Category: Pandemic

Introduction

One of the defining features of the 2020s will undoubtedly be the long-term societal effects of the Covid-19 pandemic. The first known case of the severe respiratory syndrome was reported in Wuhan, China, in November 2019. It continued to spread to almost all countries around the world, leading to lockdowns, political protests, mass unemployment, and economic instability (The British Academy, 2021). It has resulted in almost half a billion cases worldwide and over six million deaths (Worldometer, 2022). More than two years later, the world is gradually reverting to its normal state as employees return to work and governments ease epidemiological restrictions. However, one crucial area suffering from the burden of the pandemic is being forgotten: the healthcare industry, which is still experiencing a heightened risk of infection both for care providers and patients. Covid-19 has had a significant impact on the running of healthcare facilities, but numerous academic studies offer solutions that could ameliorate the situation.

Impact of Covid-19 on Infusion Centers

Experience

My professional experience of Covid-19 is based on my work performing blood transfusions, antibiotics, and injections in an infusion center. Each employee is required to wear a respirator, maintain hand hygiene, and uphold a physical distance of at least six feet from other employees or patients whenever possible. Furthermore, the pandemic has radically shifted the way our organization sees patients. Patients that enter the building are obligated to undergo a screening process, which involves answering Covid-related questions such as whether they have experienced signs of fever, lost their sense of smell, or have recently been in close contact with Covid-19 positive persons. No visitors are allowed to accompany them unless they need assistance going to the bathroom or eating. After Covid-19, infusion centers now regulate and record patients’ activities, behaviors, and actions more rigorously.

Data

Most of the data concerning the impact of Covid-19 on infusion centers comes from a survey of 89 OIOBD members, including North America, Europe, Israel, Hong Kong, New Zealand, Brazil, China, and India. Before the pandemic, the centers were staffed by general patients providing over fifty infusions per week to patients from different specialties (Dotan et al., 2020). Clinical disease activity, laboratory tests, and therapeutic drug monitoring were routinely performed, but patients were discharged immediately after infusion without further monitoring. During Covid-19, 81% of infusion centers increased cleaning between infusions, 67% reduced the number of patients allowed in the center to maintain social distancing, and 28% consequently expanded hours of operation. The vast majority of other infusion centers around the world enforced the same rules as my place of work.

Strategies to Deal with Covid-19

Disinfecting High-touch Surfaces

The article by Choi et al. (2021) focuses on strategies to mitigate the transmission of Covid-19 through surfaces in healthcare settings. Research has shown that one of the ways coronavirus is transmitted is through contact with touched objects, and it can survive on inanimate surfaces for up to nine days. The classical disinfection strategy involves the use of chemicals, but its efficiency is undermined by the fact that cleaning is done sporadically in healthcare facilities. One potential way to resolve this issue is by implementing automated disinfection approaches such as hydrogen peroxide vapor and ultraviolet light (Choi et al., 2021). Another method involves using copper, a material with antimicrobial properties that had been confirmed to rapidly inactivate coronavirus. A copper-based alloy can be used to coat high-touch surfaces, including doorknobs, credit card holders, pens, computers, or pumps (Choi et al., 2021). Apart from traditional chemical treatment, techniques such as automated disinfection and copper-coating could be enforced by healthcare facilities to improve disinfection capability.

Waste Management

The article by Das et al. (2021) describes numerous strategies to manage healthcare waste during the pandemic. The increased number of hospitalizations due to Covid-19 and the use of personal protective equipment has led to the production of more healthcare solid waste. Its improper disposal may cause further infection, particularly for exposed waste pickers, who can then unintentionally spread the virus within their community (Das et al., 2021). The Center for Disease Control and Prevention does not differentiate between regular healthcare waste and waste generated by Covid-19 patients; thus, both are treated the same. However, in Hubei, China, hospital employees segregate and sterilize infected waste with chlorine before packing it in double bags and storing it in temporary facilities before incineration (Das et al., 2021). The Philippines passed an amendment that requires special registered transporters and facilities to acquire permits to handle the infected waste. In Jordan, Covid-19-contaminated waste is sanitized and disposed of daily. The authors state that the most optimal strategy is to transfer hospital waste to temporary treatment centers before waste disposal centers. In other countries, infected waste produced by Covid-19 patients is collected and stored separately to lower the possibility of further infection.

Impact of Strategies on Infusion Centers

Infusion centers could implement the strategies proposed in these two articles to lower the risks of infection. While masks, physical distancing, and pre-appointment screenings are the foundation of combatting Covid-19, the severity of the stressor warrants further action. Firstly, high-touch surfaces in infusion centers should be coated with copper-based alloys to inactivate coronavirus and other pathogens. These include doorknobs, computers, chair rails, and drip stands. While this measure will lower the risks of infection, it has a potentially negative impact because copper is more expensive than the steel traditionally used in healthcare facilities. Furthermore, copper oxidizes and tarnishes to dark brown after a few years, although it still retains its antibacterial properties. Installing copper-based coating on high-touch surfaces potentially has some financial and aesthetic drawbacks, but its ability to inactivate pathogens outweighs both.

Secondly, proper waste management procedures should be implemented. Infusion centers generally utilize offsite waste treatments due to cost efficiency. However, the center should be more active in addressing the problem of excess and inadequately sanitized waste. A possible solution is having infusion center employees disinfect the waste with chemicals approved by the CDC against Covid-19. The waste could be double-bagged and stored in a temporary facility, separate from workers and patients, for a maximum of 24 hours before being transported to offsite incineration treatment centers. Sanitation and daily disposal are more expensive due to material and staffing costs but improve workplace safety and prevent further infection.

Conclusion

In conclusion, Covid-19 is a significant problem in contemporary healthcare, but various organizations are implementing effective strategies to mitigate the risk of infection. The infusion center I work at has mostly limited its epidemiological measures to masks, patient screenings, and physical distancing. Academic articles propose further action, such as installing copper-based coating on high-touch surfaces based on its antibacterial properties. Furthermore, it is recommended to sterilize and dispose of health waste daily. These strategies are potentially more high-cost than traditional healthcare methods, such as stainless steel and offsite waste treatment, but have been confirmed to lower infection rates.

