Dataset Information

Maintaining Maternal-Newborn Safety During the COVID-19 Pandemic.

ABSTRACT: COVID-19, the disease caused by the SARS-CoV-2 virus, was declared a global pandemic by the World Health Organization on March 11, 2020. In addition to older individuals and those with underlying chronic health conditions, maternal and newborn populations were also identified as being at greater risk. It became critical for hospitals and clinicians to maintain the safety of individuals in the facility and minimize the transmission of COVID-19 while continuing to strive for optimized outcomes by providing family-centered care. Rapid change during the pandemic made it appropriate to use the plan-do-study-act (PDSA) cycle to continually evaluate proposed and standard practices. Our team established an obstetric COVID-19 unit for women and newborns, developed guidelines for visitation and for the use of personal protective equipment, initiated universal COVID-19 testing, and provided health education to emphasize shared decision making.

SUBMITTER: Patrick NA

PROVIDER: S-EPMC7983449 | biostudies-literature | 2021 Jun

REPOSITORIES: biostudies-literature

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Maintaining Maternal-Newborn Safety During the COVID-19 Pandemic.

Patrick Nancy A NA Johnson Teresa S TS

Nursing for women's health 20210322 3

COVID-19, the disease caused by the SARS-CoV-2 virus, was declared a global pandemic by the World Health Organization on March 11, 2020. In addition to older individuals and those with underlying chronic health conditions, maternal and newborn populations were also identified as being at greater risk. It became critical for hospitals and clinicians to maintain the safety of individuals in the facility and minimize the transmission of COVID-19 while continuing to strive for optimized outcomes by ...[more]

PMID: 33811824

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Project description:BackgroundMaintaining the physical and psychological well-being of healthcare workers (HCWs) is crucial for health system resilience. In sub-Saharan Africa, particularly Uganda, HCWs faced significant challenges during the coronavirus disease 2019 (COVID-19) pandemic, compounded by pre-existing resource constraints. This study investigated challenges faced by HCWs at a designated COVID-19 hospital ('the Hospital') and explored determinants of maintaining healthcare personnel's motivation during the COVID-19 pandemic in Uganda.MethodsA facility-based cross-sectional study was conducted at the Hospital from May to July 2023, with 120 HCWs categorised by profession. Data were collected using a structured questionnaire. Descriptive and logistic regression analyses were performed to identify motivation-related factors. The questionnaire assessed sociodemographic data, COVID-19 knowledge, medical history, support received, and pandemic-related challenges. Psychological impact was measured using a four-point Likert scale.ResultsAmong respondents, 61.7% worked during the first lockdown and 93.3% during the second. COVID-19 knowledge was high, with over 70% answering questions correctly, although vaccine effectiveness had a slightly lower accuracy rate. The study revealed that 32.5% of HCWs tested positive for COVID-19 and 25% displayed vaccine hesitancy. Key challenges included fear of infection, transportation disruptions, income reduction, and social isolation. Notably, 92.5% reported significant anxiety related to infection. Factors positively associated with remaining motivated were age (≤ 30 versus > 30 years; adjusted odds ratio [AOR]: 10.34, 95% CI; 1.92-55.74), profession (co-medical/non-medical staff versus medical doctors/medical officers; AOR: 11.66, 95% CI: 1.03-132.22), receiving mentoring/tutoring (AOR: 18.87, 95% CI: 2.55-139.72), and information from supervisors/management (AOR: 12.5, 95% CI: 2.60-60.42). In contrast, psychological impact was negatively affected by isolation from family and friends (AOR: 0.61, 95% CI: 0.41-0.92).ConclusionsDespite challenges, most HCWs at the Hospital remained motivated. These findings emphasised the importance of technical and psychological support, such as mentoring and effective communication from upper-level supervisors, rather than financial incentives, in maintaining motivation among the HCWs. Comprehensive support systems are essential for sustaining HCWs' motivation during the pandemic, especially in resource-limited settings. Further research should address the long-term mental health effects and enhance HCWs' resilience in future health crises.

