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Article ; Online: The impact of maternity service restrictions related to COVID-19 on women's experiences of giving birth in England: A qualitative study.

Irvine, Lucy C / Chisnall, Georgia / Vindrola-Padros, Cecilia

2023 Volume 128, Page(s) 103887

Abstract: Background: The COVID-19 pandemic led to significant changes in maternity service delivery in England, including: antenatal appointments being cancelled or held by phone; women having to attend antenatal scans alone; partners not being allowed to ... ...

Abstract	Background: The COVID-19 pandemic led to significant changes in maternity service delivery in England, including: antenatal appointments being cancelled or held by phone; women having to attend antenatal scans alone; partners not being allowed to accompany women during labor; visitor restrictions on postnatal wards; and limited postnatal support. Methods: We conducted semi-structured interviews with 46 women aged 18-45 who had low-risk pregnancies and gave birth to their babies using NHS services in England between 1st March 2020 and 1st March 2021. Results: Our thematic analysis of interview data generated key themes: profound negative impacts of birth partners not being allowed to accompany women (including on emotional wellbeing, birth preferences and care-seeking choices); deep frustration about policy variation between trusts and inconsistent implementation of guidance; women being more concerned about the risk of giving birth alone than of COVID-19 infection; and women turning towards private care or delaying seeking NHS care so that they could have the birth experience they desired. The latter two results are, to the best of our knowledge, unique to this paper. Conclusion: Our participants reported significant negative affects to their emotional and physical wellbeing because of maternity service restrictions. Going forward, efforts are required by policymakers and health service providers to re-establish trust in NHS maternity care and ensure capacity to provide for potential shifts in birthplace preferences. Health systems strengthening efforts should prioritise protecting the rights of women to access high quality, person-centred care in the event of future health emergencies that strain NHS capacity.
MeSH term(s)	Pregnancy ; Female ; Humans ; Pandemics ; Maternal Health Services ; COVID-19 ; England ; Qualitative Research ; Labor, Obstetric
Language	English
Publishing date	2023-11-20
Publishing country	Scotland
Document type	Journal Article
ZDB-ID	1036567-9
ISSN	1532-3099 ; 0266-6138
ISSN (online)	1532-3099
ISSN	0266-6138
DOI	10.1016/j.midw.2023.103887
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Article ; Online: Accessing health information during the COVID-19 pandemic: the experience of NHS maternity service users.

Ambihaipahan, Rushvini / Chisnall, Georgia / Vindrola-Padros, Cecilia / Irvine, Lucy

BMC pregnancy and childbirth

2023 Volume 23, Issue 1, Page(s) 851

Abstract: Background: The COVID-19 pandemic caused various disruptions to NHS maternity services in England. Changes were made to antenatal and postnatal care and the way that information was shared with maternity service users during these times. Fewer face-to- ... ...

Abstract	Background: The COVID-19 pandemic caused various disruptions to NHS maternity services in England. Changes were made to antenatal and postnatal care and the way that information was shared with maternity service users during these times. Fewer face-to-face appointments, increased virtual appointments and changes in guidance about the suitability of the COVID-19 vaccine without appropriate information sharing and evidence caused concern. Methods: This study took a blended inductive-deductive approach to secondary data analysis using a population subset of 16 from a wider study that sought to understand the impact of COVID-19 on maternity services in England. Participants of this study were aged 28-44 and gave birth using NHS maternity services in England. The data were collected and coded using Rapid Analysis Procedure sheets, which generated key themes, which are used here to structure the results. Results: Four main themes were generated from the analysis: 1) service restrictions to antenatal and postnatal appointments 2) access to information and changes to antenatal and postnatal care 3) inconsistencies in the implementation of government and NHS policy and 4) limited information about COVID-19 vaccine provided by NHS trusts and hesitancy in vaccine acceptance. Conclusion: Participants experienced poor communication that affected their understanding of maternity service changes and there was limited general and maternal health information provided. Vaccine information was also inadequate, and participants expressed a desire for clearer guidance. The UK Government, Royal College of Obstetricians and Gynaecologists, and NHS must collaborate with maternity service users to ensure that there are evidence-based guidelines and policies that can be understood and standardised across all NHS maternity trusts.
MeSH term(s)	Pregnancy ; Female ; Humans ; State Medicine ; COVID-19 Vaccines ; Pandemics/prevention & control ; COVID-19/prevention & control ; England/epidemiology ; Maternal Health Services
Chemical Substances	COVID-19 Vaccines
Language	English
Publishing date	2023-12-11
Publishing country	England
Document type	Journal Article
ZDB-ID	2059869-5
ISSN	1471-2393 ; 1471-2393
ISSN (online)	1471-2393
ISSN	1471-2393
DOI	10.1186/s12884-023-06160-w
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Article ; Online: A systematic review of de-escalation strategies for redeployed staff and repurposed facilities in COVID-19 intensive care units (ICUs) during the pandemic.

