scholarly journals The impact of the COVID-19 pandemic on hospital services for patients with cardiac diseases: a scoping review

2021 ◽  
Author(s):  
Mats de Lange ◽  
Ana Sofia Carvalho ◽  
Oscar Brito Fernandes ◽  
Hester Lingsma ◽  
Niek Klazinga ◽  
...  
Keyword(s):  
Scoping Review ◽  
Care Pathway ◽  
Data Extraction ◽  
Delayed Presentation ◽  
Cardiac Procedures ◽  
Future Events ◽  
Coronary Syndromes ◽  
Treatment Procedures ◽  
The Impact ◽  
Full Text Screening

Aim: To assess the impact of the COVID-19 pandemic on hospital care for cardiac patients. Methods and results: Scoping review, including studies with empirical data on changes in the use of health services measured by performance indicators during January - June 2020. Database searches yielded 6277 articles, of which 838 articles met the inclusion criteria during initial screening. After full-text screening, 94 articles were considered for data extraction. In total, 1637 indicators were retrieved, showing large variation in the indicators and their definitions. Most of the indicators that provided information on changes in number of admissions (n=118, 88%) signalled a decrease in admissions; 88% (n=15) of the indicators showed patients delayed presentation and 40% (n=54) showed patients in a worse clinical condition. A reduction in diagnostic and treatment procedures was signalled by 95% (n=18) and 81% (n=64) of the indicators reporting on cardiac procedures, respectively. Length of stay decreased in 58% (n=21) of the indicators and acute coronary syndromes treatment times increased in 61% (n=65) of the indicators. Outpatient activity decreased in 94% (n=17) of the indicators related with outpatient care, whereas telehealth utilization increased in 100% (n=6). Outcomes worsened in 40% (n=35) of the indicators, and mortality rates increased in 52% (n=31). Conclusion: All phases of the hospital cardiac care pathway were affected. This information could support the planning of care during the ongoing pandemic and in future events. Furthermore, to ensure continuity of care during crises, fostering the use of standardised indicators is paramount.

scholarly journals Mobile Self-Monitoring ECG Devices to Diagnose Arrhythmia that Coincide with Palpitations: A Scoping Review

Healthcare ◽  
2019 ◽  
Vol 7 (3) ◽  
pp. 96 ◽  
Author(s):  
Hannah Ramsden Marston ◽  
Robin Hadley ◽  
Duncan Banks ◽  
María Del Carmen Miranda Duro
Keyword(s):  
Primary Care ◽  
Mobile Devices ◽  
Scoping Review ◽  
Care Pathway ◽  
Primary Care Providers ◽  
Positive Trend ◽  
Care Providers ◽  
Heart Monitoring ◽  
The Impact ◽  
Monitoring Devices

The use and deployment of mobile devices across society is phenomenal with an increasing number of individuals using mobile devices to track their everyday health. However, there is a paucity of academic material examining this recent trend. Specifically, little is known about the use and deployment of mobile heart monitoring devices for measuring palpitations and arrhythmia. In this scoping literature review, we identify the contemporary evidence that reports the use of mobile heart monitoring to assess palpitations and arrhythmia across populations. The review was conducted between February and March 2018. Five electronic databases were searched: Association for Computing Machinery (ACM), CINHAL, Google Scholar, PubMed, and Scopus. A total of 981 records were identified and, following the inclusion and exclusion criteria, nine papers formed the final stage of the review. The results identified a total of six primary themes: purpose, environment, population, wearable devices, assessment, and study design. A further 24 secondary themes were identified across the primary themes. These included detection, cost effectiveness, recruitment, type of setting, type of assessment, and commercial or purpose-built mobile device. This scoping review highlights that further work is required to understand the impact of mobile heart monitoring devices on how arrhythmias and palpitations are assessed and measured across all populations and ages of society. A positive trend revealed by this review demonstrates how mobile heart monitoring devices can support primary care providers to deliver high levels of care at a low cost to the service provider. This has several benefits: alleviation of patient anxiety, lowering the risk of morbidity and mortality, while progressively influencing national and international care pathway guidelines. Limitations of this work include the paucity of knowledge and insight from primary care providers and lack of qualitative material. We argue that future studies consider qualitative and mixed methods approaches to complement quantitative methodologies and to ensure all actors’ experiences are recorded.

scholarly journals Patient and public involvement in stroke research: a scoping review protocol