Project description:ImportanceThe study team previously showed that maternal mRNA COVID-19 vaccination during pregnancy confers protection against SARS-CoV-2 infection and COVID-19-related hospital admission in newborns and young infants. In this study, the study team evaluated newborn and early infant safety outcomes following maternal messenger RNA (mRNA) COVID-19 vaccination during pregnancy, for which there is limited comparative epidemiological evidence.ObjectiveTo determine if maternal mRNA COVID-19 vaccination during pregnancy is associated with adverse newborn and early infant outcomes.Design, setting, and participantsThis population-based retrospective cohort study took place in Ontario, Canada, using multiple linked health administrative databases. Singleton live births with an expected delivery date between May 1, 2021, and September 2, 2022, were included. Data were analyzed from January 2023 through March 2023.ExposureMaternal mRNA COVID-19 vaccination (1 or more doses) during pregnancy.Main outcomes and measuresSevere neonatal morbidity (SNM), neonatal death, neonatal intensive care unit (NICU) admission, neonatal readmission, and hospital admission up to 6 months of age. The study team calculated inverse probability of treatment weighted risk ratios (RRs) and fit weighted Cox proportional hazards regression models comparing outcomes in infants of mothers who received COVID-19 vaccination during pregnancy with those who received no COVID-19 vaccine doses before delivery.ResultsIn total, 142 006 infants (72 595 male [51%]; mean [SD] gestational age at birth, 38.7 [1.7] weeks) were included; 85 670 were exposed to 1 or more COVID-19 vaccine doses in utero (60%). Infants of vaccinated mothers had lower risks of SNM (vaccine exposed 7.3% vs vaccine unexposed 8.3%; adjusted RR [aRR], 0.86; 95% CI, 0.83-0.90), neonatal death (0.09% vs 0.16%; aRR, 0.47; 95% CI, 0.33-0.65), and NICU admission (11.4% vs 13.1%; aRR, 0.86; 95% CI, 0.83-0.89). There was no association between maternal vaccination during pregnancy and neonatal readmission (5.5% vs 5.1%; adjusted hazard ratio, 1.03; 95% CI, 0.98-1.09) or 6-month hospital admission (8.4% vs 8.1%; adjusted hazard ratio, 1.01; 95% CI, 0.96-1.05).Conclusions and relevanceIn this population-based cohort study in Ontario, Canada, maternal mRNA COVID-19 vaccination during pregnancy was associated with lower risks of SNM, neonatal death, and NICU admission. In addition, neonatal and 6-month readmissions were not increased in infants of mothers vaccinated during pregnancy.

Project description:BackgroundMaternal and newborn healthcare providers are essential professional groups vulnerable to physical and psychological risks associated with the COVID-19 pandemic. This study uses machine learning algorithms to create a predictive tool for maternal and newborn healthcare providers' perception of being safe in the workplace globally during the pandemic.MethodsWe used data collected between 24 March and 5 July 2020 through a global online survey of maternal and newborn healthcare providers. The questionnaire was available in 12 languages. To predict healthcare providers' perception of safety in the workplace, we used features collected in the questionnaire, in addition to publicly available national economic and COVID-19-related factors. We built, trained and tested five machine learning models: Support Vector Machine (SVM), Random Forest (RF), XGBoost, CatBoost and Artificial Neural Network (ANN) for classification and regression. We extracted from RF models the relative contribution of features in output prediction.ResultsModels included data from 941 maternal and newborn healthcare providers from 89 countries. ML models performed well in classification and regression tasks, whereby RF had 82% cross-validated accuracy for classification, and CatBoost with 0.46 cross-validated root mean square error for regression. In both classification and regression, the most important features contributing to output prediction were classified as three themes: (1) information accessibility, clarity and quality; (2) availability of support and means of protection; and (3) COVID-19 epidemiology.ConclusionThis study identified salient features contributing to maternal and newborn healthcare providers perception of safety in the workplace. The developed tool can be used by health systems globally to allow real-time learning from data collected during a health system shock. By responding in real-time to the needs of healthcare providers, health systems could prevent potential negative consequences on the quality of care offered to women and newborns.

Project description:IntroductionThe COVID-19 pandemic forced leaders and employees in health care services to take difficult decisions to manage risks associated with employee health and the organizations' functioning. This study aims to identify the changes in employee working routines, job demands, and job resources within Swedish maternal healthcare during the COVID-19 pandemic, and how these changes affected workload and health.MethodsData were derived from the longitudinal COPE Staff study involving midwives and physicians within maternal healthcare. Three focus group discussions with midwives and physicians (n = 13), and open-ended survey responses (n = 604) during the third wave of the pandemic (January to May 2021) were analyzed using deductive content analysis based on the Job Demands-Resources model. Quantitative measures of workload and burnout from three survey waves, both during the pandemic (January to May 2021 [n = 782] and January to March 2022 [n = 503]) and after the pandemic (February to March 2023 [n = 759]), were analyzed.ResultsMultiple changes in working routines were implemented to adhere to national and local guidelines aiming to decrease the spread of Sars-CoV-2. As a result, midwives and physicians experienced increased job demands, including an increased workload and higher emotional and cognitive demands. To balance these demands, new working routines were introduced, and managers increased their efforts to communicate and support the employees. Collegial support also grew. When surveyed, however, most of the maternal healthcare workers said they experienced a high workload. It was found that between 3-7% likely experienced burn out, while another 10% were at risk of burnout during and after the pandemic.ConclusionsThe pandemic had a large effect on maternal healthcare employees. Strategies and adaptations on an organizational, managerial, and individual level played an important role in modifying the impact on the organization's operations and employees.

Dataset Information

Maintaining Maternal-Newborn Safety During the COVID-19 Pandemic.

Publications

Maintaining Maternal-Newborn Safety During the COVID-19 Pandemic.

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