Practical Applicability of Teledentistry in Pediatric Patients Amidst Pandemic : A Narrative Review

The coronavirus disease-2019 (COVID-19) pandemic has imposed a situation where all healthcare facilities except emergency services remain suspended. These times generated the necessity for the implementation of a healthcare delivery system that can be accessed digitally and, thus, benefit the majority of children as well as healthcare professionals. This review aims to propose a sound model of less technique sensitive, safe and handy strategies for dental traumatic injuries, endodontic and restorative concerns, and orthodontic urgencies until complete clinical help can be sought. Five hundred thirty articles were obtained from the PubMed, Google Scholar, Embase, Lilacs, and Cochrane databases published from 2011 to 2021. Nineteen articles that described teledentistry in the COVID-19 era were included. Teledentistry can serve as a vital patient management strategy that can aid in triaging urgent and elective patient treatment needs, ultimately easing the burden of clinics and at the same time providing a safer means of consultation.

423 Patient Perspective on the Use of the Independent Sector to Maintain Elective NHS Services During the COVID-19 Pandemic

Introduction COVID-19 resulted in the suspension of planned treatments for patients worldwide leaving millions suffering the physical and mental effects of delay. Reports indicate that when services have been re-established, patients have been afraid to take up appointments. Hospitals put processes in place to counter this, notably separating emergency and elective patient cohorts. Most notably seen by the co-operation between the NHS and independent private healthcare providers in March 2020 at the height of the pandemic. We undertook a study to ascertain the perceptions of NHS patients who underwent elective treatment at independent ‘cold’ sites during the COVID-19 pandemic. Method A cross-sectional study with structured telephone interviews of patients who had planned elective treatments at ‘cold’ independent hospitals between March and September 2020. 1150 patients were identified, and a 20% sample formed a 230 patient study group, with 158 (70%) agreeing to participate. Results 30% of patients delayed their treatment due to COVID related concerns, with 76% of these only accepting treatment because this was at a ‘cold’ site. 46% of patients perceived treatment at a ‘cold’ site as the most important factor contributing to their safety. 153 patients (97%) supported the paid arrangement between the NHS and the independent sector to provide separate ‘cold’ sites for elective treatments. Discussion Safely restarting elective services to allow important planned treatments to take place, as was the pandemic continues, is a priority. Our study indicates that physical separation of patient pathways impacted most on patient confidence, and that the use of ‘cold’ sites is a viable option.

416 Prospective Multicentre Study of Impact of COVID-19 on Colorectal Cancer Resections

Introduction COVID-19 pandemic has posed a major challenge to healthcare systems globally. In NHS, around 36,000 cancer operations have been estimated to be cancelled during the peak time alone. This regional study evaluated the risk of COVID-19 in patients undergoing surgery for colorectal cancer during the peak time. Method This prospective multicentre observational study conducted in four busy district hospitals included 52 patients with colorectal cancer who underwent surgery during the COVID lockdown period (23rd March to 5th May). PCR swab testing was used to detect COVID. Data was collected from patient notes, MDT files and pathology results. Results 73% (38/52) underwent elective procedures, 90% with curative intent. Overall, mean (SD) age was 70 (12.2) years, 50% were female. 60% (32/52) had left sided cancers and a total of 48% (25/52) patients had stage 3 or above. 27% (14/52) had post-operative complications, with 4% (2/52) being Grade 3 Clavien-Dindo. Total mortality was 6% (3/52) of which 1 was elective patient. Only one patient developed COVID infection during the inpatient stay. Conclusions Data suggests, local policies to prevent COVID spread have been effective. Local lockdown in case of second peak may be a reasonable option. Improvement in COVID testing could have major impact on outcomes.

Enhanced recovery after surgery (ERAS): a literature review of implications for ostomates and stoma care nurses

This article explores the rationale behind enhanced recovery after surgery (ERAS), and the implications for both patients and stoma care nurses (SCNs). ERAS is used for many elective patient surgical pathways worldwide. The aim is to reduce hospital stay, maximise patient outcomes and minimise complications, with the added benefit of reducing cost for the hospital service provider. The literature demonstrates that centres adhere to the various modalities of the ERAS pathway differently; however, the outcomes follow similar trends. The SCN plays a key role in the education of stoma patients on the ERAS pathway. With intensive pre- and postoperative training, the need for patient education in stoma self-care should not delay discharge. The SCN also needs to be easily accessible for patient support and review, preventing unnecessary readmission to hospital. When asked, patients are happy with their pathway and level of support received from the SCN.

Mortality and Morbidity in Elective Patient of Coronary Artery Bypass Graph at National Cardiovascular Center, Harapan Kita Hospital, Indonesia

This study is aimed to find out mortality and morbidity in the elective patients while waiting and description of waiting time in elective patients at The Department of cardiovascular surgery, Harapan Kita Hospital. This study research was using quantitative and qualitative design study. The quantitative data collected prospectively within two months from August until September 2010. From 58 patients, one patient died while waiting and one patient falls into stroke. There’s no adequate system in scheduling patient, including put the patient into the list of que, decide the urgency and remove the patients from the list. It’s known that morbidity and mortality are not found as a significant event happened while waiting for CABG in this study. It’s difficult to ignore the two patients, especially after knowing there’s no adequate system to decide wait time and schedule at The Department of cardiovascular surgery, Harapan Kita Hospital, while resources are still quite enough (facility and human resources) to accommodate all the cases.