Clark, Sigrún Eyrúnardóttir / Chisnall, Georgia / Vindrola-Padros, Cecilia

EClinicalMedicine

2022 Volume 44, Page(s) 101286

Abstract: Background: Intensive care units (ICUs) experienced a surge in patient cases during the COVID-19 pandemic. Demand was managed by redeploying healthcare workers (HCWs) and restructuring facilities. The rate of ICU admissions has subsided in many regions, ...

Abstract	Background: Intensive care units (ICUs) experienced a surge in patient cases during the COVID-19 pandemic. Demand was managed by redeploying healthcare workers (HCWs) and restructuring facilities. The rate of ICU admissions has subsided in many regions, with the redeployed workforce and facilities returning to usual functions. Previous literature has focused on the escalation of ICUs, limited research exists on de-escalation. This study aimed to identify the supportive and operational strategies used for the flexible de-escalation of ICUs in the context of COVID-19. Methods: The systematic review was developed by searching eight databases in April and November 2021. Papers discussing the return of redeployed staff and facilities and the training, wellbeing, and operational strategies were included. Excluded papers were non-English and unrelated to ICU de-escalation. Quality was assessed using the mixed methods appraisal tool (MMAT) and authority, accuracy, coverage, objectivity, date, and significance (AACODS) checklist, findings were developed using narrative synthesis and thematic analysis. Findings: Fifteen papers were included from six countries covering wellbeing and training themes encompassing; time off, psychological follow-up, gratitude, identification of training needs, missed training catch-up, and continuation of ICU and disaster management training. Operational themes included management of rotas, retainment of staff, division of ICU facilities, leadership changes, traffic light systems, and preparation for re-expansion. Interpretation: The review provided an overview of the landscape of de-escalation strategies that have taken place in six countries. Limited empirical evidence was available that evaluated the effectiveness of such strategies. Empirical and evaluative research from a larger array of countries is needed to be able to make global recommendations on ICU de-escalation practices.
Language	English
Publishing date	2022-02-07
Publishing country	England
Document type	Journal Article ; Review
ISSN	2589-5370
ISSN (online)	2589-5370
DOI	10.1016/j.eclinm.2022.101286
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Article ; Online: A new neonatal BCG vaccination pathway in England: a mixed methods evaluation of its implementation.

Jones, Koren / Chisnall, Georgia / Crocker-Buque, Tim / Elliman, David / Horwood, Jeremy / Mounier-Jack, Sandra / Campbell, Colin Nj / Saliba, Vanessa / Chantler, Tracey

BMC public health

2024 Volume 24, Issue 1, Page(s) 1175

Abstract: Introduction: The introduction of a national evaluation of newborn screening for Severe Combined Immunodeficiency (SCID) in England triggered a change to the selective Bacillus Calmette-Guerin (BCG) vaccination programme delivery pathway, as this live ... ...