References

Choi, H., Chatterjee, P., Lichtfouse, E., Martel, J. A., Hwang, M., Jinadatha, C., & Sharma, V. K. (2021). Classical and alternative disinfection strategies to control the COVID-19 virus in healthcare facilities: a review. Environmental Chemistry Letters, 19(3), 1945-1951.

Das, A. K., Islam, M. N., Billah, M. M., & Sarker, A. (2021). COVID-19 pandemic and healthcare solid waste management strategy–A mini-review. Science of the Total Environment, 778, 1-6.

Dotan, I., Panaccione, R., Kaplan, G. G., O’Morain, C., Lindsay, J. O., & Abreu, M. T. (2020). Best practice guidance for adult infusion centres during the COVID-19 pandemic: Report from the COVID-19 International Organization for the Study of IBD [IOIBD] task force. Journal of Crohn’s and Colitis, 14(Supplement_3), S785-S790.

The British Academy. (2021). The COVID Decade: understanding the long-term societal impacts of COVID-19. Web.

Worldometer. (2022). Covid-19 coronavirus pandemic. Web.

The coronavirus pandemic affected every single area of people’s lives and humanity. It damaged business, education, and entertainment, including sports, music, and movie industries. Indeed, all of that has significantly impacted the economy of the world and countries separately. COVID-19 affected people’s workplaces, and schools, and colleges where their children study. After two years of the pandemic, society got used to it and made adjustments to live almost like before, but still has no clue when it will entirely end.

One of the main problems connected to the COVID-19 pandemic is inequality. Studies show that fifty-nine percent of New York students five years and older “have received at least one dose of coronavirus vaccine” (McCarthy). However, there is a massive gap between the districts of the city. As McCarthy claims in her work about New York school vaccination, in district number two, one of the wealthiest parts of the city, “eighty percent have received at least one dose.” At the same time, only thirty-eight percent of children from the twenty-third district’s schools can confirm vaccination (McCarthy). That creates a noticeable gap between different layers of society in their possibility to be healthy. Even so, almost seventy percent of Americans are already vaccinated as of June twenty-second, and nearly eighty percent got at least one dose (Carlsen et al.). The disparity in vaccination between different layers of the society reflects the general inequalities.

Pandemics demonstrate the weaknesses of the systems, especially in economics. Many economic experts stated that most of the last years’ tendencies were temporary, but that is not proven yet, instead, the movement in the opposite direction can be seen. The COVID-19 crisis is multiplied by war in Ukraine, creating genuine uncertainty in the world’s future at all levels. Over these years of the pandemic, the house owners in America have gained a lot in housing wealth. Badger and Quoctrung in their work about the pandemic housing market say that it is perfect for those with their own house, but “it’s also inseparable from the housing affordability crisis for those who don’t”. The rents rise, inflation only grows, and the availability to own real estate at least someday is smaller than ever. That creates another distance between different categories of the population.

Coronavirus as a disease has affected people of different ages differently. The ONS claims that “three-quarters of all deaths were among those aged seventy-five and over in the UK” (Cheshire-Allen and Calder). That situation not only shows the problem of ageism but also demonstrates careless systems and procedures and continuous examples of it. It shows how “frail and shaky can such a conception be as the basis for support for family carers” (Cheshire-Allen and Calder). America needs to understand the challenges and risks of caring for older people to build itself after the pandemic.

Countries’ governments spent colossal amounts of money to help businesses and companies survive lockdown. US government spent at least five trillion dollars on it (Smialek). That is another global problem of inequality that COVID-19 caused. As Smialek states in her work about the American economy during the pandemic, “businesses discovered that they were able to raise prices without losing customers. Workers saw their bills swelling, airfares climbing, and they began to ask their employers for more money” (Smialek). However, the Russian invasion of Ukraine could change the world’s interconnections even more, and it has already made gigantic moves in international in former times regular connections. Everything is unclear, and it could take a lot of time until the world understands what the future economy will look like.

Another coronavirus issue directly associated with inequality is the international migration of medical workers. Throughout the pandemic, thousands of nurses and doctors from Africa migrated to developed countries like the United States, Germany, Finland, and the United Kingdom. The problem is the lack of medical workers, due to frequent cases of infections, especially at the beginning of COVID-19. African nurses understand that many countries can value their work a lot more in terms of money than their homeland. At the same time, the amount of qualified medical workers in Africa is many times less than, for example, in Canada. According to Sinead Carbery, president of O’Grady Peyton International, “about a thousand nurses are arriving in the United States each month from African nations, the Philippines, and the Caribbean” (Nolen). That means that North American and European countries raise the importance of their citizens’ health much higher than the residents of poor countries.

The COVID-19 pandemic crisis is still on, and even though some industries have positive developments, nations will deal with the consequences of this virus for many years more. The war in Ukraine has made the process of returning to the usual complicated and uncertain. The economic and political conditions changed a lot and will change even more if the war does not stop soon. Although COVID-19 happened, the war was not necessary, and it must be stopped as quickly as possible if humanity wants to escape the crisis.

Works Cited

Badger, Emily and Quoctrung Bui. “The Extraordinary Wealth Created by the Pandemic Housing Market”. The New York Times, Web.

Carlsen, Audrey, et al. “How are the COVID-19 Vaccine and Booster Campaigns Going in Your State?”. NPR, Web.

Cheshire-Allen, Maria, and Calder Gideon. “The Risks of Care: Justice, Family Carers, and the Pandemic.”TransformingSociety, Web.

McCarthy, Lauren. “New York City’s School Vaccination Numbers Show Deep Disparities Between Rich and Poor”. The New York Times, Web.

Nolen, Stephanie. “Rich Countries Lure Health Workers from Low-Income Nations to Fight Shortages”. The New York Times, Web.

Smialek, Jeanna. “Is America’s Economy Entering a New Normal?”. The New York Times, Web.

