Adapting obstetric and neonatal services during the COVID-19 pandemic: a scoping review.
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ABSTRACT: Background
The provision of care to pregnant persons and neonates must continue through pandemics. To maintain quality of care, while minimizing physical contact during the Severe Acute Respiratory Syndrome-related Coronavirus-2 (SARS-CoV2) pandemic, hospitals and international organizations issued recommendations on maternity and neonatal care delivery and restructuring of clinical and academic services. Early in the pandemic, recommendations relied on expert opinion, and offered a one-size-fits-all set of guidelines. Our aim was to examine these recommendations and provide the rationale and context to guide clinicians, administrators, educators, and researchers, on how to adapt maternity and neonatal services during the pandemic, regardless of jurisdiction.Method
Our initial database search used Medical subject headings and free-text search terms related to coronavirus infections, pregnancy and neonatology, and summarized relevant recommendations from international society guidelines. Subsequent targeted searches to December 30, 2020, included relevant publications in general medical and obstetric journals, and updated society recommendations.Results
We identified 846 titles and abstracts, of which 105 English-language publications fulfilled eligibility criteria and were included in our study. A multidisciplinary team representing clinicians from various disciplines, academics, administrators and training program directors critically appraised the literature to collate recommendations by multiple jurisdictions, including a quaternary care Canadian hospital, to provide context and rationale for viable options.Interpretation
There are different schools of thought regarding effective practices in obstetric and neonatal services. Our critical review presents the rationale to effectively modify services, based on the phase of the pandemic, the prevalence of infection in the population, and resource availability.
SUBMITTER: Gold S
PROVIDER: S-EPMC8840792 | biostudies-literature | 2022 Feb
REPOSITORIES: biostudies-literature
Publications
Adapting obstetric and neonatal services during the COVID-19 pandemic: a scoping review.
Gold Shira S Clarfield Lauren L Johnstone Jennie J Diambomba Yenge Y Shah Prakesh S PS Whittle Wendy W Abbasi Nimrah N Arzola Cristian C Ashraf Rizwana R Biringer Anne A Chitayat David D Czikk Marie M Forte Milena M Franklin Tracy T Jacobson Michelle M Keunen Johannes J Kingdom John J Lapinsky Stephen S MacKenzie Joanne J Maxwell Cynthia C Preisman Mary M Ryan Greg G Selk Amanda A Sermer Mathew M Silversides Candice C Snelgrove John J Watts Nancy N Young Beverly B De Castro Charmaine C D'Souza Rohan R
BMC pregnancy and childbirth 20220211 1
<h4>Background</h4>The provision of care to pregnant persons and neonates must continue through pandemics. To maintain quality of care, while minimizing physical contact during the Severe Acute Respiratory Syndrome-related Coronavirus-2 (SARS-CoV2) pandemic, hospitals and international organizations issued recommendations on maternity and neonatal care delivery and restructuring of clinical and academic services. Early in the pandemic, recommendations relied on expert opinion, and offered a one- ...[more]
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Project description:Evidence suggests that COVID-19 may impair access to sexual and reproductive health services and safe abortion. The purpose of this systematic review was investigating the changes of abortion services in the COVID-19 pandemic era. We searched PubMed, Web of Science and Scopus for relevant studies published as of August 2021, using relevant keywords. RCT and non-original studies were excluded from the analysis and 17 studies of 151 included in our review. Requests to access medication abortion by telemedicine and demand for self-managed abortion were the main findings of identified studies. Women requested an abortion earlier in their pregnancy, and were satisfied with tele-abortion care due to its flexibility, and ongoing telephone support. Presenting telemedicine services without ultrasound has also been reported. Visits to clinics were reduced based on the severity of the restrictions, and abortion clinics had less revenue, more costs, and more changes in the work style of their healthcare providers. Telemedicine was reported safe, effective, acceptable, and empowering for women. Reasons for using tele-abortion were privacy, secrecy, comfort, using modern contraception, employing of women, distance from clinics, travel restrictions, lockdowns, fear of COVID-19, and political reasons (abortion prohibition). Complications of women using tele-abortion were pain, lack of psychological support, bleeding, and need to blood transfusions. The results of this study showed that using telemedicine and teleconsultations for medical abortion in the pandemic conditions may be extended after pandemic. Findings can be used by reproductive healthcare providers and policy makers to address the complications of abortion services.Trail registration This study is registered in PROSPERO with number CRD42021279042.