2021 ◽  
Vol 4 ◽  
pp. 118
Author(s):  
Patricia Hall ◽  
Thilo Kroll ◽  
Julianne Hickey ◽  
Diarmuid Stokes ◽  
Olive Lennon
Keyword(s):  
Scoping Review ◽  
Public Involvement ◽  
Data Extraction ◽  
Research Question ◽  
Grey Literature ◽  
Healthcare Research ◽  
Stroke Research ◽  
Health And Social Care ◽  
Review Protocol ◽  
The Impact

Background: Growing consensus supports public and patient involvement (PPI) in research as the lived experience of patients, family carers and users of health and social care services bring unique insights to healthcare research. The impact and burden of stroke present ongoing challenges for those living with its consequences and could potentially limit PPI activity. This review aims to explore PPI in published stroke research to identify and describe the extent, nature and design of PPI activities, the type/s of studies involved and the profile of PPI participants engaged in stroke research. Methods: This systematic scoping review, guided by the Arksey & O’Malley five step framework, will be reported according to the PRISMA-ScR reporting guidelines. PPI is embedded at each stage of this proposed scoping review from conceptualisation, participation, contribution and collaboration. The Population, Concept, Context (PCC) structure defines the research question which asks - How is PPI in stroke research currently being conducted and how do the study authors report their PPI activities and its impact? A comprehensive range of electronic databases including PubMed, CINAHL, EMBASE, PsychINFO and the Cochrane Database of Systematic Reviews will generate a broad range of studies. Grey literature (e.g. OpenGrey, Leanus) and internationally recognised stroke organisation websites will be searched for additional research reports. Data extraction will adhere to the Joanna Briggs Institute guidelines, with results collated and mapped to the research cycle stage/s. Conclusions: The outlined scoping review protocol will comprehensively identify and map the existing scientific literature that reports PPI in stroke research. Findings will be presented in relation to PPI conceptualisation, participant profiles and activities in stroke research, volume, type and range of approaches. Knowledge gaps and future priorities for PPI in stroke research will be identified.

scholarly journals Building patient capacity to participate in care during hospitalisation: a scoping review

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e026551
Author(s):  
Donna Goodridge ◽  
Meghan McDonald ◽  
Lucia New ◽  
Murray Scharf ◽  
Elizabeth Harrison ◽  
...  
Keyword(s):  
Scoping Review ◽  
Data Extraction ◽  
Behaviour Change Techniques ◽  
Positive Outcomes ◽  
Care Environment ◽  
Patient Capacity ◽  
Study Selection ◽  
The Social ◽  
Abstract Screening ◽  
Full Text Screening

ObjectivesTo map the existing literature and describe interventions aimed at building the capacity of patients to participate in care during hospitalisation by: (1) describing and categorising the aspects of care targeted by these interventions and (2) identifying the behaviour change techniques (BCTs) used in these interventions. A patient representative participated in all aspects of this project.DesignScoping review.Data sourcesMEDLINE, Embase and CINAHL (Inception −2017).Study selectionStudies reporting primary research studies on building the capacity of hospitalised adult patients to participate in care which described or included one or more structured or systematic interventions and described the outcomes for at least the key stakeholder group were included.Data extractionTitle and abstract screening and full text screening were conducted by pairs of trained reviewers. One reviewer extracted data, which were verified by a second reviewer. Interventions were classified according to seven aspects of care relevant to hospital settings. BCTs identified in the articles were assigned through consensus of three reviewers.ResultsDatabase searches yielded a total 9899 articles, resulting in 87 articles that met the inclusion criteria. Interventions directed at building patient capacity to participate in care while hospitalised were categorised as those related to improving: patient safety (20.9%); care coordination (5.7%); effective treatment (5.7%) and/or patient-centred care using: bedside nursing handovers (5.7%); communication (29.1%); care planning (14%) or the care environment (19.8%). The majority of studies reported one or more positive outcomes from the defined intervention. Adding new elements (objects) to the environment and restructuring the social and/or physical environment were the most frequently identified BCTs.ConclusionsThe majority of studies to build capacity for participation in care report one or more positive outcomes, although a more comprehensive analysis is warranted.

scholarly journals Patient race, ethnicity, and care in the emergency department: A scoping review

