Background: Being at the frontline, nurses working in hospital settings are vulnerable to a range of experiences that impact their wellbeing. Measures to protect their health and welfare during the COVID-19 pandemic have been the focus of discussion among policymakers and administrators. There is a need to collectively understand their personal experiences to inform relevant policy decisions. Objective: To synthesize and present the best available evidence describing the experiences of nurses working in hospital settings during the COVID-19 pandemic. Design: This is a rapid review using Tricco's seven stage process. Data sources: A structured search using PubMed, CINAHL, Scopus, and a local database Herdin was conducted. Review Methods: A rapid review of studies published from January to August 2020, describing nurses' experiences of working in hospital facilities during the COVID-19 pandemic were included regardless of methodology. Following data screening and extraction, a narrative synthesis of the findings was conducted. Results: Nineteen articles were included in the review. The experiences of nurses described in these articles generated a total of fifteen categories, based on similarities of meaning. Four synthesized findings were identified from the categories: (a) supportive nursing culture; (b) physical, emotional, and psychological impact of frontline work; (c) organizational responsiveness; (d) and maintaining standards of care. Conclusions Nurses' experiences working in hospital settings during the COVID-19 pandemic are diverse, profound, and dependent on the context of practice and prevailing healthcare system and organization. These experiences reflect personal encounters and shifts in healthcare delivery that ensure protection and safety while maintaining standards of care. Robust studies are needed to capture and explore the breadth of these experiences and heighten the discussions that advocate for nurses' welfare and safety during pandemics.
COVID-19 ; Pandemics

Background: The COVID-19 pandemic has put an immense strain on health systems worldwide. Nurses at the front line are prone to experience several staffing issues facing ever-increasing stresses to the health care system by a pandemic situation. The staffing experiences of nurses in this context can have a significant impact on current nursing practice and existing policies. Objective: To carry out a synthesis of the scientific evidence available on the staffing experiences of nurses during the SARS, MERS, and Ebola epidemics. Method: A narrative review was conducted. A literature search was carried out in PubMed, Scopus, and CINAHL databases. All studies describing nurses' experiences were included regardless of methodology. Atotal of 16 articles was included in the review. Results: Narrative synthesis revealed ten themes from the results of the articles: training, staffing ratios and models, shifting models, volunteer staffing, skill mix, planning staffing needs, hospital preparedness, communication, effects of workload, and structured workflow processes. Conclusions Nurses are pivotal to the healthcare response to infectious disease pandemics and epidemics. The results of this review should provide a basis for nurse managers and administrators on how they can actively engage in supporting the staffing concerns and issues of nurses during the COVID-19 pandemic.
COVID-19 ; Pandemics

Introduction. The COVID-19 pandemic has not only resulted in a public health crisis but has also strained hospital services. The provision of surgical care should therefore also be guided by ethical, and whenever applicable, also legal, principles. Methods. An integrative approach that covers clinical and ethical dimensions, as well as spans the spectrum of surgical care, is therefore necessary. This action research involved three key steps: 1) identification of ethical dilemmas related to the provision of surgical care during the COVID-19 pandemic; 2) preparation of clinical scenarios that highlight these dilemmas; and 3) determination of the appropriate options for the said scenarios, based on the best available evidence as well as most applicable ethical principles. Results. Ethical theories included utilitarianism, human rights, and communitarianism. Ethical principles included non-maleficence, justice, autonomy, and beneficence. Values considered were duty, reciprocity, human life, efficiency, fairness, fidelity, ownership, social value, and fair innings. Also incorporated were informed consent, allocation principles, resource allocation, and triage. In terms of operational issues and surgical technical concerns, the following were considered: phased standards of care, categorization of interventions, prioritization, surgical approaches, infection control, diagnostics, patient welfare, staff welfare, operations protocols, surgical training, and communication. Key points derived from the ethical and technical considerations of surgical care delivery during the COVID-19 pandemic are presented. Conclusion. This action research involving a review of the literature and stakeholder engagement has provided a concise ethical and technical resource for surgical administrators, practitioners, and trainees.
COVID-19 ; Pandemics

