1
|
Ziegler E, Martin-Misener R, Rietkoetter S, Baumann A, Bougeault IL, Kovacevic N, Miller M, Moseley J, Wong FKY, Bryant-Lukosius D. Response and innovations of advanced practice nurses during the COVID-19 pandemic: A scoping review. Int Nurs Rev 2024; 71:250-275. [PMID: 37737005 DOI: 10.1111/inr.12884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 08/17/2023] [Indexed: 09/23/2023]
Abstract
AIM Identify and map international evidence regarding innovations led by or involving advanced practice nurses in response to COVID-19. BACKGROUND COVID-19 necessitated unprecedented innovation in the organization and delivery of healthcare. Although advanced practice nurses have played a pivotal role during the pandemic, evidence of their contributions to innovations has not been synthesized. Evidence is needed to inform policies, practices, and research about the optimal use of advanced practice nurses. METHODS A scoping review was conducted and reported using the PRISMA-ScR checklist. Electronic databases were searched for peer-reviewed articles published between January 2020 and December 2021. Papers were included that focused on innovations emerging in response to COVID-19 and involved advanced practice nurses. RESULTS Fifty-one articles were included. Four themes were identified including telehealth, supporting and transforming care, multifaceted approaches, and provider education. Half of the articles used brief and mostly noncomparative approaches to evaluate innovations. CONCLUSION This is the first synthesis of international evidence examining the contributions of advanced practice nurses during the pandemic. Advanced practice nurses provided leadership for the innovation needed to rapidly respond to healthcare needs resulting from COVID-19. Innovations challenged legislative restrictions on practice, enabled implementation of telehealth and new models of care, and promoted evidence-informed and patient-centered care. IMPLICATIONS FOR PRACTICE Advanced practice nurses led, designed, implemented, and evaluated innovations in response to COVID-19. They facilitated the use of telehealth, supported or transformed models of care, and enabled health providers through education, mentorship, and mental health support. IMPLICATION FOR POLICY Advanced practice nurses are a critical resource for innovation and health system improvement. Permanent removal of legislative and regulatory barriers to their full scope of practice is needed.
Collapse
Affiliation(s)
- Erin Ziegler
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, Ontario, Canada
| | | | | | - Andrea Baumann
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Ivy Lynn Bougeault
- School of Sociological and Anthropological Studies, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Minna Miller
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jessica Moseley
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | | | | |
Collapse
|
2
|
Hayden EM, Nentwich LM, Jung OS, Zheng H, White BA. Patient Perceptions of Emergency Department Observation Care at Home. Telemed J E Health 2024. [PMID: 38597956 DOI: 10.1089/tmj.2023.0705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024] Open
Abstract
Introduction: The Virtual Observation Unit (VOU) utilizes telehealth and community paramedicine to provide observation-level care in patients' homes. Patients' experience of this novel program has not been reported. Methods: A phone-based patient experience survey was administered to the patients who were admitted to the VOU at an urban, academic Emergency Department in the Northeast United States. The survey asked about patient's perception of the program's quality of care (0 = worst care possible, 10 = best care possible). t Tests with a Bonferroni adjustment assessed for differences between patient demographic groups. Results: The survey response rate was 40% (124/307). Overall mean scores for perceived quality of care were very high (9.51 ± 1.19). There were no significant differences in patient's perception of quality of care between demographic cohorts of age, gender, race, or ethnicity. Conclusions: Patient experience with a novel VOU program was very positive and did not differ significantly by demographic cohort. Further research is warranted.