CJEM ◽  
2020 ◽  
Vol 22 (2) ◽  
pp. 245-253 ◽  
Author(s):  
Allison Owens ◽  
Brian R. Holroyd ◽  
Patrick McLane
Keyword(s):  
Emergency Department ◽  
Scoping Review ◽  
Race And Ethnicity ◽  
Research Question ◽  
The United States ◽  
Subjective Experiences ◽  
Patient Race ◽  
Abstract Screening ◽  
The Impact ◽  
Full Text Screening

ABSTRACTObjectivesHealth disparities between racial and ethnic groups have been documented in Canada, the United States, and Australia. Despite evidence that differences in emergency department (ED) care based on patient race and ethnicity exist, there are no comprehensive literature reviews in this area. The objective of this review is to provide an overview of the literature on the impact of patient ethnicity and race on the processes of ED care.MethodsA scoping review was conducted to capture the broad nature of the literature. A database search was conducted in MEDLINE/PubMed, EMBASE, CINAHL Plus, Social Sciences Citation Index, SCOPUS, and JSTOR. Five journals and reference lists of included articles were hand searched. Inclusion and exclusion criteria were defined iteratively to ensure literature captured was relevant to our research question. Data were extracted using predetermined variables, and additional extraction variables were added as familiarity with the literature developed.ResultsSearching yielded 1,157 citations, reduced to 153 following removal of duplicates, and title and abstract screening. After full-text screening, 83 articles were included. Included articles report that, in EDs, patient race and ethnicity impact analgesia, triage scores, wait times, treatments, diagnostic procedure utilization, rates of patients leaving without being seen, and patient subjective experiences. Authors of included studies propose a variety of possible causes for these disparities.ConclusionsFurther research on the existence of disparities in care within EDs is warranted to explore the causes behind observed disparities for particular health conditions and population groups in specific contexts.

Health Equity in Artificial Intelligence and Primary Care Research: Protocol for a Scoping Review (Preprint)

2021 ◽  
Author(s):  
Jonathan Xin Wang ◽  
Sulaiman Somani ◽  
Jonathan H Chen ◽  
Sara Murray ◽  
Urmimala Sarkar
Keyword(s):  
Artificial Intelligence ◽  
Primary Care ◽  
Health Equity ◽  
Scoping Review ◽  
Underserved Populations ◽  
Care Delivery ◽  
Data Extraction ◽  
Cochrane Library ◽  
Preventative Care ◽  
The Impact

BACKGROUND Though artificial intelligence (AI) has potential to augment the patient-physician relationship in primary care, bias in intelligent healthcare systems has the potential to differentially impact vulnerable patient populations. OBJECTIVE The purpose of this scoping review is to summarize the extent to which AI systems in primary care examine the inherent bias towards or against vulnerable populations and appraise how these systems have mitigated the impact of such biases during their development. METHODS We will conduct a search update from an existing scoping review to identify AI and primary care articles in the following databases: Medline-OVID,Embase,CINAHL, Cochrane Library, Web of Science, Scopus, IEEE Xplore, ACM Digital Library, MathSciNet, AAAI, and arXiv. Two screeners will independently review all abstracts, titles and full-texts. The team will extract data using structured data extraction form and synthesize the results according to PRISMA-Scr guidelines. RESULTS This review will provide an assessment of the current state of healthcare equity within AI for primary care. Specifically, we will identify the degree to which vulnerable patients have been included, assess how bias is interpreted and documented, and understand the extent harmful biases are addressed. As of October 2020, the scoping review is in the title and abstract screening stage. The results are expected to be submitted for publication in fall of 2021. CONCLUSIONS AI applications in primary care are becoming an increasingly common tool in health care delivery, including in preventative care efforts for underserved populations. This scoping review aims to understand to what extent AI-primary care studies employ a health equity lens and take steps to mitigate bias.

scholarly journals Community Initiatives to Promote Basic Life Support Implementation—A Scoping Review

2021 ◽  
Vol 10 (24) ◽  
pp. 5719
Author(s):  
Andrea Scapigliati ◽  
Drieda Zace ◽  
Tasuku Matsuyama ◽  
Luca Pisapia ◽  
Michela Saviani ◽  
...  
Keyword(s):  
Hospital Discharge ◽  
Scoping Review ◽  
Basic Life Support ◽  
Life Support ◽  
Data Extraction ◽  
Screening Process ◽  
Community Initiatives ◽  
Scoping Reviews ◽  
Bystander Cpr ◽  
The Impact

