COVID-19 and wound care: A Canadian perspective
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Notice bibliographique
Résumé
To the Editor: Delivering acute and chronic wound care with physical distancing measures has been a major challenge during the coronavirus disease 2019 pandemic. The average age of patients with chronic wounds is older than 70 years, putting this population at increased risk.1Pina E. Epidemiology of chronic wounds treated in primary health care in Portugal.Rev Port Cir Cardiotorac Vasc. 2007; 14: 49-52PubMed Google Scholar Health care providers should continue to focus on reducing exposure risk in this subgroup of patients while adapting to the new normal. We recommend a multifaceted approach including virtual wound care, patient education, and interprofessional collaboration to optimize care (Fig 1). Currently, many wound care appointments are being postponed or changed to a telephone consultation.2COVID-19 guidelines - Wound Healing Society.https://woundheal.org/COVID-guidelines.cgiGoogle Scholar These regular appointments are often essential for optimizing care and preventing unscheduled emergency department visits for complications including infections. Telewound care can be as effective as in-person visits and is conducted through store-and-forward technologies, telephone, or videoconferencing. Store and forward allows patients to send wound photographs and information to the dermatologist, whereas videoconferencing or telephone communication allows real-time interaction between patients and providers. Newer cellphone photographs often have better photographic resolution than most video transmissions. Provincial governments in some areas also compensate for telephone appointments as an emergency response. To limit exposure, the Wound Healing Society has recommended a decrease in the frequency of wound dressing changes at clinics and has encouraged caregivers and patients to undertake interim dressing applications.2COVID-19 guidelines - Wound Healing Society.https://woundheal.org/COVID-guidelines.cgiGoogle Scholar This may pose a challenge, with the need to educate patients about a detailed dressing change approach. A self-education tool by Wounds Canada can be downloaded and given to patients as a handout during visits because online videos may be difficult for older patients to access.3Additional best practice resources - Wounds Canada.https://www.woundscanada.ca/health-care-professional/resources-health-care-pros/wcc-magazine/28-publications/wound-care-canada/200-library-2Google Scholar Because of the cancellation of many educational events, there is a reduced opportunity for dermatologists, primary care clinicians, and other professionals to exchange knowledge and discuss the appropriate management of wound care patients. With reassignment of some health care providers to coronavirus disease 2019 emergency duties, community dermatologists have a greater wound care responsibility. One way to mitigate this concern is through Project ECHO (Extension for Community Health Outcomes).4Sibbald R.G. Project ECHO Ontario skin and wound care.https://wound.echoontario.ca/Google Scholar A virtual hub of interprofessional teams exists in Ontario, Canada, for improving skin and wound care. During the 2-hour weekly sessions, care providers present anonymous patient cases facilitated by Zoom technology. The virtual forum allows attendees to collectively generate management plans that are generalizable to other similar patients. More than 30 organizations with greater than 100 care providers attend weekly sessions provided free by the Ontario Ministry of Health and Long-Term Care. These efforts have led to increased interprofessional and coordinated wound care expertise. A positive influence on professional satisfaction and effectiveness was documented, with 83% of respondents indicating that they would implement changes to their practices.5Project Echo Ontario skin and wound program evaluation. Faculty of Health Sciences.https://healthsci.queensu.ca/faculty-staff/opdes/educational-programs-opportunities/project-echo-ontario-skin-and-wound-programGoogle Scholar The coronavirus disease 2019 pandemic has drastically affected wound care delivery for the foreseeable future. Without timely adjustments to optimize care, the health care burden of wound care will continue to increase. We hope that this 3-pronged approach will help alleviate some of the challenges faced during this pandemic.
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Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle