The objective of this study was to assess burdens placed on and consequences of the COVID‐19 pandemic on nursing home staff. Design We conducted a qualitative descriptive interview study. Methods We interviewed 18 nurses, nursing aides and care aides from five different nursing homes by using a semi‐structured interview guideline between June and September 2020. Data were analysed with a qualitative content analysis method by combining an inductive and deductive coding frame. Results Results show that the qualitative work load and work organization were major concerns. Regarding the qualitative work load, participants stated that they were required to perform additional tasks to care for residents, because the pandemic interventions placed the residents under stress and dealing with relatives presented significant challenges. Nursing home staff reported that psychological consequences such as uncertainty, fear and stress represented major effects of the COVID‐19 situation. Conclusion We could show that qualitative workloads were assessed and perceived differently. Most nursing home care staff members experienced the changes in working conditions as both physically and psychologically challenging. Impact We highly recommend that nursing home staff receive support in such pandemics by being allowed, for example personal protective equipment breaks. Individually tailored programs need to be established to enhance wellbeing and decrease psychological stress and fear in such challenging times.
Aims To reflect on the situation of nurse managers, examining their professional relationships and additional working duties during the second COVID‐19 wave. Design Cross‐sectional online survey with open questions. Methods Nurse managers from different healthcare institutions, for example, hospitals and nursing homes, were included. Data collection took place from November 2020 to March 2021. Open questions were analysed with qualitative content analysis. Result In total, 321 managers took part. With regard to professional relationships, four main themes were identified: cooperation, cohesion, communication and consequences. While cooperation and cohesion in the nursing and the interprofessional team were predominantly considered positive, communication was seen as challenging. Additional work duties arose in relation to fulfilling regulatory requirements, managing personnel and carrying out both organizational and informational tasks. Consequences of the pandemic were mentioned in two thematic categories (professional relations and additional work duties). Participants referred to a loss of image, a reduction in job satisfaction and mental stress. Conclusion The regulation of certain tasks by the central authority, such as the enrolment of employees to manage the use of personal protective equipment, would make the managers' duties simpler. This would enable them to direct their attention towards their teams and provide necessary support in other parts of their profession. Impact What problem did the study address? Nursing managers are important members of the nursing team and faced particular challenges during the pandemic. Nevertheless, their perspectives are rarely presented in research. What were the main findings? Overall, communication was perceived as good, and cohesion was strengthened during the pandemic. However, heavy burdens were placed on nursing managers due to the numerous additional tasks. On whom will the research have an impact? Facility managers and government representatives are called upon to provide supportive measures and clear information for nursing managers to relieve them from additional duties during the pandemic.
Funding Acknowledgements Type of funding sources: None. Background Catheter ablation of atrial fibrillation is (AF) an established second line therapy for patients with symptomatic paroxysmal (PAF) and persistent AF (persAF). Novel ablation catheters with integrated thermocouples allow fast application of radiofrequency lesions with powers up to 90W. We aimed to describe primary and secondary outcomes after very high-power short duration (vHPSD) ablation. Methods 201 consecutive patients (127 PAF, 68 persAF, 6 longstanding persistent AF) underwent pulmonary vein isolation (PVI) using the QDOT Micro Catheter (Biosense Webster) with the ablation mode QMODE+ (90W, 4s, interlesion distance ≤4mm anterior, ≤6mm posterior). Results Mean age was 62±10 years, 38% were female, median CHA2DS2-VASc Score was 2 (0, 7). Median follow up duration was 196 (30, 461) days. 35% of patients had additional ablation of typical right atrial flutter. Primary success rate to achieve pulmonary vein isolation was achieved in all patients, no catheter-related complications (e.g., charring, steam pop) occurred. First pass isolation of all 4 PVs was achieved in 53% of patients, re-ablations were necessary in the carina regions (right: 27% of cases, left: 20%), 34% at multiple regions including the ridge, 12% in other regions around the PVs. Median procedure for PVI only were 110 (36-344) minutes. Arrhythmia-free survival was 79,3%. 21 patients underwent re-do procedures during follow-up showing most commonly showing gaps in the right PVs (RSPV 52%, RIPV 43%), the left inferior PV (48%), as well as the LSPV (38%) and the ridge (24%); with 91% of patients with recurrence showing more than one site reconnected. Conclusion Very high-power short duration ablation allows safe and quick pulmonary vein isolation. However, first pass isolation rate is low due to gaps in the carina regions. Arrhythmia-free survival is comparable to other pulmonary vein isolation techniques.
SummaryThis rapid review was conducted by following a predefined protocol developed by the Cochrane Rapid Reviews Methods Group. A total of 172 potential reviews and 167 primary studies of interest were found. AMSTAR II was used to assess the quality of the included reviews and the JBI Checklist for Randomized Controlled Trials for primary studies. Overall, four studies were included in this review. The study quality ranged from 5 to 12 out of 13 possible stars. No robust evidence was found that psychosocial interventions can reduce psychological distress. No significant effect could be found regarding post-traumatic stress. Two studies on anxiety were identified, one which showed an effect and another which did not. The psychosocial intervention had no beneficial effect on burnout and depression, whereas providing a mindfulness- or relaxation-based intervention resulted in a significant improvement in sleep quality. By considering the secondary results and results of previous reviews, a combination of training and mindfulness seems to be beneficial for decreasing anxiety and stress in home care workers. In summary, the evidence-based recommendations are still limited and, therefore, more evidence is needed to make a general statement of high certainty about the effects.
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