Introduction

The pandemic has become a severe blow to the whole world by threatening the population’s health and forcing it to adapt all activities to new conditions. According to Platto et al. (2021), although the first outbreak occurred in Wuhan and the city is considered the place of origin of the disease, the conditions for its occurrence were also present in other places. Human activity changes nature, resulting in the loss of ecosystem biodiversity. Species multifariousness should reduce the transmission of pathogens through the dilution effect (Platto et al., 2021). As a result of diversity decline, bats, which are critical carriers of the coronavirus, have been in more significant contact with pets and humans, transmitting the SARS-CoV-2 virus to them (Platto et al., 2021). Despite the rapid disease spread and its dangers, specific measures and interventions can reduce the risks.

Epidemiology

Epidemiology helps to determine patterns in the spread of the disease to find solutions to control and overcome it. To achieve these goals, researchers use epidemiological calculations and measurements. Incidence and prevalence rates provide critical information for understanding the disease, and their calculations require data on the total number of populations and the number of new or existing cases (Vaughan et al., 2018). Continuously updated World Health Organization (2022) data on the American population show that cases for the day are nearly 133,265, and total cases are 88,544,725. Considering that US Census Bureau (2022) estimated the US population at 32,403,650, calculations are as follows:

• Incidence = (133,265 / 332,403,650) × 1,000 = 0.4 cases/1,000 Population
• Prevalence = (88,544,725 / 332,403,650) × 1,000 = 266.4 cases/1,000 Population

Vulnerable populations are less protected against the disease and most at risk of suffering the effects of COVID-19. Following Frérot et al. (2018) definition, which includes basic principles of epidemiology, includes elements of study, determinants, distribution, specified populations, health-related states or events, and applications. One can use the principle of determinants to understand and address risks to vulnerable people to determine the critical risk causes for these groups. In particular, the vulnerable population will not receive the necessary treatment without equal access to health services and is more likely to develop complications.

The situation for these groups is complicated by related problems which require a solution. For example, the regulatory issue is the management of patients with chronic diseases and disabilities, which are a vulnerable group (Saleh et al., 2021). Due to the need to regularly visit a doctor, they are more at risk of COVID-19. A significant ethical issue is the allocation of limited health resources, which also increases the vulnerability of a population part, as they are less likely to receive care (Saleh et al., 2021). With many problems and complications accompanying the pandemic, interventions are of critical importance.

Nursing Interventions

Nurses can make a significant contribution to overcoming the pandemic. To stop the epidemic, nurses have roles in prevention, treatment, surveillance and accountability, and protecting vulnerable populations (Chen et al., 2020). Using descriptive and analytical methods of epidemiology, nurses can develop interventions. For example, intervention to educate the people on infection prevention measures can cover different groups. Training can be carried out through online lectures in schools, distribution of leaflets, and other methods, making it possible to establish contact with the population. Another intervention is monitoring vital signs and O2 saturation for patients visiting hospitals. It allows nurses to identify signs of the disease and start treatment in time. Such measures can contribute to reducing the impact of the coronavirus.

Conclusion

Thus, the COVID-19 pandemic arose due to the loss of biodiversity, which reduced the dilution effect and led to closer interaction of the virus carriers with humans. In the US, the disease incidence per day is 0.4 cases per 1,000 people, and the prevalence is 266.4 per 1,000 people. The vulnerable population is more at risk, and using the epidemiological principle of determinants, one can understand the key risk factors to reduce it. Complex regulatory and ethical problems accompany the situation putting the vulnerable population in more danger. However, nurses can significantly reduce the spread of the disease through education and monitoring interventions.

References

Chen, S. C., Lai, Y. H., & Tsay, S. L. (2020). Nursing perspectives on the impacts of COVID-19.The Journal of Nursing Research, 28(3), 1-5.

Frérot, M., Lefebvre, A., Aho, S., Callier, P., Astruc, K., & Aho Glélé, L. S. (2018). What is epidemiology? Changing definitions of epidemiology 1978-2017.PloS One, 13(12), 1-27.

Platto, S., Wang, Y., Zhou, J., & Carafoli, E. (2021). History of the COVID-19 pandemic: Origin, explosion, worldwide spreading.Biochemical and Biophysical Research Communications, 538, 14-23.

Saleh, B. M., Aly, E. M., Hafiz, M., Abdel Gawad, R. M., El Kheir-Mataria, W. A., & Salama, M. (2021). Ethical dimensions of public health actions and policies with special focus on COVID-19.Frontiers in Public Health, 9, 1-12.

U.S. Census Bureau. (2022). U.S. population estimated at 332,403,650 on Jan. 1, 2022. U.S. Department of Commerce.

Vaughan, J. P., Victora, C., & Chowdhury, A. M. R. (2018). Epidemiological principles. In Practical epidemiology: Using epidemiology to support primary health care (pp. 1-14). Oxford University Press.

World Health Organization. (2022). Coronavirus (COVID-19) cases and deaths.

Introduction

COVID-19 is an ongoing pandemic caused by SAR-COV-2 that was first identified in China. The epidemic’s signs and symptoms vary from none to life-threatening, and the most common ones include high fevers above 39 degrees Celsius, flu-like symptoms, cough, loss of sense of smell, and breathing difficulties. The virus is spread through respiratory droplets, coughs, sneezes, or talks (Heriyati, 2020). Social distancing, covering the mouth with the elbow when sneezing, and hand washing are some of the preventive measures.

Electronic Health Records Data about COVID-19

Most hospitals use Electronic Health Records (EHR) to store patients’ data. On the verge of the pandemic, EHR has been used to retrieve COVID 19 data to monitor the current trends of the pandemic and the treatment. Surveillance data that I have come across include the number of people tested, the number of COVID-19 confirmed cases, and the number of deaths caused by the disease. Among the few EHR I have come across, they record the treatment measures given to the patients. The data came from the community, hospitals, isolation centers, and primary care settings.

Twitter Information and its Impact on Future Collaborative Trends

The tweet given below is from the New England Journal of Medicine (NEJM) and it is a resource for the global health community. It reminds people to stay updated with the current research and information on COVID-19. The picture is also a reminder to the community members to practice safety measures. This tweet is a reminder to the tweeter users to practice social distance, wash hands, and avoid crowds. The tweet urges the public to get COVID-19 information from their articles and resources. Such information nurtures an informed society that can collaborate with public health in the fight against the pandemic in the future.