Background: With the increasing number of COVID positive cases still being reported in the country, coupled with the possible vulnerability of pregnant patients to the disease, aggressive measures must be taken by all institutions to ensure safety of the patients. Objective: This study aimed to the determine the clinical profile and pregnancy outcome of patients who were admitted at a tertiary private hospital in Metro Manila from March 16, 2020 to June 15, 2020 in relation to the protocols that were implemented in response coronavirus disease 2019 pandemic. Methods: The protocols and guidelines implemented by the Department of Obstetrics and Gynecology of a private tertiary hospital in Metro Manila from March 16, 2020 to June 15, 2020 were retrieved. The case record of patients who were admitted and delivered during this period were retrieved and reviewed for pertinent data, which were recorded in a patient data collection form. Results: During the 3-month study period, COVID positive pregnant patients were effectively separated from COVID negative patients from admission to discharge based on a health declaration form and universal reverse transcriptase polymerized chain reaction (RT-PCR) testing. Discharge was facilitated after 12–48 h for uncomplicated deliveries and post partum follow-up was done via telemedicine. Conclusion The separation of COVID positive from COVID negative patients based on symptoms and RT-PCR results were effective in ensuring the safety of patients.
COVID‑19 ; Pandemics ; Quarantine

Introduction: The emergence of the COVID‑19 pandemic has left the vulnerable members of the society at risk, most especially pregnant women. This event has caused anxieties on their pregnancy journey. Their main concerns are the effects and transmissibility of the infection to them and to their unborn child. COVID‑19 significantly affects their mental health status Objectives: The purpose of this study is to determine the fears, perceptions, and common concerns of pregnant women during COVID‑19 in a tertiary hospital in Manila Materials and Methods: This is a prospective, cross‑sectional study design that uses a pretested and validated questionnaire, which directly asks about the fears, perceptions, and common concerns on COVID‑19 among pregnant women. The survey proper was conducted among singleton, term pregnant women aged 18 year old and above Results: The analysis included 313 respondents with a mean (± standard deviation) age of 31 ± 6 years. The three most common fears relayed by the pregnant women were (1) losing their babies if they get COVID‑19 (67.41%); (2) dying if they get the infection (58.79%); and (3) getting a positive test result for COVID‑19 (54.95%). Most of these patients (99.04%) were aware of the changes on their prenatal consultation and health care services. Majority of the participants (53.35%) raised their concerns on the in utero transmission of the virus and nosocomial COVID infection on their newborn from the hospital personnel (42.81%). Conclusions This study showed that fear is a common emotion among pregnant women. With the emergence of the COVID‑19 pandemic, it exacerbated their fears and raised concerns on the harmful effects that may bring on their well‑being and on their unborn child. This pandemic had caused a significant impact on their mental health
COVID‑19 ; Pandemics

Humans ; COVID-19 ; Pandemics

Introduction. The COVID-19 pandemic presented an extraordinary challenge to the operations of private hospitals involved in neurological residency training. Numerous adaptations were made to restructure the hospital, including the special units and diagnostic centers. Teaching and training activities were swiftly transitioned to online platforms and research activities were streamlined. Manpower allocation into teams with active duties followed by mandatory quarantine periods became the norm.

Objective. To evaluate the effect of the COVID-19 pandemic on the neurology training program by comparing two periods: pre-pandemic and pandemic periods.

Methods. We reviewed the changes implemented by the hospital in response to the pandemic. We also looked into our residency training program pre-pandemic and the subsequent changes instituted to adapt to the pandemic.

Results. Due to the community quarantine imposed by the government, there was a drastic drop by as much as 70.5% in the out-patient census, 38.4% in the in-patient census, and 46.9% in neurodiagnostic (electroencephalography and electrodiagnostic medicine). The residents were reorganized into three teams of 4 residents, further divided into COVID and non-COVID rotations for 5 days straight duty. Consultants were also stratified into high-risk (on-call for emergency referrals in a work-from-home scheme) and non-high-risk (COVID patient rounds). Teleconsultation was likewise utilized. Academic activities were shifted to blended online learning.

