scholarly journals A Covid -19 Virtual Ward Model: A Preliminary Retrospective Clinical Evaluation From a UK District General Hospital

2022 ◽  
Vol 13 ◽  
pp. 215013192110666
Author(s):  
Emily-Jane O’Malley ◽  
Shanil Hansjee ◽  
Basil Abdel-Hadi ◽  
Elizabeth Kendrick ◽  
She Lok
Keyword(s):  
Length Of Hospital Stay ◽  
District General Hospital ◽  
Supplemental Oxygen ◽  
Ongoing Treatment ◽  
Care Services ◽  
Early Supported Discharge ◽  
Potential Benefits ◽  
Collaborative Working ◽  
Length Of Hospitalization ◽  
At Home

Objective: This study aims to evaluate the safety, utilization, ability to reduce length of hospitalization and overall outcomes of a COVID-19 virtual ward providing ongoing treatment at home. Method: A retrospective single-center study of patients discharged to the COVID-19 virtual “step down” ward between January 27th 2021 and March 2nd 2021. The referral process, length of hospitalization, length of stay on the virtual ward, readmissions, and ongoing treatment requirements including supplemental oxygen, antibiotics, and/or steroids were all noted. Results: A total of 50 patients were referred to the virtual ward. 43 referrals were accepted, 39 of which were from the respiratory ward. Four patients were readmitted, all due to hypoxia. All readmissions occurred within 5 days of discharge. 72% (n = 31) were discharged home with an ongoing oxygen requirement. 14.3% of patients were discharged with antibiotics only, 9.5% with steroids only and 23.8% with both antibiotics and steroids. The mean length of hospital stay for patients discharged to the virtual ward was 10.3 ± 9.7 days and 11.9 ± 11.6 days for all covid positive patients during this time. On average, patients spent 13.7 ± 7.3 days on the virtual ward. The average number of days spent on oxygen on the virtual ward was 11.6 ± 6.0 days. Conclusion: The virtual ward model exemplifies the potential benefits of collaborative working between primary and secondary care services, relieving pressure on hospitals whilst providing ongoing treatments at home such as supplemental oxygen. It also facilitates an early supported discharge of clinically stable patients with an improving clinical trajectory by managing them in the community.

scholarly journals Caring for One’s Wife With Dementia—at Home: Older Husbands’ Experiences With Managing Challenges of Everyday Life

SAGE Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 215824401983445
Author(s):  
Linda Rykkje ◽  
Oscar Tranvåg
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Qualitative Interviews ◽  
Care Services ◽  
People With Dementia ◽  
Memory Clinics ◽  
Male Caregivers ◽  
Caregiving Roles ◽  
Caregiver Role ◽  
At Home

More than 80,000 Norwegians live with dementia. Most caregivers for people with dementia are spouses, and women outnumber men. Due to an aging population, and women’s higher risk of dementia as well as men’s increased life expectancy, the number of male caregivers will rise. There are some differences in the caregiving roles of men and women. Research suggest that males report lower burden and depression than female caregivers, but some men struggle to adjust to the caregiver role, and men are less likely to access health care services. The aim of this study is to explore the experiences of husbands engaged in caregiving for their home-dwelling spouse with dementia. This knowledge will add to the growing body of research about men in the context of dementia care and may raise gender awareness. The method is qualitative interviews with hermeneutical interpretation. The participants are five husbands recruited from two Hospital Memory Clinics in Norway. The results portray how the husbands managed their everyday challenges, and how they adapted to changes, experiences of loss and bereavement, and how they redefined personal freedom and expanded their responsibilities. Acknowledging the rewards of caregiving, the husbands found their life meaningful and they were thriving in their caregiving role. Health care personnel should recognize and respect the challenging life situation caregiving husbands may experience, calling for personnel to learn from, care for, and collaborate with them, enabling the couple to live a meaningful life together at home as long as possible.

scholarly journals Older people living at home: experiences of healthy ageing

2021 ◽  
Vol 22 ◽  
Author(s):  
Astrid Fjell ◽  
Kristin Ådnøy Eriksen ◽  
Monica Hermann ◽  
Anne-Marie Boström ◽  
Seiger Berit Cronfalk
Keyword(s):  
Health Care ◽  
Older People ◽  
Older Persons ◽  
Health Care Services ◽  
Healthy Ageing ◽  
Group Discussions ◽  
Care Services ◽  
Manifest Content ◽  
Professional Perspective ◽  
At Home

