services ◽  
Palliative Care Services

ObjectiveDespite needs, people with advanced non-malignant respiratory disease are infrequently referred to palliative care services. Integrated models of palliative care and respiratory service delivery have been advocated to address this inequity of access. This study mapped current ambulatory palliative care service provision for patients with advanced non-malignant respiratory disease in Australia and New Zealand. MethodsAn online survey was distributed to the palliative care physician membership of the Australian and New Zealand Society of Palliative Medicine. Information was sought regarding access to specific breathlessness and integrated respiratory and palliative care services, and their operation. Data were described using descriptive statistics. ResultsIn all, 133 respondents (93 from Australia, 40 from New Zealand; representing 55 Australian and 26 New Zealand discrete sites) with complete data were available for analysis. More than half the respondents reported seeing patients with advanced non-malignant respiratory disease frequently (56/97; 58%), and 18 of 81 services (22%) reported having breathlessness or integrated respiratory and palliative care services caring for this patient group. Such services were mostly staffed by respiratory and palliative care doctors and nurses and based in the clinic environment, with limited support available outside this setting. Of the 63 respondents without existing breathlessness or integrated services, 49 (78%) expressed interest in their establishment, with limited resources cited as the most common barrier. ConclusionsThere is limited availability of integrated respiratory and palliative care or specialised breathlessness services in Australia and New Zealand despite widespread support by palliative care physicians. This study provides a snapshot to inform strategic service development. What is known about the topic?People with advanced respiratory disease have very significant morbidity with complex needs equivalent to, and in many cases more intense than, people with end-stage lung cancer; they also have significant mortality. Yet, these people frequently do not access palliative care services. The establishment of integrated respiratory and palliative care services has been advocated as an effective means to overcome the barriers to palliative care access. Such services have demonstrated improved patient and family-reported outcomes, as well as service-level improvements. What does this paper add?This paper maps the availability of integrated respiratory palliative care services in Australia and New Zealand. We reveal that although most palliative care physicians report seeing patients with advanced respiratory disease in practice, just one-fifth of services report having an integrated service approach. There was high interest and enthusiasm for such services (78%), but resources limited their establishment. What are the implications for practitioners?Palliative care services recognise the needs of patients with advanced respiratory disease and the benefits of integrated respiratory and palliative care services to address these needs, but scarcity of resources limits the ability to respond accordingly. This study provides a snapshot of current service level to inform strategic development.

Utilization of echocardiography in Intensive Care Units: results of an online survey in Germany

2019 ◽  
Vol 85 (3) ◽  
Author(s):  
Felix Balzer ◽  
Ralf F. Trauzeddel ◽  
Martin Ertmer ◽  
Joachim Erb ◽  
Matthias Heringlake ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Online Survey

COVID-19: The Importance of Adequate Personal Protective Equipment in Healthcare Medical Staff

2020 ◽  
Author(s):  
Anne Weissenstein
Keyword(s):  
Health Care ◽  
Personal Protective Equipment ◽  
Health Care Services ◽  
Infection Prevention And Control ◽  
Protective Equipment ◽  
Emotional Resilience ◽  
Healthcare Facilities ◽  
Care Services ◽  
Healthcare Settings ◽  
And Control

We present an update on infection prevention and control for COVID-19 in healthcare settings. This update focuses on measures to be applied in settings with increasing community transmission, growing demand for concern about COVID-19 patients, and subsequent staffing issues in the event of shortages of personal protective equipment for healthcare facilities worldwide. The comfort and emotional resilience of health care workers are key components in maintaining essential health care services during the COVID-19 virus (coronavirus) outbreak.

scholarly journals ‘They just came with the medication dispenser’- a qualitative study of elderly service users’ involvement and welfare technology in public home care services

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Heidi Snoen Glomsås ◽  
Ingrid Ruud Knutsen ◽  
Mariann Fossum ◽  
Kristin Halvorsen
Keyword(s):  
Qualitative Study ◽  
Home Care ◽  
Health Care Quality ◽  
Care Service ◽  
User Involvement ◽  
Home Care Services ◽  
Care Quality ◽  
Service Users ◽  
Care Services ◽  
Welfare Technology