Collapse
Affiliation(s)
- Emily M Hayden
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Lauren M Nentwich
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Olivia S Jung
- Department of Health Policy and Management, University of California-Los Angeles, Los Angeles, California, USA
| | - Hui Zheng
- Biostatistics Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Benjamin A White
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| |
Collapse
|
3
|
Rockey N, Cervantes L, LeMasters K, Rizzolo K. Challenging Health Inequities in Incarceration: a Call for Equitable Care for Kidney Disease and Hypertension. Curr Hypertens Rep 2023; 25:437-445. [PMID: 37773248 DOI: 10.1007/s11906-023-01267-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2023] [Indexed: 10/01/2023]
Abstract
PURPOSE OF REVIEW To review the current literature on care of hypertension and chronic kidney disease for people who are currently and formerly incarcerated, and to make recommendations for improving outcomes. RECENT FINDINGS There is a growing body of literature describing care for kidney disease and hypertension for incarcerated and formerly incarcerated individuals that documents the provision of care itself, notably that many jails contract with private companies; the system is not designed to provide sustained, chronic disease care; and the transition from incarceration to community is fraught with gaps in care. However, deficiencies in data collection and regulation still limit our understanding of the quality of care provided in jails and prisons. Furthermore, more data is needed to understand the impact of structural racism in the criminal legal system on overall disparities in care for hypertension and kidney disease. Insurance coverage rates for people who were formerly incarcerated continue to be lower than the general population despite Medicaid expansion in many states. There is little recent data regarding kidney replacement therapy for this population despite known variation in dialysis modalities and transplant programs by state. Transitions clinics, which connect people who were formerly incarcerated with care in the community upon release, are growing and are important avenues by which to deliver care. People who are incarcerated are disproportionately affected by hypertension and kidney disease, yet data regarding the extent of these inequities and availability of quality care is lacking. More work is needed to understand the care of individuals with kidney disease and hypertension in prisons and to improve outcomes for these common chronic conditions. Both providing effective treatment of kidney disease and hypertension in prisons and jails and providing coordinated, quality transition to community care upon release represents an important opportunity for reform in care for a marginalized population.
Collapse
Affiliation(s)
- Nathan Rockey
- Department of Medicine, University of Colorado School of Medicine, Aurora, USA
| | - Lilia Cervantes
- Department of Medicine, University of Colorado School of Medicine, Aurora, USA
- Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Katherine LeMasters
- Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Katherine Rizzolo
- Section of Nephrology, Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center, 650 Albany Street, EBRC508, Boston, Massachusetts, 02118, USA.
| |
Collapse
|
4
|
Khairat S, Zebrowski A, Stabile K, Bohlmann A, Wallace E, Yao Y, Lakdawala A, Edson BS, Catlett TL, Dorn SD. Assessment of Stakeholder Perceptions and Cost of Implementing a Telemedicine Specialty Program at Correctional Facilities in North Carolina. Perm J 2023; 27:49-59. [PMID: 37303184 PMCID: PMC10502381 DOI: 10.7812/tpp/22.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Background Delivering in-person health care to the more than 1.2 million incarcerated adults can be expensive, logistically challenging, fragmented, and pose security risks. The purpose of this study was to evaluate the implementation of a specialty care telemedicine program in statewide prisons in North Carolina during the COVID-19 pandemic. Methods We evaluated the first 6 months of implementation of a new telemedicine program to deliver specialty care to adults incarcerated in 55 North Carolina prison facilities. We measured patient and practitioner perceptions and the impact on the cost of care. Results A total of 3232 telemedicine visits were completed across 55 prisons within the first 6 months of the program. Most patients reported that the ability to use telemedicine contributed to their overall personal well-being and safety. Many practitioners found that working with the on-site nursing staff to conduct physical exams and to make collective decisions were key drivers to the success of telemedicine. A direct relationship was found between the telemedicine experience and patients' preference for future visits such that as satisfaction increased, the desire to use telemedicine increased. Telemedicine reduced total costs of care by $416,020 (net: -$95,480) within the first 6 months, and $1,195,377 estimated in the first 12 months postimplementation (95% confidence interval: $1,100,166-$1,290,587). Conclusions Implementing specialty care telemedicine in prison facilities enhanced patient and practitioner experiences and reduced costs within the prison system. The implementation of telemedicine in prison systems can increase access to care and reduce public safety risks by eliminating unnecessary off-site medical center visits.