Abstract	Introduction: The introduction of a national evaluation of newborn screening for Severe Combined Immunodeficiency (SCID) in England triggered a change to the selective Bacillus Calmette-Guerin (BCG) vaccination programme delivery pathway, as this live attenuated vaccine is contraindicated in infants with SCID. The neonatal BCG vaccination programme is a targeted programme for infants at increased risk of tuberculosis and used to be offered shortly after birth. Since September 2021 the BCG vaccine is given to eligible infants within 28 days of birth, when the SCID screening outcome is available. We explore the experiences of those implementing the new pathway, and how they made sense of, engaged with, and appraised the change. Methods: A mixed-methods evaluation was conducted between October 2022 and February 2023. This involved national online surveys with BCG commissioners and providers and qualitative semi-structured interviews with commissioners, providers, and Child Health Information System stakeholders in two urban areas. Survey data was analysed using descriptive statistics and interview data was analysed thematically. The data was triangulated using Normalization Process Theory as a guiding framework. Results: Survey respondents (n = 65) and qualitative interviewees (n = 16) revealed that making sense of the new pathway was an iterative process. Some expressed a desire for more direction on how to implement the new pathway. The perceived value of the change varied from positive, ambivalent, to concerned. Some felt well-prepared and that improvements to data capture, eligibility screening, and accountably brought by the change were valuable. Others were concerned about the feasibility of the 28-day target, reductions in vaccination coverage, increased resource burden, and the outcome of the SCID evaluation. New collaborations and communities of practice were required to facilitate the change. Three main challenges in implementing the pathway and meeting the 28-day vaccination target were identified: appointment non-attendance; appointment and data systems; and staffing and resourcing. Feedback mechanisms were informal and took place in tandem with implementation. Conclusion: The new NHS neonatal BCG service specification has created an effective structure for monitoring and managing the BCG vaccination programme, but further work is required to support delivery of the 28-day vaccination target and improve uptake rates.
MeSH term(s)	Humans ; BCG Vaccine/administration & dosage ; England ; Infant, Newborn ; Immunization Programs ; Severe Combined Immunodeficiency ; Tuberculosis/prevention & control ; Qualitative Research ; Program Evaluation ; Surveys and Questionnaires ; Neonatal Screening
Chemical Substances	BCG Vaccine
Language	English
Publishing date	2024-04-26
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2041338-5
ISSN	1471-2458 ; 1471-2458
ISSN (online)	1471-2458
ISSN	1471-2458
DOI	10.1186/s12889-024-18586-8
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Training and redeployment of healthcare workers to intensive care units (ICUs) during the COVID-19 pandemic: a systematic review.

Vera San Juan, Norha / Clark, Sigrún Eyrúnardóttir / Camilleri, Matthew / Jeans, John Paul / Monkhouse, Alexandra / Chisnall, Georgia / Vindrola-Padros, Cecilia

BMJ open

2022 Volume 12, Issue 1, Page(s) e050038

Abstract: Objectives: The rapid influx of patients with COVID-19 to intensive care at a rate that exceeds pre-existing staff capacity has required the rapid development of innovative redeployment and training strategies, which considered patient care and ... ...

Abstract	Objectives: The rapid influx of patients with COVID-19 to intensive care at a rate that exceeds pre-existing staff capacity has required the rapid development of innovative redeployment and training strategies, which considered patient care and infection control. The aim of this study was to provide a detailed understanding of redeployment and training during the first year of the COVID-19 pandemic by capturing and considering the merit of the strategies enlisted and the experiences and needs of redeployed healthcare workers (HCWs). Design: The review involved a systematic search of key terms related to intensive care AND training AND redeployment AND healthcare workers within nine databases (Medline, CINAHL, PsychINFO, MedRxiv, Web of Science, The Health Management Consortium database, Social Science Research Network, OpenGrey and TRIP), which took place on 16 July 2021. Analysis consisted of a synthesis of quantitative study outputs and framework-based thematic analysis of qualitative study outputs and grey literature. These results were then combined applying an interpretative synthesis. We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses, and the review protocol was available online. Results: Forty papers were analysed. These took place primarily in the UK (n=15, 37.5%) and USA (n=17, 42.5%). Themes presented in the results are Conclusions: The COVID-19 pandemic presents unique challenges to develop flexible redeployment strategies and deliver training promptly while following infection control recommendations. This review synthesises original approaches to tackle these challenges, which are relevant to inform the development of targeted and adaptative training and redeployment plans considering the needs of HCWs.
MeSH term(s)	COVID-19 ; Health Personnel ; Humans ; Intensive Care Units ; Pandemics ; SARS-CoV-2
Language	English
Publishing date	2022-01-07
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Systematic Review
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2021-050038
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Article ; Online: Global changes to the chemotherapy service during the covid-19 pandemic.