Conclusion. There was a need to reorganize resident staffing brought about by the hospital changes as well, to ensure safety during the pandemic. The pandemic has forced us to shift to alternative methods of teaching and examination, such as teleneurology. Regular assessments and adjustments to the training program will need to be done to adapt to an evolving situation.

Objective: To present a case of a 37-year-old man presenting with craniofacial impalement injury from a screwdriver that happened during the early stages of the COVID-19 pandemic. Methods: Design: Case Report. Setting: Tertiary Government Training Hospital. Patient: One. Results: During the early stages of COVID-19 pandemic a 37-year-old man was brought to the emergency room with a screwdriver embedded in his right eye. A multidisciplinary team observing available recommendations (level IV PPE, carefully planned operative directives) successfully performed endoscopic endonasal transsphenoidal surgery with application of a nasoseptal Hadad flap and abdominal fat obliteration. Aside from medial gaze limitations of the right eye, there was no CSF leak or rhinorrhea and no neurologic sequelae on follow up. Conclusion Endoscopic skull base surgery for such an impalement injury as this is a formidable multidisciplinary challenge, even in normal times. The early stages of the COVID-19 pandemic presented additional challenges. Observing evolving guidelines minimized the high risk of exposure for health care workers while maximizing care for the patient.
COVID-19 ; Pandemics

Objective: To describe the use of commercially available, non-medical grade USB cameras in a non-contact examination of simple cases involving the ears, nose and oral cavity of patients during the COVID-19 pandemic Methods: Design: Instrument innovation. Setting: Tertiary Government Training Hospital. Participants: Patients who consulted at the ENT-HNS outpatient department during the COVID-19 pandemic. Results: Commercially available USB cameras were able to provide basic visualization of the ears, nose and oral cavity. The non-medical grade USB cameras captured lower quality images when compared to the medical grade endoscopes but provided enough visualization to aid in the examination and diagnosis of simple cases. There was a learning curve in using the set-up but patients were able to adjust well, taking an average time of 2.7 minutes to complete the examination. Conclusion Non-medical grade USB cameras may play a role in aiding otolaryngologists in examining simple cases during the COVID-19 pandemic. Integration of this system into current examination practices may offer an extra layer of protection for otolaryngologists and patients alike. However, the use of these instruments as part of regular ENT practice may be controversial and will need further study.
COVID-19 ; Pandemics ; Outpatients

Background: The COVID-19 pandemic has caused a global public health emergency. High levels of fear and limited access to cancer treatment may jeopardize the delivery of optimal oncologic care, potentially influencing treatment outcomes. This study aimed to identify patients’ and their caregivers’ perception of safety and accessibility of cancer care during the COVID-19 pandemic. Methods: A cross-sectional survey of patients and caregivers at the Benavides Cancer Institute, University of Santo Tomas Hospital was performed from August to October 2020 using a 20-item investigator-developed questionnaire. Results: A total of 207 participants answered the survey. Frequency of hospital visits varied from none to more than ten times in the previous month; but having multiple postponements were uncommon. Eighty-two percent, 77%, 62%, and 55% of participants reported being afraid of contracting COVID-19 from other patients, hospital surroundings, hospital staff, and doctors, respectively. Twenty-six percent and 12% had difficulty finding transportation and passing through checkpoints, respectively. Twenty-eight percent strongly expressed financial limitations in prioritizing cancer care. Participants were amenable to the use of telemedicine and stringent protocols to reduce in-hospital transmission risk, but had some reluctance to spend out of their pockets for screening tests. Conclusion The perceived safety of cancer care was influenced by fears of contracting COVID-19; and accessibility was influenced by limited transportation and financial constraints. Despite these, multiple postponements and cancelled hospital visits were uncommon. Institutional approaches targeting these concerns will be crucial to ensure safe and timely delivery of cancer care during the COVID-19 pandemic and further mitigate its impact on oncologic outcomes.
COVID-19 ; Pandemics ; Safety