Abstract Aim: The purpose of this study was to investigate how old persons perceived their life to be, how they viewed the ageing process and their need of health care and societal support. Background: The purpose of WHO’s Healthy Ageing strategy and development of age-friendly environments is to support physiological and psychosocial changes in old persons by facilitating basic needs. Interventions to operationalize these needs in older people living at home are often developed from a professional perspective and to a small extent involves the perceptions, experience and expectations of the older persons. Method: This qualitative study has an explorative design using focus group discussions to collect data. In all, 34 persons between 69 and 93 years of age participated in seven group discussions. The interviews were analyzed using inductive manifest content analysis. Findings: The main results suggest that most old persons enjoyed life and wished it to continue for as long as possible. Important was to sustain networks and to feel useful. Unexpected changes were described as threats and the need to use health care services was associated with illness and being dependent. The result is presented in three categories with sub-categories: ‘Embracing life’, ‘Dealing with challenges’ and ‘Considering the future’.

scholarly journals Mechatronic Design of a Robot for Upper Limb Rehabilitation at Home

2021 ◽  
Vol 18 (4) ◽  
pp. 857-871
Author(s):  
Elio Matteo Curcio ◽  
Giuseppe Carbone
Keyword(s):  
Design Process ◽  
Upper Limb ◽  
Experimental Tests ◽  
Design Solution ◽  
Upper Limb Rehabilitation ◽  
Potential Benefits ◽  
Significant Cost Reduction ◽  
Dynamics Models ◽  
Limb Rehabilitation ◽  
At Home

AbstractThis paper addresses the design of a novel bionic robotic device for upper limb rehabilitation tasks at home. The main goal of the design process has been to obtain a rehabilitation device, which can be easily portable and can be managed remotely by a professional therapist. This allows to treat people also in regions that are not easily reachable with a significant cost reduction. Other potential benefits can be envisaged, for instance, in the possibility to keep social distancing while allowing rehabilitation treatments even during a pandemic spread. Specific attention has been devoted to design the main mechatronic components by developing specific kinematics and dynamics models. The design process includes the implementation of a specific control hardware and software. Preliminary experimental tests are reported to show the effectiveness and feasibility of the proposed design solution.

scholarly journals Managing children and adolescents on parenteral nutrition: challenges for the nutritional support team

2006 ◽  
Vol 65 (3) ◽  
pp. 217-221 ◽  
Author(s):  
Tracey Johnson ◽  
Elaine Sexton
Keyword(s):  
Parenteral Nutrition ◽  
Children And Adolescents ◽  
Nutritional Support ◽  
Intestinal Failure ◽  
Home Care Services ◽  
Cholestatic Liver Disease ◽  
Care Services ◽  
Child Assessments ◽  
The Individual ◽  
At Home

Managing infants, children and adolescents, ranging from premature infants to 18-year-old adolescents, on parenteral nutrition (PN) is a challenge. The ability of children to withstand starvation is limited and, unlike adults, children require nutrition for growth. PN in children is often required secondary to a congenital bowel problem rather than because of an acquired condition. Conditions requiring PN include motility disorders, congenital disorders of the intestinal epithelium and short-bowel syndrome (SBS). Intestinal failure may be temporary and children with SBS may be weaned from PN. However, other children require permanent PN. There are no comprehensive guidelines for the nutritional requirements of children and adolescents requiring PN. Practice in individual centres is based on clinical experience rather than clinical trials. Requirements are assessed on an individual basis according to age, nutritional status and clinical condition. These requirements need regular review to ensure that they remain appropriate for the changing age and weight of the child. Assessments of intakes use different methods, e.g. reference tables and predictive equations. Complications of PN include infection, accidental damage to, or removal of, the line and cholestatic liver disease. Home parenteral nutrition (HPN) is associated with fewer line infections and allows continuation of nutritional support in a more normal environment, encouraging normal development and participation in family activities. However, having a child at home on HPN is associated with physical and psychological stresses. A feeling of depression, loneliness and social isolation is common amongst children and their families. Home-care services are essential to supporting children at home and should be tailored to, and sensitive to, the individual needs of each family.