Reference

Heriyati, P. (2020). Analyzing factors affect human behavior during the Covid-19 pandemic. Journal of Advanced Research in Dynamical and Control Systems, 12(SP8), 73-80. Web.

Introduction

The COVID-19 pandemic is currently the largest healthcare issue that the world has faced in recent history. Although the entire world feels its impact, some countries are more affected than others. With the largest number of confirmed cases in the world, the United States poses a special interest in terms of how the country’s healthcare system has handled the pandemic and what could have been done differently to achieve a better outcome. While the novel nature of the COVID-19 was a challenge in its own right during the beginning of the outbreak in the United States, it was also combined with and magnified by other factors complicating the design and delivery of healthcare services to the affected population. Limited resources in rural hospitals and the lack of cultural awareness regarding the ethnically complex populations affected were among these factors. A case study analysis reveals that, while there was not much breathing room to prepare better for the outbreak of COVID-19 specifically, hospital personnel could still engage in cultural immersion training well before the outbreak to be better equipped to provide culturally aware care to the population.

Background

The case study is focused on two hospitals – namely, the Valley River Hospital and Northwest Communities Hospital – serving a rural country in Oregon and their approach to handling the COVID-19 pandemic during its early stage on American soil. Both are critical access hospitals of 15 and 20 beds, respectively and belong to the Oregon Health Services, covering three counties of the state. The two hospitals have been preparing for COVID-19 since March when the World Health Organization declared it a pandemic. However, rural areas in the United States tend to have lower resources in terms of access to healthcare than urban areas (Cuadros et al., 2021). Due to their position at the end of the supply line, the hospitals in question faced challenges in procuring the necessary equipment and supplies and additional costs of transporting tests to urban testing facilities. Moreover, the hospital staffing proved not sufficiently prepared in terms of cultural awareness, especially since the majority of confirmed cases were Hispanics, including indigenous Guatemalans. Thus, at the beginning of the outbreak, both hospitals faced challenges due to insufficient material supply and a lack of cultural awareness.

Alternatives

The organization of testing in the hospitals and the drive-through testing facilities on the outskirts of the three-county area was most likely the optimal way to conduct testing. The alternatives, such as sending medical staff to test those potentially affected at home, would hardly be feasible considering the limited resources and lower population density in rural healthcare as well as a higher percentage of the elderly, who are more susceptible to COVID-19 (Henning-Smith, 2020). Given the difficulties that the Valley River Hospital and Northwest Communities Hospital encountered in procuring nasopharyngeal swabs or personal protective equipment, both hospitals could benefit from exploring alternative supply channels to meet the need. Since the case study identifies the lack of cross-cultural competencies, most notably when dealing with the Hispanic population of Guatemalan origin, as the main challenge experienced during the early stages of the COVID-19 outbreak, both hospitals could also use alternative approaches to alleviate this shortcoming. These approaches will be covered in more detail in the following section.

Proposed Solutions

Regarding the difficulties of procuring the necessary supplies and equipment to meet the population’s healthcare needs under the conditions of the COVID-19 outbreak, both hospitals could benefit from engaging alternative supply options. As mentioned above, the key reason why rural hospitals tend to have worse access to resources is the fact that they tend to be at the end of the supply chain, which is also explicitly stressed in the case study (Cuadros et al., 2021). Given that, the most logical solutions to the issue are either engaging new and previously unused sources of supply or straightening the supply lines and lessening the number of intermediaries in the procurement of the required supplies and equipment. If possible, the perfect option would be to establish a working relationship with the immediate producers of the required supplies and equipment. Since the case study does not offer additional information regarding the specifics of the supply chains of Valley River Hospital and Northwest Communities Hospital, formulating more specific recommendations does not seem feasible with the information available.

In terms of the personnel’s cultural awareness, the hospitals could and arguably should have done more to be better prepared to accommodate Hispanic and, specifically, Guatemalan patients as well as contain the spread of COVID-19. While the outbreak of COVID-19 was a sudden crisis, the population composition in the counties served by the Oregon Health Services was well-known long before the pandemic. The solution to the emerging problem of insufficient cultural awareness would be cultural immersion training, which Brock et al. (2019) recommend as an efficient approach to fostering cross-cultural competencies. Moreover, the generally lower standard of living, cramped living conditions, and cultural traditions make Hispanics more susceptible to the threat presented by COVID-19 (Gil et al., 2020). With this in mind, prompt and sustained delivery of information on countering and limiting the spread of COVID-19 is also a necessary solution to the problem of its increased incidence among Hispanics (Gil et al., 2020). This information, as well as its delivery, should be tailored according to the perceptions of the population, which, once again, stresses the necessity of improving the cross-cultural competencies of medical staff.

Recommendations

The recommended course of action for this case study is to continue providing COVID-19 testing in hospitals and drive-by sites while paying more attention to the medical personnel’s cultural awareness and information dissemination. Given the constraints of the pandemic, a full-fledged educational campaign intended to raise cultural awareness is hardly feasible. Based on existing experience, both hospitals need to identify a list of cross-cultural issues that are most likely to arise when aiding Hispanic patients, devise specific ways to address these issues, and disseminate the information among the personnel. The hospitals should also arrange staffing patterns to increase the likelihood of Spanish-speaking personnel being present in situations involving language barriers (Gil et al., 2020). In terms of information dissemination to counter the spread of disease among the population, it should mainly aim to prevent large social gatherings, which can be an exceptionally potent way to spread infection in rural areas (Mahale et al., 2020). For example, the information campaign may stress the vulnerability of older community members and p[resent it through the Latino concept of familismo, which emphasizes familial ties and the importance of family members’ safety.

Conclusion

To summarize, the Valley River Hospital and Northwest Communities Hospital, as described in the case study, organized efficient COVID-19 testing during the outbreak in rural Oregon, which seems to be the best option as compared to the alternatives. At the same time, both hospitals could have benefited from training in cross-cultural competencies with a focus of Hispanic populations before the pandemic or on-the-job training during the outbreak. An information dissemination campaign would also be crucial to prevent or limit the spread of COVID-19 in rural areas, particularly among Hispanics. Finally, the diversification and straightening of the supply chain for the necessary items and protective equipment is also advisable.