Chow, Man-Chie / Chambers, Pinkie / Singleton, Georgina / Patel, Jignesh / Cooper, Silvie / Mythen, Charlotte / Bautista-González, Elysse / Chisnall, Georgia / Djellouli, Nehla / Thwaites, Benjamin / Wong, Ian Ck / Vindrola-Padros, Cecilia

Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners

2021 Volume 27, Issue 5, Page(s) 1073–1079

Abstract: Purpose: In response to the COVID-19 pandemic, changes to chemotherapy services were implemented as a means of managing imposed workload strains within health services and protecting patients from contracting COVID-19. Given the rapidly evolving nature ... ...

Abstract	Purpose: In response to the COVID-19 pandemic, changes to chemotherapy services were implemented as a means of managing imposed workload strains within health services and protecting patients from contracting COVID-19. Given the rapidly evolving nature of the pandemic many changes were rapidly adopted and were not substantiated by robust evidence. This study aimed to describe the changes adopted internationally to chemotherapy services, which may be used to guide future changes to treatment delivery. Methods: A survey was developed to understand the impact of COVID-19 on the delivery of systemic anti-cancer therapies (SACT). It comprised 22 questions and examined the strategies implemented during the pandemic to prioritise and protect patients receiving SACT and the participants' professional opinion of the strategies employed. The survey was available in English, Spanish and French and was distributed via professional bodies. Results: 129 responses were obtained from healthcare professionals working across 17 different countries. 45% of institutions had to implement treatment prioritisation strategies and all hospitals implemented changes in the delivery of treatment, including: reduction in treatments (69%), using less immunosuppressive agents (50%), allowing treatment breaks (14%) and switching to oral therapies (45%). Virtual clinic visits were perceived by participants as the most effective strategy to protect patients. Conclusions: The pandemic has forced chemotherapy healthcare professionals to adopt new ways of working by reducing health interactions. Many areas of research are needed following this period, including understanding patients' perceptions of risks to treatment, utilisation of oral treatments and the impact of treatment breaks on cancer outcomes.
MeSH term(s)	Antineoplastic Agents/administration & dosage ; COVID-19 ; Health Personnel/organization & administration ; Humans ; Neoplasms/drug therapy ; Surveys and Questionnaires ; Workload
Chemical Substances	Antineoplastic Agents
Language	English
Publishing date	2021-05-13
Publishing country	England
Document type	Journal Article
ZDB-ID	1330764-2
ISSN	1477-092X ; 1078-1552
ISSN (online)	1477-092X
ISSN	1078-1552
DOI	10.1177/10781552211015767
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Article ; Online: Redeployment and training of healthcare professionals to Intensive Care during COVID-19: a systemic review

Vera San Juan, Norha / Camilleri, Matthew / Jeans, John Paul / Monkhouse, Alexandra / Chisnall, Georgia / Vindrola-Padros, Cecilia

medRxiv

Abstract: Background: A rapid influx of patients to intensive care and infection control measures during the COVID-19 pandemic required the rapid development of innovative redeployment and training strategies. Methods: We conducted a systematic search of 9 ... ...

Abstract	Background: A rapid influx of patients to intensive care and infection control measures during the COVID-19 pandemic required the rapid development of innovative redeployment and training strategies. Methods: We conducted a systematic search of 9 databases including key terms related to intensive care AND training AND redeployment AND healthcare workers. Analysis consisted of a narrative synthesis of quantitative study outputs, and a framework-based thematic analysis of qualitative study outputs and grey literature. These results were then combined applying an interpretative synthesis. Results: Twenty papers were analysed. These took place primarily in the UK (N=8, 40%) and USA (N=5, 25%). Themes included in the results are Redeployment: Implementation strategies and learnings; Redeployed staff experience and strategies to address their needs; Redeployed staff learning needs; Training formats offered and training evaluations; and Future redeployment and training concerns. Some of the redeployment implementation and training strategies documented in this review are: Skills-based redeployment, buddy support systems, and agreeing on locally-specific principles, rather than strict procedures. Conclusion: The COVID-19 pandemic presented unique challenges to deliver training promptly while following infection control recommendations and develop flexible redeployment strategies. This study synthesises original approaches to tackle these challenges which are relevant to inform the development of targeted and adaptative training and redeployment plans.
Keywords	covid19
Language	English
Publishing date	2021-01-22
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2021.01.21.21250230
Database	COVID19

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Article: Carrying Out Rapid Qualitative Research During a Pandemic: Emerging Lessons From COVID-19.

