Articles: pandemics.
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Review
Rethinking Traditional Emergency Department Care Models in a Post-Coronavirus Disease-2019 World.
As the nursing shortage in United States emergency departments has drastically worsened since the coronavirus disease-2019 (COVID-19) pandemic, emergency departments have experienced increased rates of inpatient onboarding, higher rates of patients leaving without being seen, and declining patient satisfaction scores. This paper reviews the impacts of the coronavirus disease-2019 pandemic on the current nursing shortage and considers how various medical personnel (emergency nurse-extenders) can ameliorate operational challenges by redesigning emergency department systems. ⋯ Health care workers who can be trained to augment the existing emergency department workforce include paramedics, Emergency Medical Technicians, emergency department technicians, ancillary staff, scribes, and motivated health sciences students. Utilizing non-nurse providers to fulfill tasks traditionally assigned to emergency nurses can improve emergency department flow and care delivery in a post-coronavirus disease-2019 world.
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Studies of mentorship in emergency medicine show that mentored residents are twice as likely to describe their career preparation as excellent as compared to nonmentored peers. There has been significant interest in the mentor-mentee relationship in medicine; however, there is minimal guidance and published literature specific to emergency medicine residents. ⋯ Alternative approaches to the traditional and hierarchal dyadic mentoring style (eg, team mentoring) are effective methods that residencies may promote to increase effective mentoring. Future efforts in mentoring emergency medicine residents emphasize these strategies, which are increasingly beneficial given the constraints and use of technology highlighted by the COVID-19 pandemic.
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Review Practice Guideline
Critical Care Staffing in Pandemics and Disasters: A Consensus Report from a Sub-committee of the Task Force for Mass Critical Care- Systems Strategies to Sustain the Healthcare Workforce.
The COVID-19 pandemic has led to unprecedented mental health disturbances, burnout, and moral distress among health care workers, affecting their ability to care for themselves and their patients. ⋯ The Workforce Sustainment subcommittee of the TFMCC offers evidence-informed operational strategies to assist health care workers and hospitals plan, prevent, and treat the factors affecting health care worker mental health, burnout, and moral distress to improve resilience and retention following the COVID-19 pandemic.
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Kidney transplantation remains the best available treatment for end-stage renal disease. However, promoting graft longevity and preventing allosensitization requires strict adherence with a stringent immunosuppression regimen. The COVID-19 pandemic has offered new challenges for kidney transplant patients and many transplant centers are denying transplantation to unvaccinated patients. The aim of this study was to evaluate whether unvaccinated patients had inferior adherence after kidney transplantation along with a reduction in graft survival. ⋯ Patients not vaccinated against COVID-19 had higher rate of postoperative nonadherence in key areas of immunosuppression monitoring and clinic visit attendance. Providers should be cognizant that an unvaccinated status may be a harbinger for poor adherence; therefore, stricter strategies for patient outreach are critical to ensure graft success in this vulnerable patient population.
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Palliative medicine · Jul 2023
Deaths at home, area-based deprivation and the effect of the Covid-19 pandemic: An analysis of mortality data across four nations.
The number and proportion of home deaths in the UK increased during the Covid-19 pandemic. It is not known whether these changes were experienced disproportionately by people from different socioeconomic groups. ⋯ The Covid-19 pandemic exacerbated a previously described socioeconomic inequality in place of death in the UK. Further research to understand the reasons for this change and if this inequality has been sustained is needed.