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新冠疫情期间儿科重症监护混合式临床查房:一项试点研究

Pediatric Intensive Care Hybrid-Style Clinical Round During COVID-19 Pandemic: A Pilot Study.

作者信息

Temsah Mohamad-Hani, Alhboob Ali, Abouammoh Noura, Al-Eyadhy Ayman, Aljamaan Fadi, Alsohime Fahad, Alabdulhafid Majed, Ashry Ahmad, Bukhari Ahmad, ElTahir Omer, Jamal Amr, Halwani Rabih, Alhasan Khalid, Alherbish Adi, Temsah Reem, Al-Tawfiq Jaffar A, Barry Mazin

机构信息

College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.

出版信息

Front Pediatr. 2021 Aug 19;9:720203. doi: 10.3389/fped.2021.720203. eCollection 2021.

Abstract

With the evolving COVID-19 pandemic and the emphasis on social distancing to decrease the spread of SARS-CoV-2 among healthcare workers (HCWs), our pediatric intensive care unit (PICU) piloted the integration of Zoom meetings into clinical rounds. We aimed to explore the feasibility of these hybrid virtual and physical clinical rounds for PICU patients. Mixed quantitative and qualitative deductive thematic content analysis of narrative responses. PICU, single tertiary-care academic center. Multidisciplinary PICU HCWs. Integration of Zoom meeting into clinical daily PICU rounds. For the quantitative part, we gathered the details of daily PICU hybrid rounds in terms of times, number of HCWs, and type of files shared through Zoom. For the qualitative part, open-ended questions were used. The physical round took statistically significantly less time (34.68 ± 14.842 min) as compared with the Zoom round (72.45 ± 22.59 min), < 0.001. The most shared component in the virtual round was chest X-rays (93.5%). Thirty-one HCWs participated in focus group discussions and were included in the analysis. Some of the HCWs' perceived advantages of the hybrid rounds were enabling multidisciplinary discussions, fewer round interruptions, and practicality of virtual discussions. The perceived challenges were the difficulty of the bedside nurse attending the virtual round, decreased teaching opportunities for the trainees, and decreased interactions among the team members, especially if video streaming was not utilized. Multidisciplinary hybrid virtual and physical clinical rounds in the PICU were perceived as feasible by HCWs. The virtual rounds decreased the physical contact between the HCWs, which could decrease the possibility of SARS-CoV-2 spread among the treating team. Still, several components of the hybrid round should be optimized to facilitate the virtual team-members' interactions and enhance the teaching experience.

摘要

随着新冠疫情的不断演变,以及为减少严重急性呼吸综合征冠状病毒2(SARS-CoV-2)在医护人员中传播而强调社交距离,我们的儿科重症监护病房(PICU)试点将Zoom会议纳入临床查房。我们旨在探索这些虚拟与实体相结合的临床查房模式用于PICU患者的可行性。对叙述性回复进行定量与定性相结合的演绎主题内容分析。研究地点为一家三级医疗学术中心的PICU。研究对象为多学科的PICU医护人员。将Zoom会议纳入PICU日常临床查房。在定量部分,我们收集了PICU每日混合查房的时间、医护人员数量以及通过Zoom共享的文件类型等详细信息。在定性部分,我们使用了开放式问题。实体查房在统计学上花费的时间(34.68±14.842分钟)明显少于Zoom查房(72.45±22.59分钟),P<0.001。虚拟查房中共享最多的内容是胸部X光片(93.5%)。31名医护人员参与了焦点小组讨论并被纳入分析。一些医护人员认为混合查房的优点包括能够进行多学科讨论、查房中断较少以及虚拟讨论具有实用性。他们认为的挑战包括床边护士参加虚拟查房存在困难、实习医生的教学机会减少以及团队成员之间的互动减少,尤其是在未使用视频流的情况下。PICU医护人员认为多学科混合虚拟与实体临床查房是可行的。虚拟查房减少了医护人员之间的身体接触,这可能降低SARS-CoV-2在治疗团队中传播的可能性。不过,混合查房的几个方面仍需优化,以促进虚拟团队成员之间的互动并提升教学体验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f97/8417365/e4e1868c0f94/fped-09-720203-g0001.jpg

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