LitCovid-sentences  

PMC:7536903 / 929-11207 JSONTXT 8 Projects

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Id Subject Object Predicate Lexical cue
T11 0-197 Sentence denotes Hospital‐in‐the‐home (HITH) provision of acute medical care at home is increasingly advocated as safe, effective, psychologically beneficial and reducing financial burden on hospitals and patients.
T12 198-356 Sentence denotes 1 , 2 , 3 During a pandemic where hospitals are at capacity and patients need to be isolated, the role of ambulatory services has never been more relevant.
T13 357-358 Sentence denotes 4
T14 360-396 Sentence denotes The role of acute home care services
T15 397-640 Sentence denotes The role of HITH is to provide hospital‐level patient‐centred care that can safely and effectively be delivered at home to keep patients out of hospital, 5 for example, outpatient parenteral antibiotic therapy, chemotherapy and physiotherapy.
T16 641-1012 Sentence denotes The COVID‐19 pandemic does not change this, but the role of HITH may be impacted through: (i) increased referrals of patients without COVID‐19 to maximise hospital inpatient capacity; and (ii) new referrals of patients suspected or confirmed to have COVID‐19 with clinical features on the less severe end of the spectrum but requiring some element of hospital‐level care.
T17 1014-1055 Sentence denotes Challenges posed by the COVID‐19 pandemic
T18 1056-1131 Sentence denotes There are several challenges unique to HITH posed by the COVID‐19 pandemic.
T19 1132-1267 Sentence denotes First, there are duelling priorities of proactively trying to increase patient referrals while managing patient load to allow for that.
T20 1268-1420 Sentence denotes 6 , 7 Second, new referrals for COVID‐19 add to this increased workload and create the risk of transmission of SARS‐CoV‐2 to staff and other patients.
T21 1421-1574 Sentence denotes 8 Third, staff may become unwell, need quarantine or to provide care for their own families, reducing the available workforce with a specific skill set.
T22 1575-1710 Sentence denotes Finally, there are unique challenges with managing personal protective equipment (PPE) and cleaning items taken into the home and cars.
T23 1711-1844 Sentence denotes This is a consensus statement by the HITH Society Australasia on the planning and clinical role of HITH during the COVID‐19 pandemic.
T24 1845-2018 Sentence denotes The HITH Society Australasia represents doctors, nurses, allied health and other healthcare workers who provide HITH care in Australia and New Zealand, Asia and the Pacific.
T25 2019-2143 Sentence denotes 9 As the peak HITH body in the region for 20 years, it is well placed to consider planning for the impact on HITH services.
T26 2144-2242 Sentence denotes The content should be used in conjunction with health department and infection control guidelines.
T27 2244-2290 Sentence denotes Overall goals of HITH during COVID‐19 pandemic
T28 2291-2420 Sentence denotes To provide safe, effective patient‐centred care at home for all HITH patients, while managing increased demand for HITH services.
T29 2421-2485 Sentence denotes To plan for new clinical pathways to care for COVID‐19 patients.
T30 2486-2528 Sentence denotes To minimise the impact of staff shortages.
T31 2529-2595 Sentence denotes To minimise the risk of SARS‐CoV‐2 exposure to staff and patients.
T32 2597-2649 Sentence denotes Issues to consider in planning for HITH preparedness
T33 2650-2838 Sentence denotes It is recommended that all home care services consider what is achievable within current capacity, and the responses to increased demand for HITH services with potentially decreased staff.
T34 2839-2907 Sentence denotes A checklist of issues to consider can support this process (Fig. 1).
T35 2908-3004 Sentence denotes Figure 1 Checklist for optimising hospital‐in‐the‐home (HITH) service during COVID‐19 pandemic.
T36 3006-3023 Sentence denotes Managing staffing
T37 3024-3127 Sentence denotes Workforce planning: resources required for projected increases in patient numbers, and impact of leave.
