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加拿大不列颠哥伦比亚省癌症中心放疗师对 COVID-19 防范措施对临床实践影响的看法。

BC Cancer Radiation Therapists' perspective on the impact of COVID-19 precautions in clinical practice.

机构信息

BC Cancer Centre for the North, Radiation Therapy, Prince George, BC, Canada.

BC Cancer Centre for the North, Radiation Therapy, Prince George, BC, Canada.

出版信息

J Med Imaging Radiat Sci. 2024 Dec;55(4):101734. doi: 10.1016/j.jmir.2024.101734. Epub 2024 Aug 7.

Abstract

INTRODUCTION

There were many policy and procedure (P&P) changes implemented in health care facilities to combat the spread of the coronavirus disease 2019 (COVID-19). Common changes included an increase in personal protective equipment usage, room occupancy limits, limitations in visitors/family members and the absence of volunteers. This study evaluated the current views and opinions of Radiation Therapists (RTs) in British Columbia relating to how COVID-19 P&P changes have impacted their clinical practice. The goal was to identify gaps in the areas of RT practice, allow for self-reflection among RTs and potentially guide future P&Ps with patient-centred care at the forefront.

METHODS

A 24-item cross-sectional questionnaire was created and sent via e-mail to all RTs working across the province. Key sections explored in the questionnaire were: 1) patient care delivery, 2) staff-work environment, and 3) work satisfaction. Descriptive analysis was performed on the questionnaire responses.

RESULTS

Of the approximate 300 invited participants, 107 responses were received from all areas of Radiation Therapy (Treatment units, CT simulation, Dosimetry, etc.) and from all cancer centres in the province. RT staff indicated that COVID-19 P&P negatively impacted patient care, including the ability to verbally and non-verbally communicate with patients (82 %), assess for side effects (85 %), and build rapport (62 %). A majority (79 %) of RT staff felt that communication with co-workers had been negatively impacted as well. When queried regarding the impact on staff environment, 51 % of RT staff agreed that the absence of volunteers increased their workload and the responses were polarized (46 % disagree, 35 % agree) when asked if RT staff have enough time for cleaning their clinical areas with new COVID-19 P&Ps in place. 78 % of RTs were aware of where to go with COVID-19 safety concerns and thought they received adequate education concerning COVID P&Ps. When asked to rank the factors that most impacted RT practice, RTs identified increased PPE usage (83 %), absence of volunteers (74 %), and room occupancy limits (70 %) as the leading P&P changes that negatively impacted their practice; while plexiglass barriers (39 %), re-arranged workspaces (37 %) and working remotely (12 %) were the least negatively impactful.

CONCLUSION

The majority of RTs across BC Cancer responding to the questionnaire indicated that their ability to provide patient care and their staff-work environment were negatively impacted by implemented COVID-19 P&Ps. Views regarding COVID-19 P&P training/education was positive, yet there was no consensus regarding whether the changes were implemented smoothly. This study can facilitate reflection among both clinical leadership and RTs on how P&Ps can be implemented in the future and can encourage further retrospective analyses in aiding the development of P&Ps regarding future public health outbreaks.

摘要

简介

为了应对 2019 年冠状病毒病(COVID-19)的传播,医疗机构实施了许多政策和程序(P&P)变更。常见的变更包括增加个人防护设备的使用、房间入住人数限制、限制访客/家属和取消志愿者。本研究评估了不列颠哥伦比亚省放射治疗师(RTs)对 COVID-19 P&P 变更如何影响其临床实践的当前观点和看法。目的是确定 RT 实践领域中的差距,让 RT 进行自我反思,并可能以患者为中心的护理为指导,为未来的 P&P 提供指导。

方法

创建了一个包含 24 个项目的横断面问卷,并通过电子邮件发送给全省所有工作的 RT。问卷的关键部分包括:1)患者护理交付,2)员工工作环境,3)工作满意度。对问卷的回答进行了描述性分析。

结果

在邀请的大约 300 名参与者中,来自全省所有放射治疗领域(治疗单位、CT 模拟、剂量学等)和所有癌症中心的 107 人做出了回应。RT 工作人员表示,COVID-19 P&P 对患者护理产生了负面影响,包括与患者进行口头和非口头交流的能力(82%)、评估副作用(85%)和建立融洽关系(62%)。大多数(79%)RT 工作人员也认为与同事的沟通受到了负面影响。当被问及对员工环境的影响时,51%的 RT 工作人员同意志愿者的缺席增加了他们的工作量,而对于是否有足够的时间在新的 COVID-19 P&P 下清洁他们的临床区域的问题,工作人员的反应存在两极分化(46%不同意,35%同意)。78%的 RT 了解 COVID-19 安全问题的去向,并认为他们接受了足够的 COVID P&P 培训。当被要求对影响 RT 实践的因素进行排名时,RT 将增加 PPE 使用(83%)、缺乏志愿者(74%)和房间入住人数限制(70%)确定为对其实践产生负面影响的主要 P&P 变更;而有机玻璃屏障(39%)、重新布置工作空间(37%)和远程工作(12%)的影响最小。

结论

对问卷调查做出回应的不列颠哥伦比亚省癌症治疗中心的大多数 RT 表示,他们提供患者护理的能力和员工工作环境受到实施的 COVID-19 P&P 的负面影响。对于 COVID-19 P&P 培训/教育的看法是积极的,但对于变更是否顺利实施并没有共识。本研究可以促进临床领导和 RT 之间对未来如何实施 P&P 的反思,并鼓励进一步的回顾性分析,以帮助制定未来公共卫生事件爆发时的 P&P。

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