Abstract Background Public home care for the elderly is a key area in relation to improving health care quality. It is an important political goal to increase elderly people’s involvement in their care and in the use of welfare technology. The aim of this study was to explore elderly service users’ experience of user involvement in the implementation and everyday use of welfare technology in public home care services. Method This qualitative study has an explorative and descriptive design. Sixteen interviews of service users were conducted in five different municipalities over a period of six months. The data were analysed using reflexive thematic analysis. Results Service users receiving public home care service are not a homogenous group, and the participants had different wishes and needs as regards user involvement and the use of welfare technology. The analysis led to four main themes: 1) diverse preferences as regards user involvement, 2) individual differences as regards information, knowledge and training, 3) feeling safe and getting help, and 4) a wish to stay at home for as long as possible. Conclusion The results indicated that user involvement was only to a limited extent an integral part of public home care services. Participants had varying insight into and interest in welfare technology, which was a challenge for user involvement. User involvement must be facilitated and implemented in a gentle way, highlighting autonomy and collaboration, and with the focus on respect, reciprocity and dialogue.

scholarly journals Remote learning and students’ mental health during the Covid-19 pandemic: A mixed-method enquiry

Prospects ◽  
2021 ◽  
Author(s):  
Suzanne Lischer ◽  
Netkey Safi ◽  
Cheryl Dickson
Keyword(s):  
Mental Health ◽  
Health Status ◽  
University Students ◽  
Undergraduate Students ◽  
Mixed Method ◽  
Online Survey ◽  
Current Situation ◽  
Distance Teaching ◽  
Learning Conditions ◽  
Support Students

AbstractThe disruption caused by Covid-19 in the educational sector may last longer than originally predicted. To better understand the current situation, this article analyses the mental health status of university students during the pandemic and investigates the learning conditions needed to support students. The sample included 557 undergraduate students who took part in an online survey. Overall, the students reported coping well during lockdown but indicated that lecturers were challenged by distance teaching, which created some stress for the students.

scholarly journals Person-centered dementia care in home care services – highly recommended but still challenging to obtain: a qualitative interview study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kari-Anne Hoel ◽  
Anne Marie Mork Rokstad ◽  
Ingvild Hjorth Feiring ◽  
Bjørn Lichtwarck ◽  
Geir Selbæk ◽  
...  
Keyword(s):  
Decision Making ◽  
Home Care ◽  
Shared Decision Making ◽  
Care Service ◽  
Home Care Services ◽  
Shared Decision ◽  
Care Services ◽  
Person Centered Care ◽  
People With Dementia ◽  
Centered Care

Abstract Background Dementia is one of the main causes of disability and dependence in older people, and people with dementia need comprehensive healthcare services, preferably in their own homes. A well-organized home care service designed for people with dementia is necessary to meet their needs for health- and social care. Therefore, it is important to gain knowledge about how people with dementia experience the home care service and if the service responds to their wishes and needs. The aim of this study was to explore the experience of home care services among people with dementia, to understand the continuity in services, how the service was adapted to people with dementia, and how the patient experienced person-centered care and shared decision-making. Methods We used a qualitative, exploratory design based on a phenomenological-hermeneutic approach and performed individual in-depth interviews with persons with dementia. A convenience sample of 12 persons with moderate to severe degrees of dementia from four Norwegian municipalities participated in the study. The interviews were conducted in February 2019. Results The findings identified that the participants appreciated the possibility to stay safely in their own homes and mostly experienced good support from staff. They expressed various views and understanding of the service and experienced limited opportunities for user involvement and individualized, tailored service. The overall theme summarizing the findings was: “It is difficult for people with dementia to understand and influence home care services, but the services facilitate the possibility to stay at home and feel safe with support from staff.” Conclusion The participants did not fully understand the organization of the care and support they received from the home care services, but they adapted to the service without asking for changes based on their needs or desires. Although person-centered care is recommended both nationally and internationally, the participants experienced little inclusion in defining the service they received, and it was perceived as unclear how they could participate in shared decision-making.

scholarly journals Effectiveness of a Care Delivery Model for High-Need Community-Dwelling Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 279-279
Author(s):  
Kuei-Min Chen ◽  
Hui-Fen Hsu
Keyword(s):  
Older Adults ◽  
Comparison Group ◽  
Care Delivery ◽  
Care Service ◽  
Intervention Group ◽  
Community Dwelling ◽  
Delivery Model ◽  
Care Services ◽  
Care Delivery Model ◽  
Community Dwelling Older Adults

Abstract The effectiveness of sufficient care coordination for high-need community-dwelling older adults has not been discussed. This study aimed to examine the effectiveness of a newly-developed care delivery model for high-need community-dwelling older adults. A cluster randomized controlled trial with repeated measures design was employed. A total of 145 high-need older adults participated in the study and were randomly assigned to either the intervention group or comparison group. A categorized list of care services based on the types of high-need older adults as the intervention allowed care coordinators to make adequate care service linkages. The intervention period ranged over 6 months with regulated home visits and assesssments. Functional ability, quality of life, depressive symptoms, and healthcare and social service utilizations were measured at baseline, and at 3 and 6 months into the intervention. The participants’ satisfaction with care delivery was measured at the end of 6-month intervention. Results showed that the intervention group had a better functional ability, a higher quality of life, reduced depressive symptoms, and more efficient healthcare and social service utilizations than the comparison group at both the 3-month and 6-month intervals (all p &lt; .05). By the end of the 6-month study, the intervention group were more satisfied with the care service linkages than the comparison group (p &lt; .05). The positive effects of providing a categorized list of care services for care coordinators to make service linkages have been evidenced by the outcomes. The promising findings supported a further longer-term implementation of the care delivery model.

scholarly journals Adverse Effects of Personal Protective Equipment Among Intensive Care Unit Healthcare Professionals During the COVID-19 Pandemic: A Scoping Review

2021 ◽  
Vol 7 ◽  
pp. 237796082110261
Author(s):  
Takeshi Unoki ◽  
Hideaki Sakuramoto ◽  
Ryuhei Sato ◽  
Akira Ouchi ◽  
Tomoki Kuribara ◽  
...  
Keyword(s):  
Intensive Care ◽  
Adverse Effects ◽  
Scoping Review ◽  
Personal Protective Equipment ◽  
Healthcare Professionals ◽  
World Health ◽  
Protective Equipment ◽  
Medical Database ◽  
Publication Type ◽  
Skin Injuries

Introduction To avoid exposure to SARS-COV-2, healthcare professionals use personal protective equipment (PPE) while treating COVID-19 patients. Prior studies have revealed the adverse effects (AEs) of PPE on healthcare workers (HCWs); however, no review has focused on the AEs of PPE on HCWs in intensive care units (ICUs). This review aimed to identify the AEs of PPE on HCWs working in ICUs during the COVID-19 pandemic. Methods A scoping review was conducted. MEDLINE, CINAHL, the World Health Organization (WHO) global literature on COVID-19, and Igaku-chuo-zasshi (a Japanese medical database), Google Scholar, medRxiv, and Health Research Board (HRB) open research were searched from January 25–28, 2021. The extracted data included author(s) name, year of publication, country, language, article title, journal name, publication type, study methodology, population, outcome, and key findings. Results The initial search identified 691 articles and abstracts. Twenty-five articles were included in the analysis. The analysis comprised four key topics: studies focusing on PPE-related headache, voice disorders, skin manifestations, and miscellaneous AEs of PPE. The majority of AEs for HCWs in ICUs were induced by prolonged use of masks. Conclusion The AEs of PPE among HCWs in ICUs included heat, headaches, skin injuries, chest discomfort, and dyspnea. Studies with a focus on specific diseases were on skin injuries. Moreover, many AEs were induced by prolonged use of masks.

scholarly journals Impact of the COVID-19 Pandemic on Physicians Working in the Head and Neck Field

2021 ◽  
Vol 25 (01) ◽  
pp. e150-e159
Author(s):  
Rui Imamura ◽  
Ricardo F. Bento ◽  
Leandro L. Matos ◽  
William N. William ◽  
Gustavo N. Marta ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Head And Neck ◽  
Personal Protective Equipment ◽  
Outpatient Care ◽  
Online Survey ◽  
Family Income ◽  
Protective Equipment ◽  
Psychological Burden ◽  
The Public ◽  
The Third

Abstract Background With the COVID-19 pandemic, the clinical practice of physicians who work in the head and neck field in Brazil dropped dramatically. The sustained impact of the pandemic is not known. Methods An anonymous online survey was distributed to Brazilian otolaryngologists, head and neck surgeons, medical and radiation oncologists, asking about their clinical practice in the third to fourth months of the pandemic. Results The survey was completed by 446 specialists. About 40% reported reduction of more than 75% in outpatient care. A reduction of 90% to 100% in airway endoscopies was reported by 50% of the responders, and the same rate of reduction regarding surgeries (pediatric or nasosinusal) was reported by 80% of them. Family income decreased by 50%, and the psychological burden on physicians was considerable. The availability of personal protective equipment and safety precautions were limited, especially in the public sector. Conclusion COVID-19 is still impacting the head and neck field, and safety concerns may hinder the prompt resumption of elective care.

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