Training and reployment of non-specialists is an effective solution for the shortage of health care workers in the COVID-19 pandemic
Abstract Importance In the COVID-19 pandemic many countries encounter problems arising from shortage of specialists. Short intensive training and reployment of non-specialists is an option but the effectiveness is unknown.Objective To investigate whether there was difference in in-hospital mortality rates between COVID-19 patients managed by a mixed team (including non-specialists who had short intensive training and operated to a strict protocol) and those managed by a specialist team of health care workers.Design Cohort study, from January 26, 2020 to April 7, 2020, follow up to April 7, 2020.Setting Multicenter - Wuhan Hankou Hospital and Wuhan Xiehe Hospital, Wuhan, China.Participants 261 HCWs deployed to Wuhan from Guangdong emergency rescue team and the 269 COVID-19 patients they treated.Exposure Among 261 health care workers, 130 were in the specialist team and included 33 physicians, 32 of whom (97.0%) of whom were from relevant specialties. Each physician was in charge of 25-27 beds, with a 6-hour shift time. The mixed team included 131 health care workers, with 7 of the 28 physicians (25.0%) from relevant specialties. Each physician managed 12-13 beds, with a 4-hour shift time.Non-specialists received short-term intensive training and then followed strict management protocols. Specialists practiced as normal.Main Outcomes and Measures Main outcome was in-hospital mortality of COVID-19 patients. Another outcome was rate of SARS-CoV-2 infection in health care workers.Results A total of 269 patients were included (144 male). In-hospital mortality rate of patients treated by the specialist teams and the mixed teams was 12.6% (20/159) and 12.7% (14/110) respectively (Difference = −0.1%, 95% CI −8.2% to 7.9%, p=.97). None of the health care workers were infected.Conclusions and Relevance Training and reployment of non-specialists is an effective solution for the shortage of health care workers in the COVID-19 pandemic.Key Points Question Was there difference in mortality rates between COVID-19 patients managed by a mixed team (including non-specialists who had short intensive training and operated to a strict protocol) and those managed by a specialist team of health care workers (HCWs)?Findings In-hospital mortality rate among patients managed by specialist team (130 HCWs, 159 patients) and mixed team (131 HCWs, 110 patients) was 12.6% (20/159) and 12.7% (14/110) respectively (Difference = −0.1%, 95% CI −8.2% to 7.9%, p=.97).Meaning With shortage of specialist HCWs, training and reployment of non-specialists is an effective option in the management of COVID-19 patients..
Medienart: |
Preprint |
---|
Erscheinungsjahr: |
2021 |
---|---|
Erschienen: |
2021 |
Enthalten in: |
bioRxiv.org - (2021) vom: 15. Jan. Zur Gesamtaufnahme - year:2021 |
---|
Sprache: |
Englisch |
---|
Beteiligte Personen: |
Kuang, Ming [VerfasserIn] |
---|
Links: |
Volltext [kostenfrei] |
---|
doi: |
10.1101/2020.07.17.20156117 |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
XBI018366880 |
---|
LEADER | 01000caa a22002652 4500 | ||
---|---|---|---|
001 | XBI018366880 | ||
003 | DE-627 | ||
005 | 20230429100022.0 | ||
007 | cr uuu---uuuuu | ||
008 | 200721s2021 xx |||||o 00| ||eng c | ||
024 | 7 | |a 10.1101/2020.07.17.20156117 |2 doi | |
035 | |a (DE-627)XBI018366880 | ||
035 | |a (DE-599)biorXiv10.1101/2020.07.17.20156117 | ||
035 | |a (biorXiv)10.1101/2020.07.17.20156117 | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
082 | 0 | |a 570 |q DE-84 | |
100 | 1 | |a Kuang, Ming |e verfasserin |4 aut | |