scholarly journals Modern treatment of patent ductus arteriosus – single center experience

2014 ◽  
Vol 4 (3) ◽  
pp. 181-185
Author(s):  
Senka Mesihović Dinarević ◽  
Almira Kadic ◽  
Zijo Begić ◽  
Mirza Halimić ◽  
Emina Vukas
Keyword(s):  
Patent Ductus Arteriosus ◽  
Transcatheter Closure ◽  
Ductus Arteriosus ◽  
Length Of Hospital Stay ◽  
Single Center Experience ◽  
Pediatric Clinic ◽  
Occluder Device ◽  
Length Of Hospitalization ◽  
Selection Of ◽  
Patent Ductus

 Introduction: Transcatheter closure is a treatment choice for the most children with patent ductus arteriosus (PDA). The closure of the ductus is indicated in any child or adolescent with developed symptoms of significant L-R shunt. The aim of this article is to present our results in 5 years treatment of patients with PDA and their outcome. Methods: From 2009 to 2014, 30 patients underwent a transcatheter closure of PDA at Centre for Heart and Pediatric clinic of Clinical University Centre of Sarajevo. Aortic angiogram was performed to evaluate the size, position, and shape of the duct for selection of appropriate occluder device type and size. All procedures were performed by local team of cardiologists from the Department of Cardiology, Pediatric clinic, with invasive cardiologists team from Sweden and Austria. Echocardiography was repeated at intervals of 24 hours, then 1month, 3 months, and 1 year after the procedure to assess the outcome. Results: Thirty patients underwent transcatheter closure of PDA during the study period. PDA of ≤ 2.0 mm was present in 8 patients and they underwent PDA closure with coils, while 22 patients had PDA diameter  ≥ 2 mm, and they were treated by Amplatzer duct occluder (ADO). Only in 2 (6.2%) patients complications have been observed. The length of hospital stay after the treatment was two to three days. Conclusion: Transcatheter closure of PDA is a modern, safe and efficient method that ensures a faster recovery of the patients, shortens the length of hospitalization.

scholarly journals Management of wound infection after appendectomy: are parenteral antibiotics useful?

2021 ◽  
Vol 8 (4-5) ◽  
pp. 638-644
Author(s):  
B. Harahsheh ◽  
B. Hiyasat ◽  
A. Abulail ◽  
M. Al Basheer
Keyword(s):  
Povidone Iodine ◽  
Perforated Appendicitis ◽  
Length Of Hospital Stay ◽  
District General Hospital ◽  
Antibiotic Use ◽  
Wound Infections ◽  
Perforated Appendix ◽  
The Mean ◽  
To Receive ◽  
Single Blind

This study investigated the use of antibiotics in the treatment of wound infections after appendectomy. The subjects were 72 patients with post-operative wound infections at a district general hospital in Jordan. All patients received daily antiseptic dressings with povidone-iodine 10% in alcohol. The patients were randomized in a single-blind trial to receive either no antibiotics or parenteral antibiotics metronidazole and cefoxitin. There was no significant effect of antibiotic use in patients with early inflamed or severely inflamed appendicitis. However, for patients with perforated appendicitis the mean length of hospital stay and the mean frequency of change of dressings were significantly reduced. We conclude that antibiotics do not offer any advantage in post-appendectomy wound infections except for cases of perforated appendix

scholarly journals Advantages and challenges in using telehealth for home-based palliative care: A systematic mixed studies review protocol (Preprint)

2020 ◽  
Author(s):  
Simen A Steindal ◽  
Andréa Aparecida Goncalves Nes ◽  
Tove E. Godskesen ◽  
Susanne Lind ◽  
Alfhild Dhle ◽  
...  
Keyword(s):  
Palliative Care ◽  
Care Delivery ◽  
Patient Centered ◽  
Care Services ◽  
Home Based ◽  
Mixed Studies Review ◽  
Palliative Care Services ◽  
Meta Analyses ◽  
Systematic Mixed Studies Review ◽  
At Home

