Jeffrey R. Saffle, MD, FACS, Linda Edelman, PhD, Louanna Theurer, BS, Stephen E. Morris, MD, FACS, and Amalia Cochran, MD, FACS

Background: As the number of US burn centers has declined, access to burn care is increasingly limited. Inexperience in burn wound assessment by referring physicians often results in overtriage or undertriage. In an effort to improve access to burn care in our region, we instituted a program of telemedicine evaluation of acute burns.

Methods: We created a telemedicine network linking our burn center to three hospitals located 298 to 350 air miles away. Participants agreed to perform telemedicine consultation for acutely burned patients admitted to their emergency departments. We compared consults and referrals from these facilities during the period July 2005 to August 2007 (TELE) to those during a 2-year period before instituting telemedicine (PRE-TELE).

Results: During the TELE period, 80 patients were referred, of whom 70 were seen acutely by telemedicine, compared with 28 PRE-TELE referrals. The groups did not differ in age or burn size. Only 31 patients seen by telemedicine received emergency air transport (44.3%), compared with 100% of PRE-TELE patients (p ＜0.05). Nine other TELE patients were transported by family; 30 other patients were treated locally. Ten remaining patients were transported without telemedicine evaluation. TELE patients transported by air had somewhat larger burn sizes (9.0% vs. 6.5% total body surface area; p ＝NS) and longer length of stay (13.0 days vs. 8.0 days; p ＝NS) than PRE-TELE patients. Burn size estimates by burn center physicians made either by telemedicine or direct inspection correlated closely but both differed significantly from those of referring physicians. Providers and patients expressed a high level of satisfaction with the telemedicine experience.

Conclusions: Acute evaluation of burn patients can be performed accurately by telemedicine. This can reduce undertriage or overtriage for air transport, improve resource utilization, and both enhance and extend burn center expertise to many rural communities at low cost.

Key Words: Telemedicine, Burns, Air Transport, Triage.

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.

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.

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