Introduction: Early intervention of bystanders (the first links of the chain of survival) have been shown to improve survival and good neurological outcomes of patients suffering out-of-hospital cardiac arrest (OHCA). Many initiatives have been implemented to increase the engagement of communities in early basic life support (BLS) and cardiopulmonary resuscitation (CPR), especially of lay people with no duty to respond. A better knowledge of the most effective initiatives might help improve survival and health system organization. Aim of the scoping review: To assess the impact of specific interventions involving lay communities on bystander BLS rates and other consistent clinical outcomes, and to identify relevant knowledge gaps. Methods: This scoping review was part of the continuous evidence evaluation process of the International Liaison Committee on Resuscitation (ILCOR), and was performed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. We performed a literature search using the PubMed, EMBASE, and Cochrane databases until 1 February 2021. The screening process was conducted based on predefined inclusion/exclusion criteria, and for each included study, we performed data extraction focusing on the type of intervention implemented, and the impact of these interventions on the specific OHCAs outcomes. Results: Our search strategy identified 19 eligible studies, originating mainly from the USA (47.4%) and Denmark (21%). The type of intervention included in 57.9% of cases was a community CPR training program, in 36.8% bundled interventions, and in 5.3% mass-media campaigns. The most commonly reported outcome for OHCAs was bystander CPR rate (94.7%), followed by survival to hospital discharge (36.8%), proportion of people trained (31.6%), survival to hospital discharge with good neurological outcome (21%), and Return of Spontaneous Circulation (10.5%). Community training programs and bundled interventions improved bystander CPR in most of the included studies. Conclusion: Based on the results of our scoping review, we identified the potential benefit of community initiatives, such as community training in BLS, even as part of bundled intervention, in order to improve bystander CPR rates and patient outcomes.

scholarly journals Rehabilitation and Reintegration Programming Following Female Genital Fistula Surgery: A Scoping Review

2018 ◽  
Vol 13 (2) ◽  
Author(s):  
Alison M El Ayadi
Keyword(s):  
Scoping Review ◽  
Data Extraction ◽  
Grey Literature ◽  
Sub Saharan Africa ◽  
Social Reintegration ◽  
Fistula Surgery ◽  
Medical Librarian ◽  
Sub Saharan ◽  
Genital Fistula ◽  
Full Text Screening

Aims: To examine the range of rehabilitation and reintegration services provided as adjunct to genital fistula surgery, map the existing programming and outcomes, and identify areas where additional research is necessary. Methods: Our scoping review is informed by existing methodological frameworks and conducted in accordance with PRISMA guidelines.The search strategy was designed in collaboration with a medical librarian and is applied to nine biomedical, public health, and social science databases. Grey literature is identified through targeted searches and relevant organizational websites. Two primary reviewers independently screened titles and abstracts of all articles, followed by full-text screening and standardized data extraction. Eligible articles will discuss research or programmatic efforts around service provision in adjunct to surgery. Results: The literature review is currently underway and preliminary results including summary tables and narrative will be available to share at the ISOFS conference. Conclusions: The results of this scoping review will help in understanding and describing what is known and unknown about rehabilitation and social reintegration of women following genital fistula surgery in sub-Saharan Africa and may be useful in developing and evaluating social reintegration projects.

scholarly journals Grand Challenges as Educational Innovations in Higher Education: A Scoping Review of the Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-39
Author(s):  
Lorelli Nowell ◽  
Swati Dhingra ◽  
Kimberley Andrews ◽  
Julia Gospodinov ◽  
Cathy Liu ◽  
...  
Keyword(s):  
Higher Education ◽  
Scoping Review ◽  
Data Extraction ◽  
Collaborative Problem Solving ◽  
Grand Challenge ◽  
Educational Innovations ◽  
Problem Solving Skills ◽  
Grand Challenges ◽  
Scoping Reviews ◽  
The Impact

Grand challenges are complex problems that are common to much of society, affect large populations, and may have several possible solutions. Incorporation of grand challenges into higher education courses can facilitate the development of collaborative problem-solving skills while providing relevant and practical opportunities to experience the dynamics involved in real-world work. Although grand challenges are becoming more commonly used in higher education, to date, there has been no synthesis of how grand challenges are incorporated and the learning outcomes of engaging in grand challenge work. In this scoping review, we examined and mapped the state of evidence for the use of grand challenges in higher education. We conducted the review according to the Johanna Briggs Institute methodology for scoping reviews and considered quantitative, qualitative, and mixed-methods studies as well as literature reviews, program descriptions, and opinion papers published in English without limitations on year of publication. We used a data extraction tool to synthesize and present our findings in a tabular form with accompanying narrative summaries. The results reveal a growing global interest in the use of grand challenges in higher education while highlighting a lack of rigorous empirical evidence on the impact on student learning.