References

Brock, M. J., Fowler, L. B., Freeman, J. G., Richardson, D. C., & Barnes, L. G. (2019). Cultural immersion in the education of healthcare professionals: A systematic review. Journal of Educational Evaluation for Health Professionals, 16(4).

Cuadros, D. F., Branscum, A. J., Mukandavire, Z., Miller, F. D., MacKinnon, M. (2021). Dynamics of the COVID-19 epidemic in urban and rural areas in the United States. Annals of Epidemiology, 59, 16-20.

Henning-Smith, C. (2020). The unique impact of COVID-19 on older adults in rural areas. Journal of Aging & Social Policy, 32(4-5), 396-402.

Gil, R. M., Marcelin, J. R., Zuniga-Blanco, B., Marquez, C., Mathew T., Piggott, D. A. (2020). COVID-19 pandemic: Disparate health impact on the Hispanic/Latinx population in the United States. The Journal of Infectious Diseases 222(10), 1592–1595.

Mahale, P, Rothfuss, C., Bly, S., Kelley, M., Bennett, S., Huston, S. L., & Robinson, S. (2020). Multiple COVID-19 outbreaks linked to a wedding reception in rural Maine – August 7–September 14, 2020. Morbidity and Mortality Weekly Report, 69(45): 1686–1690.

Sequeira et al. (2021) acknowledged that the year 2020 saw rapid change in the healthcare system. For example, in mid-May 2020, nearly five million people contracted Covid-19 worldwide, already causing tens of thousands of deaths (Dong et al., 2020). With the spread of Covid-19, nations dealt with massive casualties, as hospitals continued to witness an increased number of infected persons across the world. For instance, Esmaeilzadeh & Mirzaei (2021) believed that the Covid-19 pandemic emerged as the most significant health challenge that clinicians must tackle across the world. In August 2021, roughly 232 million people have Covid, with around 4.7 million deaths linked to the same (Esmaeilzadeh & Mirzaei, 2021). The proliferated number of Covid-19 infected persons globally exposed clinicians to new work conditions characterized by increased workload and increased dangers of being infected.

The problem of clinician burnout during the Covid-19 pandemic becomes one of the key issues of concern, as clinicians forcefully spend more hours attending to the large pool of infected persons flocking healthcare centers in search of treatment (Ferry et al., 2020). However, the emergence of electronic health records (EHRs) has, in a vast way, served a crucial role in helping clinicians to avoid burnout, given that the EHR offers clinicians several features to attain a health system’s clinical needs (Kisa, 2020). Therefore, this paper aims to evaluate how EHR features impact the burnout of clinicians working in hospitals that patients admitted with covid-19 infections.

The outbreak of Covid-19 exposed healthcare professionals to patients with severe as well as mild symptoms. Although, for this reason, respiratory droplets and close contact are the main portals of entry that Covid-19 spreads, medical personnel are increasingly vulnerable to Covid-19 infections given that they directly attend to the Covid-19 patients (Ferry et al., 2020). These avenues result in health-linked stress amongst clinicians. Furthermore, the health professionals are not resilient to the stresses due to augmented phone calls from Covid-19 patients, patient portal messages, and numerous walk-in-patients on top of ambulatory care visits (Buran & Altın, 2021). Also, the number of Covid-19 patients seeking healthcare services generated additional workload to individuals, thus resulting in adverse burnout levels.

However, the use of EHR during this Covid-19 pandemic improved clinicians’ ability to establish diverse strategies to boost their capacity to manage the pandemic. Carayon et al. (2020) emphasized that the EHR contains several features that allow medical professionals to use several standardized processes, including scripted triaging, real-time data analytics, telemedicine, electronic check-in, self-screening pages, and timely health information exchange. Furthermore, the ability of EHRs to enable individuals to have access to various safe techniques caring for the Covid-19 patients, including electronic check-in and self-screening pages, reduced clinician burnout (Esmaeilzadeh & Mirzaei, 2021). In addition, through electronic check-in and self-screening pages, medical personnel must overcome some key factors such as the manual registration and recording of visiting patients, thus lowering the workload to clinicians and other healthcare professionals (Faisal et al., 2021). On the contrary, the fact remains that in a healthcare facility, medical professionals are not trainable to leverage health information technologies in their daily activities. At the same time, the introduction of EHRs is cumbersome to untrained clinicians.

As it stands, EHR use is compounded by other significant issues such as clinical volumes as well as the clinicians’ flexibility to overcome unplanned challenges. Likewise, Jalili et al. (2020) argue that the role of EHR in lowering clinician burnout, innovative techniques to lessen burnout at this present era of Covid-19 is devisable. Even so, Ferry et al (2020) show that EHR innovations cannot help reduce the level of clinicians’ burnout if healthcare centers fail to take planned calculations towards understating the socio-ecological context, national policy, and organizational culture under which these technologies occur.

The study on the effects of EHRs on clinicians’ burnout in Iran shows that medical professionals who had proper training on how to use EHRs in managing Covid-19 patients reported accelerated EHR usability. Training is one of the critical factors to enhance their ability to deliver healthcare services to Covid-19 patients, thus, in the long-term, lessening their burnout levels (Madhavan et al., 2020). Moreover, individuals trained on the use of EHRs reported that they found EHRs as a valuable tool to support Covid-19 outbreak management (Kisa, 2020). They argued that their hospitals shared higher standards for data entry and exchanging health information with other hospitals.

Nevertheless, over 168 clinicians surveyed during the study reported having no training on the use of EHRs. As a result, they acknowledged facing enormous challenges when filling data of these electronic records (Kisa, 2020). These challenges added a burden to untrained users, thus leading to more burnout. This finding aligns with the previous studies showing that poor EHR usability results in clinicians’ dissatisfaction. From the above literature and survey, it is apparent that trained health professionals find EHRs easier to leverage to lessen their burden, a move that results in lower burnout levels (Madhavan et al., 2020). For instance, hospitals that properly train staff tend to have well-integrated EHR systems and retain close collaboration with other hospitals, thus promoting their clinicians’ ability to have timely access to the patient’s data during this stressful Covid-19 period. In the long run, the staff can balance EHRs as an effective tool to support Covid-19 outbreak management (Sequeira et al., 2021). Studies show that the more training clinicians obtain on EHRs, the less likely they experience burnout while monitoring the Covid-19 pandemic. On the other hand, untrained staff finds it strenuous to use EHRs in managing the Covid-19 pandemic, a move that resulted in higher levels of burnout.