T38 3128-3256 Sentence denotes Workforce flexibility: changing shift times, teleconferencing from home, especially for those with increased risk from COVID‐19.
T39 3258-3302 Sentence denotes Managing HITH equipment use and availability
T40 3303-3479 Sentence denotes HITH equipment use: minimising the risk as a source of infection through determining what needs to be in the home, cleaning requirements and lifespan of PPE stored in hot cars.
T41 3480-3649 Sentence denotes Equipment stock availability and cars: ensuring sufficient stock or supply chain of usual and additional (PPE, flocked swabs) equipment for the duration of the pandemic.
T42 3650-3810 Sentence denotes Telehealth equipment: ensuring good connection; access to videoconferencing is not universal in patients' homes, and may need to be replaced by telephone calls.
T43 3812-3837 Sentence denotes Managing patient workload
T44 3838-3972 Sentence denotes Measures to decrease current HITH workload will maximise the number of patients that can be transferred home to free up hospital beds.
T45 3973-4172 Sentence denotes Managing interventions: minimising simple referrals, frequency of interventions and duration on HITH; 10 education and support of patients remotely in their own care; deferral of elective referrals.
T46 4173-4438 Sentence denotes Managing need for in‐home visits: replacement of some in‐home visits with telehealth; 11 use of home observation kits (thermometer, oximeter) with remote monitoring; decreased driving distance, and if too far, engaging local services or rehousing patients locally.
T47 4440-4501 Sentence denotes Minimising risk of exposure to and transmission of SARS‐CoV‐2
T48 4502-4590 Sentence denotes Staff should follow current health department guidelines for screening, testing and PPE.
T49 4591-4662 Sentence denotes Risk factor screening script use: at referral and prior to every visit.
T50 4663-4806 Sentence denotes Education and training staff for PPE use: guidance on donning, doffing and waste disposal, because every visit is in an unfamiliar environment.
T51 4807-4956 Sentence denotes Limiting exposure during visits: family members should be limited in number, physically distanced and if unwell, not in the room with visiting staff.
T52 4957-5069 Sentence denotes Decreasing risk for staff at increased risk (co‐morbidities, increased age): telehealth and non‐clinical duties.
T53 5071-5085 Sentence denotes Communications
T54 5086-5176 Sentence denotes Communication is critical in ensuring that staff and patients feel informed and supported.
T55 5177-5307 Sentence denotes HITH staff: to provide updates and support, emphasise the importance of hand hygiene and other measures and provide moral support.
T56 5308-5420 Sentence denotes Hospital staff: to remind referrers of the role and capacity of HITH in ongoing institutional pandemic planning.
T57 5421-5602 Sentence denotes General practitioners, community physicians and other healthcare workers: to ensure care is co‐ordinated with other healthcare workers providing supportive care to patients at home.
T58 5603-5801 Sentence denotes Patients: to ensure they feel safe receiving home care; development of information for all patients receiving care via HITH during the pandemic and additional information for patients with COVID‐19.
T59 5802-5861 Sentence denotes 12 This may include child‐orientated language or pictures.
T60 5863-5884 Sentence denotes Supporting each other
T61 5885-6143 Sentence denotes We support our own HITH team and our colleagues by treating everyone with respect and kindness, inclusion, regular communication, understanding of natural anxiety, reassurance and advocacy for infection protection for them in their role as front‐line carers.
T62 6145-6179 Sentence denotes Clinical role of HITH for COVID‐19
T63 6180-6349 Sentence denotes The clinical role of HITH will depend on the pathways that already exist and what capacity the HITH service has to expand or modify services and to develop new pathways.
T64 6351-6422 Sentence denotes Provision of safe effective HITH care to meet increased hospital demand
T65 6423-6489 Sentence denotes During a pandemic, the first priority is to optimise current care.
T66 6490-6582 Sentence denotes However, there may be opportunities to think about the role of HITH for more patient groups.
T67 6583-6759 Sentence denotes Maximise referral of usual HITH patients: transferring all cohorts that the institutional HITH usually takes; using communication, education and advertising signage about HITH.
