Clinical debriefing during the COVID-19 pandemic: hurdles and opportunities for healthcare teams (original) (raw)
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Communication in health work during the COVID-19 pandemic
Investigación y Educación en Enfermería, 2020
Objective. Report on communication and qualified listening in nursing work in the face of the COVID-19 pandemic. Methods. This descriptive, theoretical and reflexive report was developed by nurses between March 20th and May 25th 2020 at Emergency Care Services in the city of Fortaleza, Ceará, Brazil. Health communication served as the theoretical background for this research. Results. Two main thematic categories were highlighted: (i) Resignifications of communication in the work relationships of the health team and (ii) Guided listening to users by nurses at the Emergency Care Services during the pandemic. Conclusion. The experience revealed an excerpt of what is found under the conditions of the current situation resulting from COVID-19. Communication turned into an essential tool to maintain professional relationships and culminate in collaboration and cooperation of theteam in order to provide a close relationship with the user and promote the quality of health care processes.
European Journal of Plastic Surgery, 2020
The COVID-19 pandemic has challenged existing healthcare systems and has made prevention of healthcare personnel exposure a high priority. Essential healthcare services, including multidisciplinary team (MDT) meetings that make medical decisions, are expected to continue uninterrupted in this time of social distancing. There are a multitude of virtual platforms available to enable remote MDT meetings, and the pandemic has accelerated their arrival into daily healthcare practice. While we deal with a pandemic crisis, we have comprehensively reviewed and reported on the popular platforms and services available for this purpose. While each platform has its own unique features and drawbacks, it is essential to liaise with information technology departments and data governance teams to understand the optimal platforms for use within each healthcare setting. Level of evidence: Not ratable
Texto & Contexto Enfermagem, 2022
Objective: to know the perspectives, practices and challenges in decision-making for admitting patients into the Intensive Care Unit during the Covid-19 pandemic. Methods: a qualitative study developed in two public hospitals in Maranhão, Brazil, from November/2020 to January/2021. Data collection took place through individual interviews guided by a script. A total of 22 professionals participated in the study: nurses and doctors who worked in the Intensive Care Unit and Bed Regulation in the first wave of the pandemic. Content Analysis was used in the thematic mode, with support from the Qualitative Data Analysis software program for data categorization. The theory of Responsibility for Reasonableness guided the study. Results: two main categories emerged: "The context of the decision-making process-the paradox of celestial discharges" and "Decision-making for admission". In the scenario of high demand, a lack of beds, and the uncertainties of the "new disease", deciding who would occupy the bed was arduous and conflicting. Clinical and non-clinical criteria such as severity, chance of survival, distance to be covered and transport conditions were considered. It was found that the ambivalence of feelings attributed to death and care at that moment of the pandemic marked the social and technical environment of intensive care. Conclusions: the complexity of the decision-making process for admission to an intensive care unit was evidenced, demonstrating the importance of analyzing the allocation of critical resources in pandemic scenarios. Knowing the perspectives of professionals and their reflections on the experiences in that period can help in planning the allocation of health resources in future emergency scenarios.
Frontiers in Public Health, 2023
Introduction: The COVID-19 pandemic highlighted the lack of a government contingency plan for an effective response to an unexpected health crisis. This study uses a phenomenological approach to explore the experience of healthcare professionals during the first three waves of the COVID-19 pandemic in a public health hospital in the Valencia region, Spain. It assesses the impact on their health, coping strategies, institutional support, organizational changes, quality of care, and lessons learned. Methods: We carried out a qualitative study with semi-structured interviews with doctors and nurses from the Preventive Medicine, Emergency, and Internal Medicine Services and the Intensive Care Unit, using the Colaizzi's 7-step data analysis method. Results: During the first wave, lack of information and leadership led to feelings of uncertainty, fear of infection, and transmission to family members. Continuous organizational changes and lack of material and human resources brought limited results. The lack of space to accommodate patients, along with insufficient training in treating critical patients, and the frequent moving around of healthcare workers, reduced the quality of care. Despite the high levels of emotional stress reported, no sick leave was taken; the high levels of commitment and professional vocation helped in adapting to the intense work rhythms. Healthcare professionals in the medical services and support units reported higher levels of stress, and a greater sense of neglect by their institution than their colleagues in managerial roles. Family, social support, and camaraderie at work were effective coping strategies. Health professionals showed a strong collective spirit and sense of solidarity. This helped them cope with the additional stress and workload that accompanied the pandemic. Conclusion: In the wake of this experience, they highlight the need for a contingency plan adapted to each organizational context. Such a plan should include psychological counseling and continuous training in critical patient care. Above all, it needs to take advantage of the hard-won knowledge born of the COVID-19 pandemic.