The current pandemic may be considered to be one of the most significant disasters that occurred during the last several decades. Not only it caused considerable social, economic, and even political damage, but it also reshaped the ways of life worldwide. In some cases, the adverse effects of COVID-19 and restrictions related to the pandemic were deteriorated by a lack of relevant disaster management knowledge and experience. As a consequence, most industries faced unprecedented problems, and without appropriate response frameworks, in many cases, they failed to provide an adequate, timely solution. Nonetheless, the healthcare industry was under the most severe pressure of emerging problems, ethical dilemmas, and uncertainty. Consequently, healthcare underwent the most noticeable changes and implemented a wide variety of relevant measures, which were proven to be effective during the early stages of the pandemic. Digital technologies were broadly implemented as a response to quarantine-related limitations, and the healthcare system was no exception. Some sources state that even though emerging EHRs may face a number of limitations, the mechanism is highly promising and scalable (Brat et al., 2020). Therefore it developed rapidly and was implemented into practice in order to address various problems, including medical worker burnout.

There are several dimensions in which the implementation of EHRs may be beneficial for the healthcare system. As already mentioned, one of these dimensions is reducing medical worker burnout. It may not only achieve that goal during the current pandemic but also provide practical frameworks for the further continuing operation of medical facilities. The second dimension is the possibility to reduce direct contacts between clinicians, which corresponds with the current covid-related restrictions. Another possible benefit of EHRs is the opportunity to analyze big data effectively in accordance with the principles of patient-centered care. Recent research suggests that it may enhance individual risk profiling and consequently improve patient outcomes (Faisal et al., 2021). A number of potential benefits combined with the necessity to provide a response to the emerging post-covid paradigm make EHR a promising initiative. Nevertheless, there are several limitations and barriers that may prevent successful implementation. One of the most significant barriers is insufficient experience of using EHRs among medical workers. Lack of knowledge needed to operate EHRs may considerably reduce the potential benefits.

Based on the above findings, it is obvious that hospitals need to ensure that EHRs serve a viable role in reducing clinician burnout during this Covid-19 pandemic; they must improve the EHR user-friendliness and convenience (Buran & Altın, 2021). The reduction in burnout is obtainable by adequately training staff. In addition, it promotes users’ ability to leverage EHRs to access Covid-19 patients’ data (Buran & Altın, 2021). Having access to their Covid-19 patients’ data, health professionals do not undertake the process of collecting patients’ data from the beginning (Esmaeilzadeh & Mirzaei, 2021). Therefore, introducing comprehensive training frameworks should become the first priority for EHR implementation programs.

Conclusively, a significant correlation was determined between the use of EHRs and lesser burnout of medical employees who work with covid-19 cases. Several sources supported the presumption that EHR may considerably decrease covid-related workload and stress (Esmaeilzadeh & Mirzaei, 2021). However, further research may be needed in order to identify which aspects of EHRs have the most noticeable impact on worker burnout reduction. Moreover, it may be beneficial to widen the research by considering worker burnout unrelated to covid-19. Such scientific data may be utilized in order to improve EHRs implementation frameworks and provide appropriate training programs.

References

Brat, G. A., Weber, G. M., Gehlenborg, N., Avillach, P., Palmer, N. P., Chiovato, L., Cimino, J., Waitman, L. R., Omenn, G. S., Malovini, A., Moore, J. H., Beaulieu-Jones, B. K., Tibollo, V., Murphy, S. N., Yi, S. L., Keller, M. S., Bellazzi, R., Hanauer, D. A., Serret-Larmande, A., … Kohane, I. S. (2020). International electronic health RECORD-DERIVED COVID-19 clinical course profiles: THE 4CE consortium. Npj Digital Medicine, 3(1).

Buran, F., & Altın, Z. (2021). Burnout among physicians working in a pandemic hospital during the COVID-19 pandemic.Legal Medicine, 51, 101881.

Carayon, P., Cassel, C., & Dzau, V. J. (2020). Clinician burnout and professional well-being—Reply. JAMA, 323(13), 1318.

Dong, E., Du, H., & Gardner, L. (2020). An interactive web-based dashboard to track Covid-19 in real time. The Lancet, 20(5), 533-538.

Esmaeilzadeh, P., & Mirzaei, T. (2021). Using electronic health records to mitigate workplace burnout among clinicians during the COVID-19 pandemic: Field study in Iran (Preprint). Web.

Faisal, A., Lannou, E. L., Post, B., Haar, S., Brett, S., & Kadirvelu, B. (2021). Clustering of patient comorbidities within electronic medical records enables high-precision COVID-19 mortality prediction. Web.

Ferry, A. V., Wereski, R., Strachan, F. E., & Mills, N. L. (2020). Predictors of healthcare worker burnout during the COVID-19 pandemic. Web.

Jalili, M., Niroomand, M., Hadavand, F., Zeinali, K., & Fotouhi, A. (2020). Burnout among healthcare professionals during COVID-19 pandemic: A cross-sectional study. Web.

Kisa, S. (2020). Burnout among physicians and nurses during COVID-19 pandemic. European Journal of Environment and Public Health, 4(2), em0055. Web.

Madhavan, S., Bastarache, L., Brown, J. S., Butte, A. J., Dorr, D. A., Embi, P. J., Friedman, C. P., Johnson, K. B., Moore, J. H., Kohane, I. S., Payne, P. R., Tenenbaum, J. D., Weiner, M. G., Wilcox, A. B., & Ohno-Machado, L. (2020). Use of electronic health records to support a public health response to the COVID-19 pandemic in the United States: A perspective from 15 academic medical centers.Journal of the American Medical Informatics Association, 28(2), 393-401.