BACKGROUND Due to the increasing number of people in need of palliative care services and the current health care professional workforce strain, providing equitable, quality palliative care has become a challenge. Telehealth could be an innovative approach to palliative care delivery, enabling patients to spend more time or even remain at home, if they wish, throughout the illness trajectory. However, no previous systematic mixed studies reviews have synthesized evidence on patients’ experiences of the advantages and challenges of telehealth for home-based palliative care. OBJECTIVE The aim of this systematic mixed studies review is to critically appraise and synthesize findings from studies that investigated patients’ use of telehealth in home-based palliative care with a focus on the advantages and challenges experienced by the patients. METHODS This article describes the protocol for a systematic mixed studies review with a convergent design. The reporting will be guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. A systematic search was performed in eight databases for studies published from January 2010 to June 2020. The search will be updated in 2021. Pairs of authors will independently assess eligibility, extract data and assess methodological quality. The data will then be analyzed using thematic synthesis. RESULTS We described the rationale and design of a systematic mixed studies review. The database searches were performed on June 25, 2020. Assessment of eligibility and further steps have not yet been performed. Results are anticipated by August 2021. CONCLUSIONS Following the ethos of patient-centered palliative care, this systematic mixed studies review could contribute recommendations for practice and policy enabling the development of telehealth applications and services that align with patients’ preferences and needs when using telehealth applications and services at home.

“Safety at Home”: Experiences From Testing of Video Communication Between Patients and Home Health Care Personnel

SAGE Open ◽  
2017 ◽  
Vol 7 (4) ◽  
pp. 215824401774490 ◽  
Author(s):  
Linda Rykkje ◽  
Gunhild H. B. Hjorth
Keyword(s):  
Health Care ◽  
Home Health Care ◽  
Health Care Services ◽  
Video Communication ◽  
Health Care Personnel ◽  
Chronic Obstructive ◽  
Second Phase ◽  
Obstructive Pulmonary Disease ◽  
Care Services ◽  
At Home

The implementation of welfare technology in Norwegian municipals is a governmental priority, but there is little research on transfer of technological solutions into regular health care services. The aim of the project “Safety at home” was to test and evaluate the use of video communication between patients and health care personnel. There were two test periods, with the initial phase focusing on patients with chronic obstructive pulmonary disease (COPD). The second phase focused on patients who most likely would benefit from video communication. Nine patients tested the equipment, and they were interviewed afterward. In addition, nursing personnel evaluated the project through focus group interviews. The results identified that the equipment was user friendly and contributed to the patients’ feelings of safety. However, there were concerns about video calls replacing the “human touch” of home visits. The personnel also experienced that the technological solution had limitations, and new tasks added to their workload. The choice of focusing on COPD patients was considered a disadvantage, and we recommend that future projects should not be restricted by diagnosis and should target the most eligible candidates.

Linking Cost Control Measures to Health Care Services by Using Activity-Based Information

1995 ◽  
Vol 8 (4) ◽  
pp. 221-233 ◽  
Author(s):  
Ronald E. Hoyt ◽  
Colin M. Lay
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
New Technology ◽  
Control Measures ◽  
Patient Treatment ◽  
Management Information ◽  
Care Services ◽  
Potential Benefits ◽  
Cost Variability ◽  
The Impact

Canada's health care institutions are under pressure to limit expenditures, maintain or increase productivity, and assimilate new technology. Even though more than 75% of hospital operating expenditures are controllable, according to a study by the Economic Council of Canada, cost systems are needed to provide essential management information. The new Canadian Management Information System (MIS) Guidelines for health care are designed to provide accurate cost measurement of patient treatment and to help managers evaluate the impact of planned program changes on areas of operational responsibility. Other potential benefits of implementing the MIS guidelines include correcting dysfunctional funding of health care units with benchmarking and setting high reporting standards for resource use at the patient level (MIS, 1991). This paper focuses on one important aspect of bringing these costs under control by examining the relation between cost deviations (variances) and underlying cost drivers. Our discussion will lead to the conclusion that incompatibility of DRG methodology and traditional cost accounting models may be an important source of cost variability within diagnostically-related disease groupings.

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