T68 6760-6956 Sentence denotes Modify usual care to include additional HITH patients: extension of limits of current patient groups: acuity/severity, referral timing and intervention frequency, without decreasing level of care.
T69 6957-7059 Sentence denotes Opportunities to develop new HITH pathways: development for new patient cohorts and new interventions.
T70 7060-7148 Sentence denotes HITH societies are well positioned to establish sharing of information across hospitals.
T71 7150-7196 Sentence denotes Referral of new patients to HITH with COVID‐19
T72 7197-7297 Sentence denotes The role of HITH for patients with suspected or confirmed COVID‐19 is untested and likely to evolve.
T73 7298-7491 Sentence denotes Current case definition criteria should be used: patients with mild disease can go home without HITH, patients with severe disease need hospital admission, and the role of HITH lies in between.
T74 7492-7607 Sentence denotes HITH may also be a source of reassurance for people who are safe to go home but feel frightened by their diagnosis.
T75 7608-7706 Sentence denotes Referral processes: who will review, relay results and give isolation advice, in and out of hours.
T76 7707-8048 Sentence denotes Clinical criteria appropriate for HITH suggested for COVID‐19: these should be based on usual institutional HITH criteria:Requirement for ongoing assessment and/or management for moderate illness, for example, respiratory effort but not needing oxygen, decreased fluid intake, moderate secondary bacterial pneumonia requiring IV antibiotics.
T77 8049-8181 Sentence denotes COVID‐specific modifications may be considered, for example, tolerance of fevers and/or mild hypoxia in otherwise suitable patients.
T78 8182-8346 Sentence denotes Monitoring those at higher risk of deterioration: those with respiratory/cardiac/oncological co‐morbidities, neonates and elderly should be considered individually.
T79 8347-8482 Sentence denotes Duration of HITH admission: symptoms should be clearly improving before discharge; deterioration may occur beyond day 5 of the illness.
T80 8483-8698 Sentence denotes Additional interventions that may increase use of HITH: depending on HITH capability: equipment kits for patient self‐observation, nasogastric/intravenous hydration, oxygen using concentrators and remote monitoring.
T81 8700-8744 Sentence denotes Mode of HITH care for patients with COVID‐19
T82 8745-8838 Sentence denotes Mode of care depends on patient medical needs and risk of transmission of COVID‐19 infection.
T83 8839-8986 Sentence denotes Telehealth for assessment/review: if no clinical intervention required; also semi‐urgent review of new symptoms or potential need to escalate care.
T84 8987-9166 Sentence denotes In‐person assessment: if intervention, for example, intravenous antibiotics required, or clinical examination for deterioration alerted by telehealth or patient/family phone call.
T85 9167-9285 Sentence denotes Responsive mobile unit: consideration for ability to respond to need for an in‐person visit after a telehealth review.
T86 9287-9362 Sentence denotes Transfer from HITH back to hospital of deteriorating patients with COVID‐19
T87 9363-9522 Sentence denotes Use of standard procedure for escalation of care for deteriorating patients: contact numbers and signs to watch out for on information provided to the patient.
T88 9523-9695 Sentence denotes Consideration of specific criteria in COVID‐19 patients: worsening respiratory status, for example, oxygen saturations <92%; poor urinary output or other clinical concerns.
T89 9696-9831 Sentence denotes Transfer back to hospital: clear process for both in hours and after hours, including where and by which team patient will be reviewed.
T90 9833-9843 Sentence denotes Conclusion
T91 9844-10042 Sentence denotes As the pandemic progresses, HITH activities will need to be updated, to align with recommendations from health departments and infection control, and in response to experience of COVID‐19 infection.
T92 10043-10278 Sentence denotes This is the current consensus position of a large group of healthcare workers experienced in HITH care, with the aim of facilitating preparedness for institutions to provide acute home care in the early stages of the COVID‐19 pandemic.