245 | 1 | 0 | |a Training and reployment of non-specialists is an effective solution for the shortage of health care workers in the COVID-19 pandemic |
264 | 1 | |c 2021 | |
336 | |a Text |b txt |2 rdacontent | ||
337 | |a Computermedien |b c |2 rdamedia | ||
338 | |a Online-Ressource |b cr |2 rdacarrier | ||
520 | |a Abstract Importance In the COVID-19 pandemic many countries encounter problems arising from shortage of specialists. Short intensive training and reployment of non-specialists is an option but the effectiveness is unknown.Objective To investigate whether there was difference in in-hospital mortality rates between COVID-19 patients managed by a mixed team (including non-specialists who had short intensive training and operated to a strict protocol) and those managed by a specialist team of health care workers.Design Cohort study, from January 26, 2020 to April 7, 2020, follow up to April 7, 2020.Setting Multicenter - Wuhan Hankou Hospital and Wuhan Xiehe Hospital, Wuhan, China.Participants 261 HCWs deployed to Wuhan from Guangdong emergency rescue team and the 269 COVID-19 patients they treated.Exposure Among 261 health care workers, 130 were in the specialist team and included 33 physicians, 32 of whom (97.0%) of whom were from relevant specialties. Each physician was in charge of 25-27 beds, with a 6-hour shift time. The mixed team included 131 health care workers, with 7 of the 28 physicians (25.0%) from relevant specialties. Each physician managed 12-13 beds, with a 4-hour shift time.Non-specialists received short-term intensive training and then followed strict management protocols. Specialists practiced as normal.Main Outcomes and Measures Main outcome was in-hospital mortality of COVID-19 patients. Another outcome was rate of SARS-CoV-2 infection in health care workers.Results A total of 269 patients were included (144 male). In-hospital mortality rate of patients treated by the specialist teams and the mixed teams was 12.6% (20/159) and 12.7% (14/110) respectively (Difference = −0.1%, 95% CI −8.2% to 7.9%, p=.97). None of the health care workers were infected.Conclusions and Relevance Training and reployment of non-specialists is an effective solution for the shortage of health care workers in the COVID-19 pandemic.Key Points Question Was there difference in mortality rates between COVID-19 patients managed by a mixed team (including non-specialists who had short intensive training and operated to a strict protocol) and those managed by a specialist team of health care workers (HCWs)?Findings In-hospital mortality rate among patients managed by specialist team (130 HCWs, 159 patients) and mixed team (131 HCWs, 110 patients) was 12.6% (20/159) and 12.7% (14/110) respectively (Difference = −0.1%, 95% CI −8.2% to 7.9%, p=.97).Meaning With shortage of specialist HCWs, training and reployment of non-specialists is an effective option in the management of COVID-19 patients. | ||
700 | 1 | |a Wu, Jianfeng |e verfasserin |4 aut | |
700 | 1 | |a Luo, Yifeng |e verfasserin |4 aut | |
700 | 1 | |a Xiao, Han |e verfasserin |4 aut | |
700 | 1 | |a Liang, Ruiming |e verfasserin |4 aut | |
700 | 1 | |a Hu, Wenjie |e verfasserin |4 aut | |
700 | 1 | |a Cheng, Shouzhen |e verfasserin |4 aut | |
700 | 1 | |a Zhou, Qian |e verfasserin |4 aut | |
700 | 1 | |a Peng, Sui |e verfasserin |4 aut | |
700 | 1 | |a Cheng, KarKeung |e verfasserin |4 aut | |
700 | 1 | |a Xiao, Haipeng |e verfasserin |4 aut | |
773 | 0 | 8 | |i Enthalten in |t bioRxiv.org |g (2021) vom: 15. Jan. |
773 | 1 | 8 | |g year:2021 |g day:15 |g month:01 |
856 | 4 | 0 | |u http://dx.doi.org/10.1101/2020.07.17.20156117 |z kostenfrei |3 Volltext |
912 | |a GBV_XBI | ||
912 | |a SSG-OLC-PHA | ||
951 | |a AR | ||
952 | |j 2021 |b 15 |c 01 | ||
953 | |2 045F |a 570 |