scholarly journals The role of organizational and professional cultures in medication safety: a scoping review of the literature

2019 ◽  
Vol 31 (10) ◽  
pp. G146-G157 ◽  
Author(s):  
Samantha Machen ◽  
Yogini Jani ◽  
Simon Turner ◽  
Martin Marshall ◽  
Naomi J Fulop
Keyword(s):  
Scoping Review ◽  
Medication Safety ◽  
Local Governance ◽  
Data Extraction ◽  
Grey Literature ◽  
Evidence Base ◽  
Original Research ◽  
The Impact ◽  
Governance Arrangements

ABSTRACT Purpose This scoping review explores what is known about the role of organizational and professional cultures in medication safety. The aim is to increase our understanding of ‘cultures’ within medication safety and provide an evidence base to shape governance arrangements. Data sources Databases searched are ASSIA, CINAHL, EMBASE, HMIC, IPA, MEDLINE, PsycINFO and SCOPUS. Study selection Inclusion criteria were original research and grey literature articles written in English and reporting the role of culture in medication safety on either organizational or professional levels, with a focus on nursing, medical and pharmacy professions. Articles were excluded if they did not conceptualize what was meant by ‘culture’ or its impact was not discussed. Data extraction Data were extracted for the following characteristics: author(s), title, location, methods, medication safety focus, professional group and role of culture in medication safety. Results of data synthesis A total of 1272 citations were reviewed, of which, 42 full-text articles were included in the synthesis. Four key themes were identified which influenced medication safety: professional identity, fear of litigation and punishment, hierarchy and pressure to conform to established culture. At times, the term ‘culture’ was used in a non-specific and arbitrary way, for example, as a metaphor for improving medication safety, but with little focus on what this meant in practice. Conclusions Organizational and professional cultures influence aspects of medication safety. Understanding the role these cultures play can help shape both local governance arrangements and the development of interventions which take into account the impact of these aspects of culture.

scholarly journals Is patient navigation a solution to the problem of "leaving no one behind"? A scoping review of evidence from low-income countries

2020 ◽  
Author(s):  
Sarah Louart ◽  
Emmanuel Bonnet ◽  
Valéry Ridde
Keyword(s):  
Health Systems ◽  
Scoping Review ◽  
Low Income ◽  
Access To Health Care ◽  
Patient Navigation ◽  
Care Pathway ◽  
Health Policies ◽  
Low Income Countries ◽  
People Living With Hiv ◽  
The Impact

Abstract Patient navigation interventions, which are designed to enable patients excluded from health systems to overcome the barriers they face in accessing care, have multiplied in high-income countries since the 1990s. However, in low-income countries (LICs), indigents are generally excluded from health policies despite the international paradigm of universal health coverage (UHC). Fee exemption interventions have demonstrated their limits and it is now necessary to act on other dimensions of access to healthcare. However, there is a lack of knowledge about the interventions implemented in LICs to support the indigents throughout their care pathway. The aim of this paper is to synthesize what is known about patient navigation interventions to facilitate access to modern health systems for vulnerable populations in LICs. We therefore conducted a scoping review to identify all patient navigation interventions in LICs. We found 60 articles employing a total of 48 interventions. Most of these interventions targeted traditional beneficiaries such as people living with HIV, pregnant women and children. We utilized the framework developed by Levesque et al. (Patient-centred access to health care: conceptualising access at the interface of health systems and populations. Int J Equity Health 2013;12:18) to analyse the interventions. All acted on the ability to perceive, 34 interventions on the ability to reach, 30 on the ability to engage, 8 on the ability to pay and 6 on the ability to seek. Evaluations of these interventions were encouraging, as they often appeared to lead to improved health indicators and service utilization rates and reduced attrition in care. However, no intervention specifically targeted indigents and very few evaluations differentiated the impact of the intervention on the poorest populations. It is therefore necessary to test navigation interventions to enable those who are worst off to overcome the barriers they face. It is a major ethical issue that health policies leave no one behind and that UHC does not benefit everyone except the poorest.

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