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      PPE Portraits—a Way to Humanize Personal Protective Equipment

      research-article
      , PhD 1 , , , MD, MBA 1 , , MFA 2 , , PhD, RN, FNP-BC 1 , , MHS, PA-C 3 , , MD, MS, FAAHPM 4 , , MD, MPH 1 , 5
      Journal of General Internal Medicine
      Springer International Publishing

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          Abstract

          The use of personal protective equipment (PPE) has skyrocketed, as providers don masks, glasses, and gowns to protect their eyes, noses, and mouths from COVID-19. Yet these same facial features express human individuality, and are crucial to nonverbal communication. Isolated ICU patients may develop “post intensive-care syndrome,” which mimics PTSD with sometimes debilitating consequences. While far from a complete solution, PPE Portraits (disposable portrait picture stickers - 4" × 5") have the potential to humanize care. Preparing for a larger effectiveness evaluation on patient and provider experience, we collected initial qualitative implementation insights during Spring 2020’s chaotic surge preparation. Front-line providers reported more comfort with patient interactions while wearing PPE Portraits: “It makes it feel less like a disaster zone [for the patient].” A brief pilot showed signs of significant adoption: a participating physician requested PPE Portraits at their clinic, shift nurses had taken PPE Portraits with them to inpatient services, and masked medical assistant team-members requested PPE Portraits to wear over scrubs. We believe PPE Portraits may support patient care and health, and even potentially healthcare team function and provider wellness. While we await data on these effects, we hope hospitals can use our findings to speed their own implementation testing.

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          Most cited references4

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          Adverse effects of isolation in hospitalised patients: a systematic review

          Summary The use of transmission precautions such as contact isolation in patients known to be colonised or infected with multidrug-resistant organisms is recommended in healthcare institutions. Although essential for infection control, contact isolation has recently been associated with adverse effects in patients. We undertook a systematic review to determine whether contact isolation leads to psychological or physical problems for patients. Studies were included if (1) hospitalised patients were placed under isolation precautions for an underlying medical indication, and (2) any adverse events related to the isolation were evaluated. We found 16 studies that reported data regarding the impact of isolation on patient mental well-being, patient satisfaction, patient safety or time spent by healthcare workers in direct patient care. The majority showed a negative impact on patient mental well-being and behaviour, including higher scores for depression, anxiety and anger among isolated patients. A few studies also found that healthcare workers spent less time with patients in isolation. Patient satisfaction was adversely affected by isolation if patients were kept uninformed of their healthcare. Patient safety was also negatively affected, leading to an eight-fold increase in adverse events related to supportive care failures. We found that contact isolation may negatively impact several dimensions of patient care. Well-validated tools are necessary to investigate these results further. Large studies examining a number of safety indicators to assess the adverse effects of isolation are needed. Patient education may be an important step to mitigate the adverse psychological effects of isolation and is recommended.
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            Practices to Foster Physician Presence and Connection With Patients in the Clinical Encounter

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              Compassionomics: Hypothesis and experimental approach.

              Recent reports indicate that healthcare is experiencing a compassion crisis - an absence of (or inconsistency in) compassionate patient care. It is currently unclear if, or to what extent, this exerts significant effects on health and healthcare. Experimental data are few, and this represents a critical knowledge gap for all health sciences. We hypothesize that compassionate care is beneficial for patients (better outcomes), healthcare systems and payers (lower costs), and healthcare providers (lower burnout). Compassionomics is the branch of knowledge and scientific study of the effects of compassionate healthcare, and herein we describe a framework for hypothesis testing. If the hypotheses are confirmed, compassionate healthcare can be established in the domain of evidence-based medicine.
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                Author and article information

                Contributors
                catibj@stanford.edu
                Journal
                J Gen Intern Med
                J Gen Intern Med
                Journal of General Internal Medicine
                Springer International Publishing (Cham )
                0884-8734
                1525-1497
                14 May 2020
                : 1-3
                Affiliations
                [1 ]GRID grid.168010.e, ISNI 0000000419368956, Division of Primary Care and Population Health, , Stanford School of Medicine, ; 1265 Welch Rd, Stanford, CA 94305 USA
                [2 ]GRID grid.217156.6, ISNI 0000 0004 1936 8534, Occidental College, ; 1600 Campus Road, Los Angeles, 90041 CA USA
                [3 ]GRID grid.490568.6, ISNI 0000 0004 5997 482X, Stanford Health Care, ; 211 Quarry Road, Palo Alto, 94304 CA USA
                [4 ]GRID grid.416999.a, ISNI 0000 0004 0591 6261, Division of Palliative Care, , UMass Memorial Medical Center, ; 55 Lake Avenue, Worcester, 01655 MA USA
                [5 ]VA Center for Innovation to Implementation, 795 Willow, Menlo Park, CA 94025 USA
                Author information
                http://orcid.org/0000-0002-5415-3665
                Article
                5875
                10.1007/s11606-020-05875-2
                7224350
                32410125
                37f0c835-3c30-46c2-8dff-6691aac9df35
                © Society of General Internal Medicine 2020

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                : 3 April 2020
                : 28 April 2020
                Categories
                Innovations in Clinical Practice

                Internal medicine
                Internal medicine

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