Collapse
Affiliation(s)
- Saif Khairat
- Carolina Health Informatics Program, University of North Carolina at Chapel Hill, NC, USA
| | - Ashlyn Zebrowski
- Carolina Health Informatics Program, University of North Carolina at Chapel Hill, NC, USA
| | - Kaitlyn Stabile
- Carolina Health Informatics Program, University of North Carolina at Chapel Hill, NC, USA
| | - Aaron Bohlmann
- Carolina Health Informatics Program, University of North Carolina at Chapel Hill, NC, USA
| | - Erin Wallace
- Carolina Health Informatics Program, University of North Carolina at Chapel Hill, NC, USA
| | - Yuxiao Yao
- School of Information and Library Science, University of North Carolina at Chapel Hill, NC, USA
| | - Adnan Lakdawala
- Carolina Health Informatics Program, University of North Carolina at Chapel Hill, NC, USA
| | | | - Terri L Catlett
- Healthcare Administration, North Carolina Department of Public Safety, NC, USA
| | - Spencer D Dorn
- Department of Medicine, University of North Carolina at Chapel Hill, NC, USA
| |
Collapse
|
5
|
Khairat S, Chourasia P, Muellers KA, Andreadis K, Lin JJ, Ancker JS. Patient and Provider Recommendations for Improved Telemedicine User Experience in Primary Care: A Multi-Center Qualitative Study. TELEMEDICINE REPORTS 2023; 4:21-29. [PMID: 36950478 PMCID: PMC10027343 DOI: 10.1089/tmr.2023.0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE The purpose of this study was to explore telemedicine use and obtain actionable recommendations to improve telemedicine user experience from a diverse group of patients and providers. METHODS We interviewed adult patients and primary care providers (PCPs) across three National Patient-Centered Clinical Research Network (PCORnet) sites in New York City, North Carolina, and Florida. Both patients and providers could participate via phone or videoconferencing; patients could complete the interview in English or Spanish. Spanish interviews were conducted by a member of the research team who spoke Spanish fluently. Interviews were audio-recorded, transcribed verbatim, and when necessary, professionally translated. RESULTS We interviewed 21 PCPs and 65 patients between March and October 2021. We found that patients' and providers' perspectives on ways to improve the telemedicine experience focused on three recommendation themes: (1) expectations of care provided via telemedicine, (2) innovations to support usability, and (3) alleviation of physician burden. Key recommendations were related to expectations regarding (1) care provided, for example, adding educational content for the patients, and clarity about long-term payment models; (2) support innovation to improve telemedicine usability, for example, providing patients with remote monitoring devices, integrating in-home testing and nursing evaluation; (3) and reduce physician burden, for example, virtual rooming, reimbursement of time spent outside of the telemedicine encounter. DISCUSSION Primary care patients and providers see merit in telemedicine. However, both groups recommended novel ways to improve the quality of care and user experience. Findings from this article suggest that policymakers would be best served by addressing current gaps in patient digital literacy by creating technical support strategies, and gaps in telemedicine reimbursement to present an equitable form of payment.
Collapse
Affiliation(s)
- Saif Khairat
- Carolina Health Informatics Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- School of Nursing, University of North Carolina at Chapel Hill, North Carolina, USA
- Sheps G. Cecil Center for Health Services Research, University of North Carolina at Chapel Hill, North Carolina, USA
| | - Prabal Chourasia
- Carolina Health Informatics Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kimberly A. Muellers
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Psychology, Pace University, New York, New York, USA
| | - Katerina Andreadis
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Jenny J. Lin
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jessica S. Ancker
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| |
Collapse
|
6
|
Kim H, Hughes E, Cavanagh A, Norris E, Gao A, Bondy SJ, McLeod KE, Kanagalingam T, Kouyoumdjian FG. The health impacts of the COVID-19 pandemic on adults who experience imprisonment globally: A mixed methods systematic review. PLoS One 2022; 17:e0268866. [PMID: 35594288 PMCID: PMC9122186 DOI: 10.1371/journal.pone.0268866] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 05/09/2022] [Indexed: 12/18/2022] Open
Abstract
Background The prison setting and health status of people who experience imprisonment increase the risks of COVID-19 infection and sequelae, and other health impacts of the COVID-19 pandemic. Objectives To conduct a mixed methods systematic review on the impacts of the COVID-19 pandemic on the health of people who experience imprisonment. Data sources We searched Medline, PsycINFO, Embase, the Cochrane Library, Social Sciences Abstracts, CINAHL, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Sociology Database, Coronavirus Research Database, ERIC, Proquest Dissertations and Theses, Web of Science, and Scopus in October 2021. We reviewed reference lists for included studies. Study eligibility criteria Original research conducted in or after December 2019 on health impacts of the COVID-19 pandemic on adults in prisons or within three months of release. Study appraisal and synthesis methods We used the Joanna Briggs Institute’s Critical Appraisal Checklist for Qualitative Research for qualitative studies and the Joanna Briggs Institute’s Critical Appraisal Checklist for Studies Reporting Prevalence Data for quantitative studies. We qualitized quantitative data and extracted qualitative data, coded data, and collated similar data into categories. Results We identified 62 studies. People in prisons had disproportionately high rates of COVID-19 infection and COVID-19 mortality. During the pandemic, all-cause mortality worsened, access to health care and other services worsened, and there were major impacts on mental wellbeing and on relationships with family and staff. There was limited evidence regarding key primary and secondary prevention strategies. Limitations Our search was limited to databases. As the COVID-19 pandemic is ongoing, more evidence will emerge. Conclusions Prisons and people who experience imprisonment should be prioritized for COVID-19 response and recovery efforts, and an explicit focus on prisons is needed for ongoing public health work including emergency preparedness. Prospero registration number 239324.
Collapse
Affiliation(s)
- Hannah Kim
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Emily Hughes
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Alice Cavanagh
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Emily Norris
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Angela Gao
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Susan J. Bondy
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Katherine E. McLeod
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Tharsan Kanagalingam
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Fiona G. Kouyoumdjian
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
- * E-mail:
| |
Collapse
|
7
|
Khairat S, Wallace E, Bohlmann A, Zebrowski A, Stabile K, Yao Y, Lakdawala A, Edson B, Catlett T. Digital Health Experiences of Incarcerated Populations Using Telemedicine in North Carolina Prisons. J Patient Exp 2022; 9:23743735221092611. [PMID: 35465408 PMCID: PMC9024156 DOI: 10.1177/23743735221092611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
More than 1.2 million adults are incarcerated in the United States and hence, require health care from prison systems. The current delivery of care to incarcerated individualss is expensive, logistically challenging, risk fragmenting care, and pose security risks. The purpose of this study was to evaluate the association of patient characteristics and experiences with the perceived telemedicine experiences of incarcerated individuals during the pandemic. We conducted a cross-sectional study of incarcerated individuals in 55 North Carolina prison facilities seeking medical specialty care via telemedicine. Data collection took place from June 1, 2020 to November 30, 2020. Of the 482 patient surveys completed, 424 (88%) were male, 257 (53.3%) were over 50 years of age, and 225 (46.7%) were Black or African American and 195 (40.5%) were White, and 289 (60%) no prior telemedicine experience. There were 3 strong predictors of how patients rated their telemedicine experience: personal comfort with telemedicine (P-value < .001), wait time (P-value < .001), and the clarity of the treatment explanation by the provider (P-value < .001). There was a relationship between telemedicine experiences and how patient rated their experience. Also, patients who were less satisfied with using telemedicine indicated their preference for an in-clinic visit for their next appointment.
Collapse
Affiliation(s)
- Saif Khairat
- Carolina Health Informatics Program, University of North Carolina at Chapel Hill, NC, USA.,Cecil G. Sheps Center for Health Services Research, Chapel Hill, USA
| | - Erin Wallace
- Carolina Health Informatics Program, University of North Carolina at Chapel Hill, NC, USA
| | - Aaron Bohlmann
- Carolina Health Informatics Program, University of North Carolina at Chapel Hill, NC, USA
| | - Ashlyn Zebrowski
- Carolina Health Informatics Program, University of North Carolina at Chapel Hill, NC, USA
| | - Kaitlyn Stabile
- Carolina Health Informatics Program, University of North Carolina at Chapel Hill, NC, USA
| | - Yuxiao Yao
- School of Information and Library Science, University of North Carolina at Chapel Hill, NC, USA
| | - Adnan Lakdawala
- Carolina Health Informatics Program, University of North Carolina at Chapel Hill, NC, USA
| | | | - Terri Catlett
- Healthcare Administration, North Carolina Department of Public Safety, NC, USA
| |
Collapse
|
8
|
Lessons for Oncology From the COVID-19 Pandemic: Operationalizing and Scaling Virtual Cancer Care in Health Systems. Cancer J 2022; 28:125-133. [PMID: 35333498 PMCID: PMC9158540 DOI: 10.1097/ppo.0000000000000579] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
ABSTRACT After several decades of slow expansion, the use of virtual care in oncology rapidly expanded during the COVID-19 pandemic. Data from cancer centers across the country show that most patients and providers were satisfied with components of virtual care, and virtual care may be able to improve access to care. However, the rapid implementation of programs during the pandemic worsened disparities in access to virtual care. Health systems must develop strategies to monitor quality, support patients and providers, promote health equity, and overcome regulatory challenges to successfully deliver care in hybrid systems that combine in-person and virtual care.
Collapse
|