Assessing the Post-Pandemic Future of Virtual Care

The following is a condensed version of an upcoming news article by Joan Zolot scheduled for AJN’s May edition.

Studies of safety and quality will determine the optimum use of this option.

Photo by Anna Shvets from Pexels

The use of telemedicine surged during the COVID-19 pandemic. Phone and videoconferencing limited patients’ exposure to the virus while maintaining their access to care. One estimate found that virtual care peaked at 42% of all ambulatory visits covered by commercial insurers in April 2020. The February 2 JAMA published several articles* addressing the safety, effectiveness, and quality of virtual consults and their future in health care.

Some obvious and potential benefits.

Because of its efficiency, virtual care has been shown to be particularly suitable for mental health consults, prescription refills, and straightforward evaluations. It can reduce patient inconveniences such as travel to appointments and lost work time. It can also enable patients to receive needed care sooner, especially those with limited mobility, caregiving responsibilities, or who live in remote areas. It may also have the potential to improve care coordination by enabling primary care clinicians and specialists to confer jointly with patients.

Risks, concerns, ongoing questions.

Because virtual medicine does not allow for physical examination, it’s inadequate for common clinical […]

2021-04-07T14:15:14-04:00April 7th, 2021|digital health, patient engagement, Patients, Public health, Technology|0 Comments
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Remembering the Polio Vaccine Rollout, Addressing Concerns Today

‘A Most Welcome Spring.’

That’s the title of the editorial in the recently published April issue of AJN. And if you receive the print issue or go to our Web site, www.ajnonline.com, I think you’ll see that our cover reflects an image that harkens to the end of a hard pandemic winter of isolation and—for many families—desolation. Spring has arrived, along with a feeling of hope that the vaccines will allow the world to open again, IF we can do so with caution and are successful in vaccine campaigns.

Remembering the relief at having a polio vaccine.

I was in kindergarten when Jonas Salk’s polio vaccine was rolled out. I remember my mother telling me that everyone was going to be getting a new medicine and I vividly recall my entire class lining up to get the injection from the school nurse.

I remember my mother being very happy about it because a boy in the neighborhood—a friend of my brother—had had polio and now wore leg braces and used crutches. When she saw him, she would sometimes say, “too bad the vaccine came too late for John.”

Nurses’ role in addressing vaccine concerns.

2021-04-26T11:50:12-04:00April 5th, 2021|COVID-19, infectious diseases, Nursing, patient engagement, Public health|0 Comments
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‘Right Under Our Noses’: Nightmarish Nursing Home Conditions During the Pandemic

As vaccinations increase and COVID-19 infection rates in nursing homes plummet, it’s easy to forget just how bad things got in many of them and how ill-equipped many were in the the early months of the pandemic to provide humane and effective care.

The following excerpt is from our March Reflections essay, “Right Under Our Noses: Nursing Homes and COVID-19,” which was written by a California nursing professor who volunteered to join a California Medical Assistance Team. The mission of her team was to bring aid to a skilled nursing facility where the coronavirus was rapidly infecting both patients and staff, a facility with little PPE available and many staff members refusing to come to work out of fear of infection.

The conditions I saw were shocking, even to an experienced nurse. I saw soggy diapers on the floor at the heads of many beds on most mornings. One day a bedbound patient needed the bedpan. I searched every closet and drawer but there were no supplies. I filled a basin with warm water and cut up a PPE gown to make washcloths to clean the patient. On the second day of my deployment I realized that many of the […]

2021-03-18T12:10:25-04:00March 18th, 2021|COVID-19, Ethics, infectious diseases, Nursing, nursing perspective, safe staffing|1 Comment
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Johnson and Johnson Vaccine a Valuable Addition to the COVID-19 Toolbox

With the emergency use authorization (EUA) of the Janssen Pharmaceuticals/Johnson & Johnson COVID-19 vaccine, three vaccines are now available in the U.S. to prevent SARS-CoV-2 hospitalizations and death. The newest vaccine, given as a single dose and stable at refrigeration temperatures for at least three months, presents far fewer logistical challenges in getting doses to consumers.

All of the three current U.S. vaccines use a single protein from SARS-CoV-2 to enable the body to react to the whole virus. The Pfizer/BioNTech and Moderna vaccines are messenger RNA vaccines that use a synthetic version of part of the SARS-CoV-2 genome to teach our cells to replicate the spike protein found on the surface of the virus. This copy of the protein then stimulates the immune system to produce antibodies and other cells that will recognize the actual virus if it is encountered in the future.

The new vaccine employs a different mechanism to produce the same result. A human adenovirus, modified to disable its ability to multiply and infect, acts as a “vector” to carry a gene from the spike protein into our own cells, where the protein is replicated and activates the immune system as above.

(The Oxford/AstraZeneca COVID-19 vaccine, currently in use in the UK, Canada, and Australia, is also a vector vaccine. Granted emergency use listing by the World Health […]

2021-03-08T12:31:39-05:00March 8th, 2021|COVID-19, infection control, infectious diseases, Nursing, Public health|0 Comments
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10 Years After Fukushima Nuclear Disaster, an Actionable Preparedness Reminder

The 10th anniversary of this disaster is a reminder to review the availability, accessibility, and dosing of potassium iodide.

In the midst of a global health pandemic, it’s difficult to imagine focusing on the seemingly more nebulous threat of a nuclear accident. Yet the 10th anniversary of Japan’s Fukushima nuclear disaster on March 11, which occurred following an earthquake and tsunami, serves as an important reminder of the unexpectedness of these events and the need for greater preparedness, especially among health care providers.

Climate threats to nuclear plants raise concerns.

“More than one-third of Americans live or work within 50 miles of a nuclear power plant,” the authors of the February issue’s Environments and Health article, “Lessons from Fukushima: Potassium Iodide After a Nuclear Disaster,” point out (the article will be free until March 21).

As the frigid weather last month in Texas demonstrated, sources of power are particularly vulnerable to severe weather events. This threat is especially acute for U.S. nuclear power plants, many of which are situated in areas, such as along the East Coast, susceptible to extreme weather. Hurricanes in the Atlantic, for instance, have been occurring more frequently and intensely in recent years.

Concern that such climate change events could lead to a nuclear accident has heightened awareness of the need for preparation.

Ensuring potassium iodide availability as a public health preventive measure.

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2021-03-03T12:05:23-05:00March 3rd, 2021|climate change, environmental health, Nursing, Public health|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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