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      Implementing lateral flow devices in long-term care facilities: experiences from the Liverpool COVID-19 community testing pilot in care homes— a qualitative study

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          Abstract

          Introduction

          Antigen-based lateral flow devices (LFDs) offer the potential of widespread rapid testing. The scientific literature has primarily focused on mathematical modelling of their use and test performance characteristics. For these tests to be implemented successfully, an understanding of the real-world contextual factors that allow them to be integrated into the workplace is vital. To address this gap in knowledge, we aimed to explore staff’s experiences of integrating LFDs into routine practice for visitors and staff testing with a view to understand implementation facilitators and barriers.

          Methods

          Semi-structured interviews and thematic analysis.

          Results

          We identified two main themes and five subthemes. The main themes included: visitor-related testing factors and staff-related testing factors. Subthemes included: restoring a sense of normality, visitor-related testing challenges, staff-related testing challenges, and pre-pilot antecedent factors.

          Conclusion

          Our study demonstrates that the real-world implementation of LFDs to test visitors and staff faces significant challenges as a result of several contextual factors negatively affecting the work practice and environment. More comprehensive studies are needed to identify and inform effective implementation strategies to ensure that LFDs can be adopted in an agile way that better supports an already exhausted and morally depleted workforce.

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          Most cited references70

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          Using thematic analysis in psychology

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            Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

            Qualitative research explores complex phenomena encountered by clinicians, health care providers, policy makers and consumers. Although partial checklists are available, no consolidated reporting framework exists for any type of qualitative design. To develop a checklist for explicit and comprehensive reporting of qualitative studies (in depth interviews and focus groups). We performed a comprehensive search in Cochrane and Campbell Protocols, Medline, CINAHL, systematic reviews of qualitative studies, author or reviewer guidelines of major medical journals and reference lists of relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Duplicate items and those that were ambiguous, too broadly defined and impractical to assess were removed. Items most frequently included in the checklists related to sampling method, setting for data collection, method of data collection, respondent validation of findings, method of recording data, description of the derivation of themes and inclusion of supporting quotations. We grouped all items into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.
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              The psychological impact of quarantine and how to reduce it: rapid review of the evidence

              Summary The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.
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                Author and article information

                Contributors
                P.Kierkegaard@imperial.ac.uk
                Journal
                BMC Health Serv Res
                BMC Health Serv Res
                BMC Health Services Research
                BioMed Central (London )
                1472-6963
                25 October 2021
                25 October 2021
                2021
                : 21
                : 1153
                Affiliations
                [1 ]GRID grid.7445.2, ISNI 0000 0001 2113 8111, NIHR London In Vitro Diagnostics Co-operative, Department of Surgery and Cancer, , Imperial College London, St Mary’s Hospital, ; Praed Street, London, W2 1NY UK
                [2 ]GRID grid.11485.39, ISNI 0000 0004 0422 0975, CRUK Convergence Science Centre, Institute for Cancer Research & Imperial College London, , Roderic Hill Building, South Kensington Campus, ; Exhibition Road, London, SW7 2AZ UK
                [3 ]GRID grid.10025.36, ISNI 0000 0004 1936 8470, Institute of Infection, Veterinary and Ecological Sciences, , University of Liverpool, ; Liverpool, CH64 7TE UK
                [4 ]GRID grid.435830.9, ISNI 0000 0004 0421 1497, Public Health Department, , Liverpool City Council, Liverpool, ; Cunard Building, Water Street, Liverpool, L3 1DS UK
                [5 ]GRID grid.4563.4, ISNI 0000 0004 1936 8868, Division of Medical Sciences and Graduate Entry Medicine, , University of Nottingham, ; Nottingham, UK
                [6 ]NIHR Applied Research Collaboration East Midlands (ARC-EM), Nottingham, UK
                Article
                7191
                10.1186/s12913-021-07191-9
                8544628
                34696803
                e45567de-ef7a-4084-be66-18602d16a378
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 30 April 2021
                : 30 September 2021
                Categories
                Research
                Custom metadata
                © The Author(s) 2021

                Health & Social care
                lateral flow devices,antigen test,sars-cov-2,nursing homes,residential homes,care homes

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