Clinical Risk Management: As Modern Tool for Prevention and Management of Care and Prevention Occupational Risk

Clinical Risk Management aims to improve the performance quality of healthcare services through procedures that identify and prevent circumstances that could expose both the patient and the healthcare personnel to risk of an adverse event [...]

Extending Care Team Access to Out-of-Hospital Settings via Telehealth

This chapter explores the use of telehealth within out-of-hospital (OOH) settings, comprising skilled nursing facilities, home care, independent and assisted living, and palliative care. The transition to value-based care is discussed within the context of its applicability to these OOH settings. As health care focuses on cost containment while still providing quality care, providers are turning to the use of telehealth to improve the management of care of seniors living in both community and residential settings. The role of the emergency physician, through telehealth, is introduced as an addition to the interdisciplinary health team in meeting the goal of avoiding unnecessary emergency department visits, often resulting in hospitalization. As the adoption of telehealth grows, benefits are documented, and payment challenges are overcome, the hope is that it becomes another solution to deliver efficient and cost-effective health care, particularly in OOH settings.

The Self-Determination Theory: Health-Related Quality of Life in Adolescents with Congenital Heart Disease

The purpose of this paper is to present a conceptual-theoretical-empirical model addressing variables associated with self-management of care and adherence to treatment and its relationship to health-related quality of life for adolescents with congenital heart disease. There is limited research on adolescents with congenital heart disease regarding the relationship between autonomy, relatedness, competence, self-management of care and adherence to treatment, and health-related quality of life. The proposed Health-Related Quality of Life and Transition of Adolescents With Congenital Heart Disease to Self-Manage in Adulthood model, adapted from the Self-Determination Theory, will help to better understand these relationships.

Psychosocial burden and associated factors among nurses in care homes during the COVID-19 pandemic: findings from a retrospective survey in Germany

Background Care homes were hit hard by the COVID-19 pandemic. Although high levels of psychosocial burden (i.e., anxiety, depression and stress) during the pandemic have been described for healthcare workers in hospitals, evidence on the psychosocial burden for nurses in care homes during the pandemic is scarce. Methods A total of 811 nurses participated in a retrospective online survey between November 2020 and February 2021. Information about the COVID-19 situation (i.e., working demands, COVID-19 cases in their facility, and COVID-19-related burden) of nurses in German care homes during the first wave of the pandemic (March 2020 to June 2020) was gathered. The Stress Scale of the Depression Anxiety and Stress Scales (SDASS-21), the Generalized Anxiety Disorder Scale-2 (GAD-2), the Patients-Health-Questionnaire-2 (PHQ-2), and the Copenhagen Psychosocial Questionnaire (COPSOQ) were used to screen for psychosocial burden. Results Among nurses, 94.1% stated that work demands since the COVID-19 pandemic increased. Further, 57.5% showed clinically relevant levels of either stress, anxiety, and/or depression. Multiple regression analysis showed significant associations between COVID-19-related burden and qualification (p < .01), dissatisfaction with COVID-19 management of care home manager (p < .05), COVID-19-related anxiety (p < .001), and dementia as a focus of care (p < .05). Stress, depression, and anxiety showed associations with COVID-19 related burden at work (p < .01), COVID-19-related anxiety (p < .001), social support (p < .01), and sense of community (p < .05). Stress was also associated with COVID-19 cases among residents (p < .05), and size of care home (p < .05). Conclusion Short- and long-term strategies (i.e., psychosocial counseling, mandatory team meetings, more highly qualified nurses, additional training) in the work environment of nursing, in crises, but beyond, should be encouraged to reduce the burden on nursing staff in care homes.

Post-COVID syndrome: A reflection and opinion paper

A high proportion of people who have suffered from COVID-19 report, after recovery from the acute phase of the disease, clinical manifestations, both subjective and objective, that continue beyond 3 weeks or even 3 months after the original clinical disease. There is still no agreed nomenclature to refer to this condition, but perhaps the most commonly used is post-COVID syndrome. The Scientific Committee on COVID of the Madrid College of Physicians (ICOMEM) has discussed this problem with a multidisciplinary approach in which internists, infectious disease specialists, psychiatrists, pneumologists, surgeons, geriatricians, pediatricians, microbiologists, family physicians and other specialists have participated, trying to gather the existing information and discussing it in the group. The clinical manifestations are very variable and range from simple fatigue to persistent fibrosing lung lesions with objective alterations of pulmonary function. Post-COVID syndrome seems to be particularly frequent and severe in adults who have required admission to Intensive Care Units and has a peculiar behavior in a very small group of children. The post-COVID syndrome, which undoubtedly exists, is at first sight not clearly distinguishable from clinical manifestations that which occur after other acute viral diseases and after prolonged stays in ICUs due to other diseases. Therefore, it offers excellent research opportunities to clarify its pathogenesis and possibly that of other related entities. It is possible that progressively there will be an increased demand for care among the millions of people who have suffered and overcome acute COVID for which the health authorities should design mechanisms for the agile management of care that will possibly require well-coordinated multidisciplinary groups. This paper, structured in questions on different aspects of the post-COVID syndrome, attempts to stage the current state of this problem

Care management instruments used by nurses in the emergency hospital services

ABSTRACT Objective: To describe the instruments used by nurses for the management of care in face of the demands of the emergency hospital service. Method: This is a qualitative study, with triangulation of data from interviews, focus groups, and documents, conducted with nurses from an Emergency Hospital Service in a state in southern Brazil. Data were subjected to thematic content analysis. Results: Seventeen nurses participated in the study. The categories emerging from this study were view of the whole picture, definition of priorities, and physical instruments. These instruments are used by nurses to manage multiple tasks and provide adequate care to patients with different levels of complexity, in the face of an intense and unpredictable work process due to the constant demand for care. Conclusion: The instruments used by nurses in their work process are mainly skills and attitudes developed as a coping strategy at an intense and complex work environment.

Technologies and Applications of Internet of Things (IoT) in Healthcare

Developments in technology have opened new doors for healthcare to improve the treatment methods and prevent illnesses as a proactive method. Internet of things (IoT) technologies have also improved the self-management of care and provided more useful data and decisions to doctors with data analytics. Unnecessary visits, utilizing better quality resources, and improving allocation and planning are main advantages of IoT in healthcare. Moreover, governments and private institutions have become a part of this new state-of-the-art development for decreasing costs and getting more benefits over the management of services. In this chapter, IoT technologies and applications are explained with some examples. Furthermore, deep learning and artificial intelligence (AI) usage in healthcare and their benefits are stated that artificial neural networks (ANN) can monitor, learn, and predict, and the overall health severity for preventing serious health loss can be estimated and prevented.