Initial experiences of US neurologists in practice during the COVID-19 pandemic via survey
Initial experiences of US neurologists in practice during the COVID-19 pandemic via survey
复制标题
DOI：
10.1212/wnl.0000000000009844
复制
发表时间：
2020-08-04
期刊：
影响因子：
9.9
通讯作者：
Benameur, Karima
中科院分区：
文献类型：
--
作者：
Sharma, Akanksha;Maxwell, Christina R.;Benameur, Karima
为了验证美国神经科医生面临个人防护装备（PPE）缺乏、实践快速变化和机构协议变化等重大挑战的假设，我们进行了这项调查研究。当前的2019年冠状病毒病（COVID-19）大流行已造成广泛的疾病和死亡。患者数量的迅速增加暴露了卫生保健系统的弱点，并挑战了我们为卫生保健工作者提供最佳患者护理和适当安全措施的能力。方法通过各种媒体平台向全美神经科医师发放36项调查问卷。结果在1周的时间内，共收到567份应答。其中，56%在学术界工作。总共有87%的人能够获得个人防护装备，由于短缺，45%的人被要求重复使用个人防护装备。这次大流行使实践发生了迅速变化，最明显的是向远程神经病学提供护理的转变，尽管三分之一的国家在向这种模式过渡的过程中遇到了挑战。在测试和为暴露的、患病的或脆弱的卫生保健工作者提供的指导方面都注意到很大的差异。值得注意的是，59%的受访者认为他们的做法是尽其所能，尽管56%的人认为照顾病人不安全。我们的调查结果显示，受地区、卫生保健环境和实践模式的影响，神经病学对COVID-19大流行的准备和响应存在显著差异。需要专业学会和其他国家实体制定实践指南，以加强对医生及其患者的保护，在大流行期间促进建议的实践变革，并优化未来应对突发公共卫生事件的准备工作。
Objective To test the hypothesis that US neurologists were experiencing significant challenges with lack of personal protective equipment (PPE), rapid changes in practice, and varying institutional protocols, we conducted this survey study. The current coronavirus disease of 2019 (COVID-19) pandemic has caused widespread disease and death. Rapid increases in patient volumes have exposed weaknesses in health care systems and challenged our ability to provide optimal patient care and adequate safety measures to health care workers (HCWs). Methods A 36-item survey was distributed to neurologists around the United States through various media platforms. Results Over a 1-week period, 567 responses were received. Of these, 56% practiced in academia. A total of 87% had access to PPE, with 45% being asked to reuse PPE due to shortages. The pandemic caused rapid changes in practice, most notably a shift toward providing care by teleneurology, although a third experienced challenges in transitioning to this model. Wide variations were noted both in testing and in the guidance provided for the exposed, sick, or vulnerable HCWs. Notably, 59% of respondents felt that their practices were doing what they could, although 56% did not feel safe taking care of patients. Conclusions Results from our survey demonstrate significant variability in preparedness and responsiveness to the COVID-19 pandemic in neurology, affected by region, health care setting, and practice model. Practice guidelines from professional societies and other national entities are needed to improve protection for physicians and their patients, promote recommended practice changes during a pandemic, and optimize future preparedness for public health emergencies.