Telehealth readiness and its influencing factors among Chinese clinical nurses: A cross-sectional study

Tian Yu-tong , Zhang Yan * , Liu Zhen , Xu Bing , Cheng Qing-yun School of Nursing and Health, Zhengzhou University, China

ABSTRACT

Aim/objective: This study aimed to assess telehealth readiness among clinical nurses in China and explore the factors that affect their telehealth readiness and the relationships of telehealth readiness and telehealth practice related variables.

Background: Telehealth is a new service model that uses information and communication technology to provide professional health care services for resource-poor areas. With the global spread of COVID-19, nurses urgently need to adapt and apply telehealth technology to replace conventional face-to-face treatment. However, nurseled telehealth services in China are currently only in the pilot phase and the readiness of clinical nurses needs to be assessed to facilitate successful telehealth implementation.

Design: A cross-sectional, multicentre study was undertaken with the questionnaire survey method.Methods: Data were collected in October-December 2020 used online questionnaires. A convenience sample of 3386 nurses from 19 hospitals in China completed the Chinese version of Telehealth Readiness Assessment Tools.

Results: The mean score of the telehealth readiness was in the category between 61 and 80 points (mean 61.23, SD 11.61). The percentages of nurses meeting the following levels of telehealth readiness were as follows: low (49.9%), moderate (42.0%) and high (8.1%). Significantly higher domain scores were recorded for nurses in the unmarried, head of responsible nursing group. Moreover, there were positive correlations between telehealth readiness level and service experience, service willingness, mode cognition, manpower allocation and policy guidance.

Conclusions: There are still many factors hindering the successful implementation of telehealth. Nursing educators should formulate telehealth education curriculum and service standards to improve the telehealth readiness of nurses.

Keywords:Telehealth .Readiness. Nursing students. Nurses.  Nursing.  Quantitative context analysis.

Rapid Telehealth Implementation during the COVID-19 Global Pandemic: A Rapid Review

Cristian Lieneck 1,* , Joseph Garvey 2 , Courtney Collins 2 , Danielle Graham 2 , Corein Loving 2

and Raven Pearson 2

1 School of Health Administration, Texas State University, San Marcos, TX 78666, USA

2 School of Health Sciences, Southern Illinois University-Carbondale, Carbondale, IL 62901, USA; 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 (J.G.); 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 (C.C.); 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 (D.G.); 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 (C.L.); 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 (R.P.)

*Correspondence: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。; Tel.: +1-512-245-6362

Received: 16 October 2020; Accepted: 26 November 2020; Published: 29 November 2020

Abstract: The implementation and continued expansion of telehealth services assists a variety of health care organizations in the delivery of care during the current COVID-19 global pandemic. However, limited research has been conducted on recent, rapid telehealth implementation and expansion initiatives regarding facilitators and barriers surrounding the provision of quality patient care. Our rapid review evaluated the literature specific to rapid telehealth implementation during the current COVID-19 pandemic from three research databases between January 2020 and May 2020 and reported using preferred reporting items for systematic reviews and meta-analyses (PRISMA). The results indicate the rapid implementation and enhanced use of telehealth during the COVID-19 pandemic in the United States surrounding the facilitators and barriers to the provision of patient care, which are categorized into three identified themes: (1) descriptive process-oriented implementations,(2) the interpretation and infusion of the CARES Act of 2020 telehealth exemptions related to the relaxation of patient privacy and security (HIPAA) protocols, and (3) the standard of care protocols and experiences addressing organizational liability and the standard of care. While the study limitation of sample size exists (n = 21), an identification of rapid telehealth implementation advancements and challenges during the current pandemic may assist health care organizations in the delivery of ongoing quality care during the COVID-19 pandemic.

Keywords: telehealth; telemedicine; COVID-19; coronavirus; implementation.

Antimicrobial TiN-Ag Coatings in Leather Insole for Diabetic Foot

Sandra M. Marques 1,2,* , Isabel Carvalho 2,3 , Teófilo R. Leite 4 , Mariana Henriques 2 and Sandra Carvalho 1,3

1 CFUM-UP, Physics Department, University of Minho, 4800-058 Guimarães, Portugal; 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

2 CEB, Centre of Biological Engineering, LIBRO-Laboratório de Investigação em Biofilmes Rosário Oliveira, Campus of Gualtar, University of Minho, 4710-057 Braga, Portugal; 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 (I.C.); 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 (M.H.)

3 CEMMPRE, Department of Mechanical Engineering, University of Coimbra, 3030-788 Coimbra, Portugal

4 ICC-Indústrias e Comércio de Calçado S.A., Sol-Pinheiro, 4810-718 Guimarães, Portugal; 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。* Correspondence: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

Abstract: This work reports on TiN-Ag antimicrobial coatings deposited by d.c. magnetron sputtering on leather used for insoles on the footwear industry, studies involving the antimicrobial properties of Ag-based functionalized leathers by sputtering techniques are shown. The X-ray diffraction (XRD) results suggested the presence of crystalline fcc-TiN phase for the sample without silver, and also a fcc-Ag phase in the samples containing silver. According to the Scanning Electron Microscopy (SEM) analysis, the coatings were homogeneous and dispersed Ag clusters were detected on the surface of samples with silver content above 8 at. %. The Inductively coupled plasma—optical emission spectrometry (ICP-OES) analysis showed that the ionization of silver over time depends on the morphology of the coatings. The samples did not present cytotoxicity and only samples with incorporated silver presented antibacterial and antifungal activity, highlighting the potential of the TiN-Ag insole coatings for diseases such as diabetic foot.

