Recommendations for Welcoming Back Nursing Home Visitors During the COVID-19 Pandemic: Results of a Delphi Panel.
Recommendations for Welcoming Back Nursing Home Visitors During the COVID-19 Pandemic: Results of a Delphi Panel.
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DOI：
10.1016/j.jamda.2020.09.036
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发表时间：
2020-12
影响因子：
7.6
通讯作者：
Wasserman M
中科院分区：
文献类型：
--
作者：
Bergman C;Stall NM;Haimowitz D;Aronson L;Lynn J;Steinberg K;Wasserman M
护理院于二零二零年春季成为COVID-19的中心。由于聚集场所的病死率很高，联邦机构建议限制家属探视。COVID-19疫情爆发六个月后，这些措施基本上仍然有效。本研究的目的是产生共识的指导声明，重点是基本的家庭照顾者和访客。一个修改后的两步德尔菲过程被用来产生共识声明。德尔菲小组由21名美国和加拿大临床医学、管理和患者护理倡导方面的急性后和长期护理专家组成。州和联邦重开声明于2020年6月收集，小组使用3分制李克特量表进行投票，共识定义为≥80%的小组成员投票“同意”。然后，共识声明为制定访客指导声明提供了信息。德尔菲过程产生了77个共识声明。关于游客指南，专家组提出了5项强有力的建议：（1）保持强有力的感染预防和控制措施，（2）方便室内和室外的访问，（3）允许有适当预防措施的有限身体接触，（4）评估个别居民的护理偏好和风险承受能力，及（5）指定一名基本照顾者，并将体恤照顾探访的定义扩展至包括促进居民心理健康的照顾。COVID-19大流行导致重大监管变化，但并未充分考虑对居民的影响。在缺乏及时和严格的研究的情况下，临床医生和病人护理倡导者的参与对于帮助在居民个人偏好和集体健康之间建立平衡非常重要。这个基于证据的德尔菲过程的结果将有助于指导政策决策以及为未来的研究提供信息。
Nursing homes became epicenters of COVID-19 in the spring of 2020. Due to the substantial case fatality rates within congregate settings, federal agencies recommended restrictions to family visits. Six months into the COVID-19 pandemic, these largely remain in place. The objective of this study was to generate consensus guidance statements focusing on essential family caregivers and visitors. A modified 2-step Delphi process was used to generate consensus statements. The Delphi panel consisted of 21 US and Canadian post-acute and long-term care experts in clinical medicine, administration, and patient care advocacy. State and federal reopening statements were collected in June 2020 and the panel voted on these using a 3-point Likert scale with consensus defined as ≥80% of panel members voting “Agree.” The consensus statements then informed development of the visitor guidance statements. The Delphi process yielded 77 consensus statements. Regarding visitor guidance, the panel made 5 strong recommendations: (1) maintain strong infection prevention and control precautions, (2) facilitate indoor and outdoor visits, (3) allow limited physical contact with appropriate precautions, (4) assess individual residents' care preferences and level of risk tolerance, and (5) dedicate an essential caregiver and extend the definition of compassionate care visits to include care that promotes psychosocial well-being of residents. The COVID-19 pandemic has seen substantial regulatory changes without strong consideration of the impact on residents. In the absence of timely and rigorous research, the involvement of clinicians and patient care advocates is important to help create the balance between individual resident preferences and the health of the collective. The results of this evidence-based Delphi process will help guide policy decisions as well as inform future research.
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DOI：
10.1016/j.jamda.2020.07.038
发表时间：
2020-10-01
影响因子：
7.6
作者：
Stall, Nathan M.;Johnstone, Jennie;Sinha, Samir K.
通讯作者：
Sinha, Samir K.
影响因子：
158.5
作者：
McMichael, Temet M.;Currie, Dustin W.;Duchin, Jeffrey S.
通讯作者：
Duchin, Jeffrey S.
影响因子：
6.3
作者：
D'Adamo, Heather;Yoshikawa, Thomas;Ouslander, Joseph G.
通讯作者：
Ouslander, Joseph G.
影响因子：
6.3
作者：
Ouslander, Joseph G.;Grabowski, David C.
通讯作者：
Grabowski, David C.
影响因子：
158.5
作者：
Arons, M. M.;Hatfield, K. M.;Jernigan, J. A.
通讯作者：
Jernigan, J. A.