Vindrola-Padros, Cecilia / Chisnall, Georgia / Cooper, Silvie / Dowrick, Anna / Djellouli, Nehla / Symmons, Sophie Mulcahy / Martin, Sam / Singleton, Georgina / Vanderslott, Samantha / Vera, Norha / Johnson, Ginger A

Qualitative health research

2020 Volume 30, Issue 14, Page(s) 2192–2204

Abstract: Social scientists have a robust history of contributing to better understandings of and responses to disease outbreaks. The implementation of qualitative research in the context of infectious epidemics, however, continues to lag behind in the delivery, ... ...

Abstract	Social scientists have a robust history of contributing to better understandings of and responses to disease outbreaks. The implementation of qualitative research in the context of infectious epidemics, however, continues to lag behind in the delivery, credibility, and timeliness of findings when compared with other research designs. The purpose of this article is to reflect on our experience of carrying out three research studies (a rapid appraisal, a qualitative study based on interviews, and a mixed-methods survey) aimed at exploring health care delivery in the context of COVID-19. We highlight the importance of qualitative data to inform evidence-based public health responses and provide a way forward to global research teams who wish to implement similar rapid qualitative studies. We reflect on the challenges of setting up research teams, obtaining ethical approval, collecting and analyzing data in real-time and sharing actionable findings.
MeSH term(s)	Betacoronavirus ; COVID-19 ; Coronavirus Infections/epidemiology ; Data Accuracy ; Humans ; Newspapers as Topic/statistics & numerical data ; Pandemics ; Pneumonia, Viral/epidemiology ; Public Health ; Qualitative Research ; Research Design ; SARS-CoV-2 ; Social Media/statistics & numerical data ; Time Factors
Keywords	covid19
Language	English
Publishing date	2020-08-31
Publishing country	United States
Document type	Journal Article
ZDB-ID	1275716-0
ISSN	1552-7557 ; 1049-7323
ISSN (online)	1552-7557
ISSN	1049-7323
DOI	10.1177/1049732320951526
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Article ; Online: Carrying Out Rapid Qualitative Research During a Pandemic

Qualitative Health Research

Emerging Lessons From COVID-19

2020 Volume 30, Issue 14, Page(s) 2192–2204

Abstract	Social scientists have a robust history of contributing to better understandings of and responses to disease outbreaks. The implementation of qualitative research in the context of infectious epidemics, however, continues to lag behind in the delivery, credibility, and timeliness of findings when compared with other research designs. The purpose of this article is to reflect on our experience of carrying out three research studies (a rapid appraisal, a qualitative study based on interviews, and a mixed-methods survey) aimed at exploring health care delivery in the context of COVID-19. We highlight the importance of qualitative data to inform evidence-based public health responses and provide a way forward to global research teams who wish to implement similar rapid qualitative studies. We reflect on the challenges of setting up research teams, obtaining ethical approval, collecting and analyzing data in real-time and sharing actionable findings.
Keywords	Public Health, Environmental and Occupational Health ; covid19
Language	English
Publisher	SAGE Publications
Publishing country	us
Document type	Article ; Online
ZDB-ID	1275716-0
ISSN	1552-7557 ; 1049-7323
ISSN (online)	1552-7557
ISSN	1049-7323
DOI	10.1177/1049732320951526
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Carrying Out Rapid Qualitative Research During a Pandemic: Emerging Lessons From COVID-19

Qual Health Res

Abstract	Social scientists have a robust history of contributing to better understandings of and responses to disease outbreaks. The implementation of qualitative research in the context of infectious epidemics, however, continues to lag behind in the delivery, credibility, and timeliness of findings when compared with other research designs. The purpose of this article is to reflect on our experience of carrying out three research studies (a rapid appraisal, a qualitative study based on interviews, and a mixed-methods survey) aimed at exploring health care delivery in the context of COVID-19. We highlight the importance of qualitative data to inform evidence-based public health responses and provide a way forward to global research teams who wish to implement similar rapid qualitative studies. We reflect on the challenges of setting up research teams, obtaining ethical approval, collecting and analyzing data in real-time and sharing actionable findings.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #736334
Database	COVID19

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