Keywords: Ag nanoparticles; sputtering; leather; diabetic foot; antimicrobial properties

Analysis of risk factors for multidrug-resistant organisms in diabetic foot infection

Xi Yan1†, Jin‑fang Song2,3*†, Liang Zhang4 and Xia Li2

Abstract

Background: To study the bacteriological characteristics, risk factors, and treatment of multi-drug resistance (MDR) organisms in patients with diabetic foot infection.

Methods: Patients with diabetic foot ulcer admitted to hospital from June 2018 to December 2019 (n =180) were selected as clinical subjects. Demographic information, routine blood test, wound culture and sensitivity were col‑lected. Risk factors of MDR bacteria were analyzed.

Results: Among 180 patients with diabetic foot ulcer, 146 were positive in bacterial culture, with 84 positive in MDR bacteria. A total of 182 strains were isolated, with 104 strains being multi-drug resistant. Body mass index, glycosylated hemoglobin, fasting blood glucose, triglyceride, course of ulcer, size of ulcer, peripheral neuropathy, peripheral vascu‑lar disease, osteomyelitis, peripheral blood leukocyte count, percentage of neutrophils, and previous use of antibiotics were the related factors of infection of MDR bacteria in diabetic foot ulcer patients (P<0.05). The leukocyte count and neutrophil ratio of MDR-bacilli were lower than those of non MDR-bacilli (P<0.05).

Conclusion: The risk of MDR bacteria in diabetic foot infection is high. It is necessary to evaluate the risk of multid‑rug-resistant bacteria by characterizing the course of disease, metabolic control, local ulcer and other aspects in order to formulate an efective treatment plan. The decrease of leukocyte count and neutrophil ratio may be related to damage of the host immune response.

Keywords: Diabetic foot ulcers, Diabetic food infection, Multidrug-resistant bacteria.

Systemic sclerosis is associated with lower limb vascular stiffness and microvascular impairment: results from a prospective study

Charles Cassius1,2,3 iD Vannina Seta4 & Jean-Benoit Monfort 1 & Nathalie Abdoucheli Baudot1 & Sébastien Rivière5 & Arsène Mekinian5 & Camille Frances1 & Annick Barbaud1 & Patricia Senet 1 Received: 12 January 2021 / Revised: 10 February 2021 /Accepted: 1 March 2021 # International League of Associations for Rheumatology (ILAR) 2021

Abstract

       Objective Systemic sclerosis (SSc) is a connective tissue disease characterized by microangiopathy. Peripheral arterial disease, increasingly studied during SSc, is responsible for digital ulcers, associated with a high risk of amputation. The aim of our study was to assess the frequency of lower limb arterial impairment in SSc patients by measuring ankle-brachial index (ABI), toe pressure (TP), and toe-brachial index (TBI).

       Methods Systemic sclerosis patients were included prospectively during 1 year in Tenon and Saint-Antoine Hospitals, Paris.Clinical and biological data were recorded. For each patient, ABI, TP, and TBI were measured and an arterial duplex ultrasonography was prescribed in case of abnormal results.

       Results Eighty-six patients were included (94% women, median age 62 years). Only 24% of them had no lower limb hemodynamic vascular abnormalities; 44% had an isolated microvascular abnormality (normal ABI and TBI<0.75); 31% had at least a macrovascular injury associated or not with microvascular impairment (abnormal ABI) and 12.6% had a TP<50 mmHg. During follow-up, there was a trend towards association of low TBI with more major adverse event (all-cause mortality, non-fatal stroke, non-fatal myocardial infarction, and lower limb ischemic manifestations) than normal TBI. Conclusion By measuring ABI and TP, we showed that 76% of SSc patients had hemodynamic arterial lower limb abnormalities related to macro- and/or microvascular impairment and that 28% had vascular stiffness. In SSc patients, ABI is not an accurate tool to detect lower limb arterial disease, likely due to underlying micro- and macrovascular changes.

Key Points

      The presence of lower limb macro-and/or microvascular involvement was detected in 76% of SSc patients.

      In SSc patients, ABI is not an accurate tool to detect lower limb arterial disease, likely due to underlying microvascular changes and frequent arterial.

Keywords Ankle-brachial index . Microangiopathy . Peripheral arterial disease . Systemic sclerosis . Toe-brachial index . Vascular stiffness

Treatment of Wound Healing with Sequential Therapy to Accelerate Recovery and Inhibit Scar Hyperplasia: A Case Report

Study Design/Patients and Methods: A 19-year-old male was reported to have a postoperative facial trauma suture as a result of being involved in a car accident. Red light emitting diode (LED) therapy (20 min, 96 J/cm2 , 633 nm), Botulinum Toxin Type A 36 IU injection, Broad Band Light and Er:YAG laser at various stages of wound healing were applied as the sequential therapy.

Results: Since the correction was promptly apparent and acceptable, the treatment proved secure and efficacious for repairing wound healing.

Conclusion: Clinically sequential therapy has demonstrated marked improvement in our case. Scar sequential therapy may offer a new strategy for wound healing recovery.

Keywords: wound healing, scar, keloid, treatment