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Project description:BackgroundAccess to healthcare and service utilization are both considered essential factors for improving the general health and wellbeing of older people, especially at the time of COVID-19 pandemic. The aim of the study is to explore factors affecting healthcare access and health service utilization for older people during the pandemic.MethodsPubMed, Web of Science, Scopus and Embase were systematically searched for relevant articles. Access, utilization, health, elderly and COVID-19 were used as keywords in the search strategy. A total of 4308 articles were identified through the initial database search; 50 articles were included in the review as passing the eligibility criteria. The searches were conducted up to August 2021. Data extraction was performed, and evidence was descriptively illustrated. Thematic analysis was used to explore factors influencing the elderly's access and utilization of healthcare services, using Max QDA10, a qualitative analysis software.ResultsAmong articles included in the review (n = 50), a majority of the studies were from the United States (36%), followed by India (8%). According to the main healthcare services, a large number of articles (18%) were related to mental health services, followed by digital health services (16%). Factors were identified at an individual, provider and systems level. Seven main themes emerged from the thematic analysis, as determinants of elderly's access and utilization of healthcare services during COVID-19 pandemic. These included: access to non-COVID related services, access to COVID-related services, literacy and education, accommodation challenges, perceived attitudes of aging, and policies and structures, and social determinants.ConclusionMental health and digital health services were identified as major issues influencing or contributing to or influencing older people's health during the COVID-19 pandemic. We also argue on the importance of a rounded view, as attention to a range of factors is vital for policy decisions towards sustainable care and equitable interventions for improving the health of older people.
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Project description:BackgroundSince the start of the new Coronavirus (COVID-19) outbreak in December 2019, pharmacists worldwide are playing a key role adopting innovative strategies to minimize the adverse impact of the pandemic.ObjectivesTo identify and describe core services provided by the pharmacist during the COVID-19 pandemic.MethodsA literature search was performed in MEDLINE, Embase, Scopus, and LILACS for studies published between December 1st, 2019 and May 20th, 2020 without language restriction. Studies that reported services provided by pharmacists during the COVID-19 pandemic were included. Two independent authors performed study selection and data extraction with a consensus process. The pharmacist's intervention identified in the included studies were described based on key domains in the DEPICT v.2.ResultsA total of 1189 records were identified, of which 11 studies fully met the eligibility criteria. Most of them were conducted in the United States of America (n = 4) and China (n = 4). The most common type of publication were letters (n = 4) describing the workplace of the pharmacist in hospitals (n = 8). These findings showed the different roles of pharmacists during the COVID-19 pandemic, such as disease prevention and infection control, adequate storage and drug supply, patient care and support for healthcare professionals. Pharmacists' interventions were mostly conducted for healthcare professionals and patients (n = 7), through one-to-one contact (n = 11), telephone (n = 6) or video conference (n = 5). The pharmacists' main responsibility was to provide drug information for healthcare professionals (n = 7) as well as patient counseling (n = 8).ConclusionsA reasonable number of studies that described the role of the pharmacists during the COVID-19 pandemic were found. All studies reported actions taken by pharmacists, although without providing a satisfactory description. Thus, future research with more detailed description as well as an evaluation of the impact of pharmacist intervention is needed in order to guide future actions in this and/or other pandemic.
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Project description:IntroductionAs chest imaging is a tool for detecting coronavirus disease 2019 (COVID-19), diagnostic radiographers are a key component of the frontline workforce. Due to its unforeseen nature, COVID-19 has challenged radiographers' preparedness in combating its effects. Despite its importance, literature specifically investigating radiographers' readiness is limited. However, the documented experiences are prognostic of pandemic preparedness. Hence, this study aimed to map this literature by addressing the question: 'what does the existing literature reveal about the pandemic preparedness of diagnostic radiographers during COVID-19?'.MethodsUsing Arksey and O'Malley's framework, this scoping review searched for empirical studies in MEDLINE, Embase, Scopus, and CINAHL. Consequently, 970 studies were yielded and underwent processes of deduplication, title and abstract screening, full-text screening, and backward citation searching. Forty-four articles were deemed eligible for data extraction and analysis.ResultsFour themes that reflected pandemic preparedness were extrapolated: infection control and prevention, knowledge and education, clinical workflow, and mental health. Notably, the findings highlighted pronounced trends in adaptation of infection protocols, adequate infection knowledge, and pandemic-related fears. However, inconsistencies in the provision of personal protective equipment, training, and psychological support were revealed.ConclusionLiterature suggests that radiographers are equipped with infection knowledge, but the changing work arrangements and varied availability of training and protective equipment weakens their preparedness. The disparate access to resources facilitated uncertainty, affecting radiographers' mental health.Implications for practiceBy reiterating the current strengths and weaknesses in pandemic preparedness, the findings can guide clinical practice and future research to correct inadequacies in infrastructure, education, and mental health support for radiographers in the current and future disease outbreaks.
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