Sequeira, L., Almilaji, K., Strudwick, G., Jankowicz, D., & Tajirian, T. (2021). EHR “SWAT” teams: A physician engagement initiative to improve electronic health record (EHR) experiences and mitigate possible causes of EHR-related burnout. JAMIA Open, 4(2).

During the COVID-19 pandemic, medical facilities faced many problems: they affected protective equipment, medicines, and equipment. One serious problem was the shortage of medical personnel – nurses who worked on the front lines and provided care and monitored vital signs. Hospitals found that the lack of nurses led to rapid burnout and a complete inability to fulfill their obligations. One way or another, many nurses had to work overtime, with unpleasant consequences. At the heart of nurses’ burnout due to understaffing is the principle of competing needs, forcing them to disregard their psycho-emotional state to save patients with COVID-19.

The principle of competing needs is that organizations are forced to choose the path of least evil. It means that nurses’ emotional well-being is sacrificed to save more people. Studies indicate that more than half of nursing staff have burnout syndrome after working long hours in a hospital during a pandemic. For example, Salviato, Vasconcelos & de Oliveira (2021) report that emotional exhaustion averaged 56.52% among nursing technicians, with an overall depersonalization rate of over 65% in the study groups. These data suggest that the nursing shortage is forcing the hospital to use current employees more of their time, which is detrimental to their health (Korownyk et al., 2017). Similar data were found in Clinton et al.’ study (2022), in which the burnout rate in the study group was 50%. The work used the Copenhagen Burnout Inventory (CBI), which found that more than half of the employees believe they give much more than they receive in return. It suggests that states have prioritized national healthcare needs over the health of workers. Healthcare should create strategies to prevent burnout among nurses and address their needs and those of patients.

References

Clinton, M., Bou-Karroum, K., Doumit, M. A., Richa, N., & Alameddine, M. (2022). Determining levels of nurse burnout during the COVID-19 pandemic and Lebanon’s political and financial collapse. BMC Nursing, 21(11).

Korownyk, C., McCormack, J., Kolber, M. R., Garrison, S., & Allan, G. M. (2017). Competing demands and opportunities in primary care. Canadian family physician/Medecin de famille canadien, 63(9), 664-668.

Salviato, L. S., Vasconcelos, F., & de Oliveira, P. (2021). Burnout Syndrome in health professionals in a Covid-19 pandemic scenario: analysis of a university hospital. Revista Científica Multidisciplinar Núcleo do Conhecimento, 8(6), 27-44.

Introduction: Purpose

Research on professional burnout and emotional disadaptation of medical workers worldwide becomes especially urgent during the pandemic. It is because medical workers have to work under extreme load conditions and increased threat of infection (Adams et al., 2021). This critique aims to analyze the research that examines the burnout issue in the first stage of the pandemic. The primary parts of the study will be analyzed from the point of validity, methodology, relevance, and argumentativeness. It will enable the evaluation of the article and state what leads to burnout and how to prevent it.

Conceptual Framework

The study’s theoretical framework is based on Maslach’s theory of burnout, which is supported by most of the literature on burnout in nursing. To identify potential predictors of burnout, the researchers consider demographic and occupational variables, including work unit and numerous COVID-19 exposure risks (Bellanti et al., 2021). The article is multifaceted and looks at nurses’ perceptions of COVID-19 risk and how many percent of workers think about quitting.

Design/Method

This study was designed as an online cross-sectional survey addressed to nurses working in a hospital in Italy. Data were collected from June 1 to September 30, 2020, using an online questionnaire (Bellanti et al., 2021). A survey is the most common method of collecting information about human subjectivity, people’s thoughts and feelings, opinions and attitudes, and life plans. This method is appropriate for the study because it allows one to comprehend workers’ thoughts and explore more about people’s individuality.

Sampling/Setting

The authors obtained consent from all participants of the study. They estimated sample size with α at 0.05, mean effect size of 0.15, power of 90%, and several predictors of 18 for linear multiple regression analysis. According to the original variables and carefully conducted calculations, the minimum sample size required for this study was 170 (Bellanti et al., 2021). Power was calculated using the PS Power and Sample Size Calculations program. Four hundred and eight nurses were invited to complete the questionnaire. Of all participants, 293 (71.8%) answered the questionnaire thoroughly (Bellanti et al., 2021). These were the data used by the authors, as it is reliable and valid.

Major Variables

The questionnaire consisted of sections designed to collect several categories of information. Demographic variables and information regarding work unit, occupational experience, chronic illness, previous SARS-CoV-2 infection, or contact with COVID-19 patients were analyzed. The authors likewise considered true and false statements about the impact of the COVID-19 outbreak (Bellanti et al., 2021). This question regarded variables such as organizational support, perceived risk of COVID-19 infection, workload and stress, social relationships, emotional support, perceived mortality from COVID-19, personal protective equipment, and consideration of leaving work. It included MBI-HSS and OBI to improve psychometric properties and reduce method artifacts due to one-way questionnaires.

Data Analysis

Data were expressed as numbers and percentages for the categorical variables and as a mean. Sample analysis and distribution were assessed using the Kolmogorov-Smirnov test. The reliability and validity of the scales were assessed using Cronbach’s α and McDonald’s ω (Bellanti et al., 2021). The significance of differences was analyzed using independent t-tests and Tukey’s test as post-hoc (continuous variables, more than two groups) or in random variables tables using Pearson’s chi-square test. Multiple regression was performed to examine factors associated with COVID-19-related burnout.

Study Findings

The data revealed that burnout in nurses was not dependent on demographic characteristics or occupational factors such as working in a COVID-19 department or being directly exposed to infected patients. Still, it was associated with emotional support, consideration of leaving the job, workload, and stress. These results lead to important theoretical and practical meanings as they indicate that the COVID-19 pandemic negatively impacts nurses’ well-being (McNulty et al., 2022). Therefore, hospital managers should focus on the improvement of their valorization of nurses, on the promotion of support by family and society, and on the reduction of extra work (Foster at al., 2020). Furthermore, investments in mental well-being strategies and psychological interventions are encouraged to improve nurses’ healthcare during possible future pandemics.