Critical care work during COVID-19: a qualitative study of staff experiences in the UK
BMJ Open, 2021
Objective: To understand National Health Service (NHS) staff experiences of working in critical care during the first wave of the COVID-19 pandemic in the UK. Design: Qualitative study using semistructured telephone interviews and rapid analysis, interpreted using Baehr's sociological lens of 'communities of fate'. Participants: Forty NHS staff working in critical care, including 21 nurses, 10 doctors and advanced critical care practitioners, 4 allied health professionals, 3 operating department practitioners and 2 ward clerks. Participants were interviewed between August and October 2020; we purposefully sought the experiences of trained and experienced critical care staff and those who were redeployed. Setting: Four hospitals in the UK. Results: COVID-19 presented staff with a situation of extreme stress, duress and social emergency, leading to a shared set of experiences which we have characterised as a community of fate. This involved not only fear and dread of working in critical care, but also a collective sense of duty and vocation. Caring for patients and families involved changes to usual ways of working, revolving around: reorganisation of space and personnel, personal protective equipment, lack of evidence for treating COVID-19, inability for families to be physically present, and the trauma of witnessing extreme patient acuity and death on a large scale. The stress and isolation of working in critical care during COVID-19 was mitigated by strong teamwork, camaraderie, pride and fulfilment. Conclusion: COVID-19 has changed working practices in critical care and profoundly affected staff physically, mentally and emotionally. Attention needs to be paid to the social and organisational conditions in which individuals work, addressing both practical resourcing and the interpersonal dynamics of critical care provision. Keywords: COVID-19; intensive & critical care; organisation of health services; qualitative research.
Irish Journal of Medical Science, 2021
COVID-19 resulted in significant changes across medical wards and ICU in St James’s Hospital Dublin. This included the implementation of ward-based medical teams (WBMT). The purpose of this study was to identify how these structural changes affected inter-professional collaboration, supervision and patient safety. Questionnaires were distributed to doctors working on medical wards and ICU at the height of the first wave of COVID-19. The sense of collaboration, patient safety and supervision were assessed. Fifty-three doctors took part in the study. Thirty-three (62%) felt that collaboration was better than normal. Forty-six (87%) of participants described supervision as “good” or “excellent”. Thirty-one out of 40 participants (77%) felt that patient safety was better than normal. Implementation of WBMT may result in improved sense of collaboration, supervision and patient safety during COVID-19; however, the increased sense of solidarity and comradery felt during the initial surge m...
Being a health care professional in the ICU serving patients with covid-19: A qualitative study
Heart & Lung, 2023
Background: The COVID-19 pandemic has placed a great deal of strain on healthcare providers across the world. There has been no research into the experiences of health care providers in Turkey caring for hospitalized patients with COVID-19 in the ICU. Objectives: To explain the experiences of health care providers who provide services to patients with Covid-19 in an intensive care unit. Methods: This study used a phenomenological approach to recruit 15 participants (10 nurses and 5 physicians). The data was gathered through semi-structured in-depth interviews conducted face-to-face. Results: The four primary themes that came up in the results were COVID-19: the unidentified enemy, frontline struggle, psychological struggle, and invasion of social life. Conclusion: During the epidemic, health care providers encountered several psychological, physical, social, and professional difficulties. All health care personnel must receive information and skills training on what to do in crisis and risk circumstances such as infectious disease, decision-making, anxiety management, and problem-solving during pandemics.
Collaborative practices from health care teams to face the covid-19 pandemic
Revista Brasileira de Enfermagem, 2020
Objective: To report the experience of collaborative practices facing the COVID-19 pandemic. Methods: This is a report about the experience of collaborative practices conducted by health care teams in emergency service in the Emergency Care Units facing of COVID-19 pandemic in the city of Fortaleza, State of Ceará, in the first semester of 2020. Results: Collaborative actions, cooperation and effective communication among nursing and medical team contribute to the management of mild and complex cases of COVID-19, as well as qualify them in suitable and necessary care and confrontation measures. Final considerations: The report shows the need for collaborative practices to minimize negative effects on the population in the face of the new coronavirus pandemic.
Purpose: To understand critical care physician experiences across multiple countries with the COVID-19 pandemic to inform future pandemic preparedness planning. Methods: In this qualitative descriptive study, 16 critical care physicians (from eight countries) identified in HPJ • Fall 2022 • 2(2) | Page 20 convenience and purposive sampling took part in individual semi-structured interviews from April 7, 2020 to August 27, 2020 that captured the first wave of the pandemic. Open coding was conducted by two researchers who facilitated inductive thematic analysis. Results: Key themes identified following thematic analysis included the following: (a) sourcing and implementation of trusted information; (b) health systems-level preparedness with accessible supports; (c) institutional adaptations, including changes to patient care; (d) professional safety and occupational well-being; (e) triage and restricted visitation policies; and (f) managing personal familial responsibilities. Conclusion: The COVID-19 pandemic transformed the ways in which critical care physicians cared for their patients and personally coped with challenges. Perspectives of critical care physicians are important for ongoing pandemic planning and should be included in future pandemic policy development.
2022
Purpose To understand critical care physician experiences across multiple countries with the COVID-19 pandemic to inform future pandemic preparedness planning. Methods In this qualitative study, 16 critical care physicians (from seven countries) identified in convenience, purposive sampling took part in individual semi-structured interviews from April 7, 2020 to August 27, 2020 that captured the first wave of the pandemic. Open coding was conducted by two researchers who facilitated inductive thematic analysis. Results Key themes identified following thematic analysis included: 1) sourcing and implementation of trusted information; 2) health systems-level preparedness with accessible supports; 3) institutional adaptations including changes to patient care; 4) professional safety and occupational wellbeing; 5) triage and restricted visitation policies; and 6) managing personal familial responsibilities. Conclusion Perspectives of critical care physicians are important for ongoing pan...