Healthcare Ethics During a Pandemic

As clinicians and support personnel struggle with their responsibilities to treat during the current COVID-19 pandemic, several ethical issues have emerged. Will healthcare workers and support staff fulfill their duty to treat in the face of high risks? Will institutional and government leaders at all levels do the right things to help alleviate healthcare workers risks and fears? Will physicians be willing to make hard, resource-allocation decisions if they cannot first husband or improvise alternatives? With our healthcare facilities and governments unprepared for this inevitable disaster, front-line doctors, advanced providers, nurses, EMS, and support personnel  struggle with acute shortages of equipment—both to treat patients and  protect themselves. With their personal and possibly their family’s lives and health at risk, they must weigh the option of continuing to work or retreat to safety. This decision, made daily, is based on professional and personal values, how they perceive existing risks—including available protective measures, and their perception of the level and transparency of information they receive. Often, while clinicians get this information, support personnel do not, leading to absenteeism and deteriorating healthcare services. Leadership can use good risk communication (complete, widely transmitted, and transparent) to align healthcare workers’ risk perceptions with reality. They also can address the common problems healthcare workers must overcome to continue working (ie, risk mitigation techniques). Physicians, if they cannot sufficiently husband or improvise lifesaving resources, will have to face difficult triage decisions. Ideally, they will use a predetermined plan, probably based on the principles of Utilitarianism (maximizing the greatest good) and derived from professional and community input. Unfortunately, none of these plans is optimal

Checklists, Checklists, Every Where, but not a List to Easily Check: An Exploratory Study of Personal Health Information Management Practices

Preventive healthcare services require consumers to coordinate and manage several healthcare activities with multiple service providers. In this paper we set out to understand what challenges people face in managing personal healthcare requirements. We conducted a qualitative study of consumers who participate in a preventive care program called the Health Enhancement Program in the State of Connecticut. Data from the interviews of 15 participants of this program highlighted several challenges faced by participants in scheduling and managing their healthcare requirements. While some of the challenges were due to lack of communication between several stakeholders of the process, others provide implications for design of technology that can support management of personal healthcare requirements

The assessment of pain in older people

Pain is under-recognised and under-treated in older people. It is a subjective, personal experience, only known to the person who suffers. The assessment of pain is particularly challenging in the presence of severe cognitive impairment, communication difficulties or language and cultural barriers. These guidelines set out the key components of assessing pain in older people, together with a variety of practical scales that may be used with different groups, including those with varying levels of cognitive or communication impairment. The purpose is to provide professionals with a set of practical skills to assess pain as the first step towards its effective management. The guidance has implications for all healthcare and social care staff and can be applied in all settings, including the older person’s own home, in care homes, and in hospital

Personal information documents for people with dementia: healthcare staff’s perceptions and experiences

Person-centred care is internationally recognised as best practice for the care of people with dementia. Personal information documents for people with dementia are proposed as a way to support person-centred care in healthcare settings. However, there is little research about how they are used in practice. The aim of this study was to analyse healthcare staff’s perceptions and experiences of using personal information documents, mainly Alzheimer’s Society’s ‘This is me’, for people with dementia in healthcare settings. The method comprised a secondary thematic analysis of data from a qualitative study, of how a dementia awareness initiative affected care for people with dementia in one healthcare organisation. The data were collected through 12 focus groups (n=58 participants) and 1 individual interview, conducted with a range of healthcare staff, both clinical and non-clinical. There are four themes presented: Understanding the rationale for personal information documents; Completing personal information documents; Location for personal information documents and transfer between settings; Impact of personal information documents in practice. The findings illuminated how healthcare staff use personal information documents in practice in ways that support person-centred care. Practical issues about the use of personal information documents were revealed and these may affect the optimal use of the documents in practice. The study indicated the need to complete personal information documents at an early stage following diagnosis of dementia, and the importance of embedding their use across care settings, to support communication and integrated car

Using handheld devices for real-time wireless teleconsultation

Recent advances in the hardware of handheld devices, opened up the way for newer applications in the healthcare sector, and more specifically, in the teleconsultation field. Out of these devices, this paper focuses on the services that personal digital assistants and smartphones can provide to improve the speed, quality and ease of delivering a medical opinion from a distance and laying the ground for an all-wireless hospital. In that manner, PDAs were used to wirelessly support the viewing of digital imaging and communication in medicine (DICOM) images and to allow for mobile videoconferencing while within the hospital. Smartphones were also used to carry still images, multiframes and live video outside the hospital. Both of these applications aimed at increasing the mobility of the consultant while improving the healthcare service

Can We Talk? Bridging the Communication Gap between Nurses and Providers

Background: Effective communication is the key to successful relationships and improving patient care. Effective and efficient communication is also essential in producing a healthy self-confidence and knowledge base, which is needed by nurses and physicians who are providing daily care to patients. Purpose: The purpose of this performance improvement project is to increase the communication competence and self-awareness of staff nurses during intraprofessional interactions with the healthcare providers. Methods: A quasi-experimental quality improvement process that included a pre and post-survey alongside an educational program to arm nurses with information and communication techniques needed to help build relationships to foster effective and efficient communication. Conclusion: Nurses proved to have a better communication competence and self-confidence during communications after the implementation of an educational program directed at improving communication between nurses and healthcare providers. Implications for Nursing: Effective communication is an integral part of patient care and has proven that it results in better outcomes for the patient, healthcare providers, and health system. Building excellent communication through education, developmental tools, and personal interactions should be a priority for all institutions

Clinico-environmental system for personal monitoring

The ever-growing use of information and communication technologies in the past decades and the proliferation of mobile devices for monitoring vital signs and physical activity is enhancing the emergence of a new healthcare paradigm. More recently, citizens are becoming more sensible to the necessity of monitoring environmental health indicators and to its direct impact on personal health. This article proposes and describes the development of a clinico-environmental system for personal monitoring. The result is ContinuousCare, a personal healthcare information system that integrates personal smart devices with air quality monitors. The solution helps citizens to better understand their health and body activity with environmental context, aiding professional doctors with analysis tools and making available valuable data for external systems.publishe

COMMUNICATION IN OBSTETRIC PRACTICE AS AN ELEMENT OF SAFE PATIENT CARE

Communication is an art, a complex of methods of speaking, transmitting, perceiving information and intentions. The elements of communication have an impact on the subjects and the processes taking place. Obstetric care has its specifics and is sensitive to the content of information, the participants in the process of communication and the way of perception. The aim of this study is to differentiate the communication relationships of healthcare professionals in obstetric structures with patients, improving the safety of obstetric care. The subject of the study are medical specialists and patients from three obstetric structures in Sofia. Varna. Sociological methods of survey and observation are used. The data is processed using both urgencies and urgencies. Results and discussion: a survey was conducted among 206 respondents-healthcare professionals and patients. 38.09% of healthcare professionals rated communication as very good and 36.07% of patients as good. The problems in communication for the medics are: large administrative activity; workload; incompleteness of the information received; lack of time for communication. In patients, problems refer to: misunderstanding of the information received, insufficient time to communicate with doctors, lack of empathy, poor attitude. According to pregnant women, the leading factors for good obstetric care are personal attention, good communication with specialists, detailed information and support. In conclusion, healthcare professionals must be able to conduct proper and patient-centered communication to provide them with the care they want and need. Using the right communication strategies can help patients feel heard, encourage them to provide accurate and relevant information so they can assist during the healing process