Organizational support was considered appropriate for most nurses; perceptions of COVID-19 infection risk were high for nurses and their relatives/friends. Numerous participants reported workload and stress, although 30.7% mentioned conflicts with colleagues (Bellanti et al., 2021). Social relationships among nurses were poorly disrupted; fewer than half felt supported by their employer, but many noted good work mood and high praise from patients and the community. The estimated mortality from COVID-19 was low-moderate.

Strengths/Weaknesses

The study has weaknesses and strengths, which need to be pointed out to improve further research. First of all, it is worth mentioning the validity of the data, which were obtained through interviews with medical workers (Bellanti et al., 2021). The processing and analysis of the information were carried out in several ways, facilitating a competent presentation of the results. Moreover, the interview was relevant, clearly answering the research question and corresponding to the generated hypothesis.

It is significant to note that the study has almost no drawbacks. However, there is a small sample of participants, as the data were collected from only one hospital in Italy. Thus, it is very narrow and does not provide an opportunity to understand the scope of the problem. Therefore, it would have been more rational to cover more hospitals to obtain a more diverse data set.

Conclusion

The issue of nursing burnout is a paramount issue due to the COVID-19 pandemic. The study notes the importance of examining the dynamics of healthcare workers, as the consequences of such chronic fatigue and mental stress can be severe for healthcare workers’ physical and mental health. The research has highlighted necessary measures to reduce distress. They include the importance of psychological support, including the availability of various psychoeducational materials.

References

Adams, R., Ryan, T., & Wood, E. (2021). Understanding the factors that affect retention within the mental health nursing workforce: a systematic review and thematic synthesis. International Journal of Mental Health Nursing, 30(6), 1476-1497. Web.

Bellanti, F., Lo Buglio, A., Capuano, E., Dobrakowski, M., Kasperczyk, A., Kasperczyk, S., & Vendemiale, G. (2021). Factors related to nurses’ burnout during the first wave of Coronavirus Disease-19 in a University Hospital in Italy. International Journal of Environmental Research and Public Health, 18(10), 5051. Web.

Foster, K., Roche, M., Giandinoto, J. A., & Furness, T. (2020). Workplace stressors, psychological well‐being, resilience, and caring behaviours of mental health nurses: A descriptive correlational study. International journal of mental health nursing, 29(1), 56-68. Web.

McNulty, D. S., LaMonica-Way, C., & Senneff, J. A. (2022). The Impact of mindfulness on stress and burnout of new graduate nurses as a component of a nurse residency program. The Journal of Nursing Administration, 52(4), 12-18. Web.

The use of telehealth is one of the common techniques in the modern world, which has become popular during the times of COVID-19 pandemics. Telehealth is a medical information system used to improve the health of the world’s population through remote communication (Tuckson et al., 2017). Before COVID-19, many healthcare organizations did not use the concept, and patients preferred to have real chats with their doctors. Nevertheless, in the United States, many medical institutions actively use remote appointments to avoid overcrowding and decrease costs (Tuckson et al., 2017). The use of telehealth made it easier for the world to cope with the tension raised due to the global problem.

When the coronavirus pandemic happened, the rest of the world adjusted the concept of telehealth to their working strategies. Patients with chronic diseases who are at a high risk of catching the virus did not have to go out and visit doctors to get their life-supporting medication. Zoom and telephone appointments decreased the number of patients coming to the healthcare center (Monaghesh and Hajizadeh, 2020). Even though the COVID-19 pandemic did not finish, people managed to ease the symptoms by vaccination. These days, when the virus is part of our lives, telehealth is being used as it does not require a lot of money, and patients feel more comfortable when they do not have to spend time traveling. The role of the concept in the next year should not be underestimated, and medical workers might continue using this practice to make prescriptions or consult patients at the early stages of their treatment. Nevertheless, some patients might require a personal meeting with professionals. In this case, healthcare organizations should have alternatives that can be provided.

References

Monaghesh, E., & Hajizadeh, A. (2020). The role of telehealth during COVID-19 outbreak: A systematic review based on current evidence.BMC Public Health, 20(1193). Web.

Tuckson, R. V., Edmunds, M. D., & Hodgkins, M. L. (2017). Telehealth.The New England Journal of Medicine. Web.

The COVID-19 pandemic has transformed the world by affecting living traditions, politics, health, and the economy. The health industry has been hit the hardest as the pandemic is unpredictable. Nurses at the front line were confident they were ready to deal with COVID-19. However, the risk of fatigue, psychological distress, and stigmatization increased as the pandemic grew. Moreover, psychological and emotional suffering increased due to the high percentage of patient deaths. It shows that the nursing profession was not well-prepared in its emergency response to the coronavirus pandemic.

Most of the people who were infected went to medical facilities to seek treatment. The hospitals were overwhelmed, especially when critical conditions started to rise. The resilience of the hospitals depended on the preparedness of the nurses. Nurses were responsible for identifying new infections, attending to those in critical conditions, coordinating with other healthcare providers, and consoling relatives (Marshall et al., 2021). However, the nurses lacked the skills and knowledge to manage crises involving isolation, treatment, palliative care, and triaging (Marshall et al., 2021). In addition, most nurses were afraid to go to work because of insufficient protective equipment and the high death rate caused by coronavirus infections.

The severity of the COViD-19 pandemic was that few competent nurses offered total patient care to those in intensive care units or isolated. Thus, the area that could have been improved is increasing coronavirus staffing. All experts, including staff and retired nurses with essential skills and knowledge, should have been called to care for people infected with coronavirus (Marshall et al., 2021). It would have allowed hospitals to take more patients and reduce the number of deaths.

Finally, such a pandemic will require a disaster plan to guide nurses during, before, and after a health-related crisis. More research is needed to determine nurses’ experiences and their preparedness for a pandemic crisis. Since nurses are the largest healthcare group, they must be provided with essential protective equipment to safeguard their lives and those in their care.

Reference

Marshall, V. K., Chavez, M., Mason, T. M., & Martinez-Tyson, D. (2021). Emergency preparedness during the COVID‐19 pandemic: Perceptions of oncology professionals and implications for nursing management from a qualitative study. J Nurs Manag, 29(6), 1375-1384. Web.