Welcome to the ESPNIC Xperience Programme Scheduling
The meeting will run on Central European Summer Time
CHAIRPERSON INTRODUCTION
CARDIAC MANIFESTATIONS IN COVID-19 DISEASE
THE PSYCHOLOGICAL IMPACT OF COVID-19 ON CRITICAL CARE STAFF AND COPING MECHANISMS USED
Abstract
Background and Aims
The current coronavirus 2019 pandemic placed ICU staff at increased risk of psychological distress. We assessed the degree of psychological distress and use of coping strategies by paediatric and adult ICU staff in the context of the current pandemic.
Methods
We conducted a cross-sectional, multicentre study consisting of online and written questionnaires among critical care staff across 4 hospitals. Outcome measures were the Trauma Screening Questionnaire, Brief COPE Inventory and selected components from Measure of Moral Distress for Healthcare Professionals.
Results
Overall response rate was 59% (N=408), including 17% (n=71) doctors, 67% (n=273) nurses and 8.5% (n=35) allied health professionals. 14% of participants scored at risk of PTSD with no difference between paediatric and adult ICU staff (p=0.80). Greater moral distress scores and use of maladaptive coping strategies were predictive of PTSD risk. Those working in paediatric ICU were significantly more stressed about redeployment (p=0.016) and treating patients outside their role (p=0.000). Working in adult ICU, greater exposure to patients with COVID-19, and redeployment to ICU were associated with higher moral distress scores (p<0.0002). Participants most feared passing coronavirus to family, becoming ill with coronavirus, and PPE shortages. Commonly used coping strategies were acceptance, positive reframing and self-distraction. Participants ranked departmental debriefs, peer-support and allocation to non-COVID-19 related duties as more useful than established psychological and counselling supports.
Conclusions
The COVID-19 pandemic has placed unprecedented stresses on the ICU community. A multifaceted approach is required, involving meeting basic needs with adequate resources and staffing, facilitating peer support, and actively promoting psychological resources and positive coping techniques.
COVID-19 AND TRANSMISSION PATTERN IN PEDIATRIC INTENSIVE CARE HEALTH CARE WORKERS: MULTI-CENTER STUDY
Abstract
Background and Aims
Following the massive increase in the number of COVID-19 patients, mortality and morbidity of healthcare workers (HCW) have steadily increased. In this study, we aimed to investigate HCW in pediatric intensive care units (PICU) with respect to their number, source of infection, clinical characteristics, treatment and loss of workdays.
Methods
Information on infected HCW in PICUs between March and November 2020 was collected through an online questionnaire. Retrospective cohort.
Results
There were 768 HCWs in 16 PICUs in the study. During this study period, 114 (14.8%) HCWs were infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV2)-CoV 2. Seventy-six patients were female, mean age of infected HCWs was 29.7±6.7 years. Sixty two infected HCWs were nurses, 39 were physicians, 13 were other HCWs. Comorbidity was present in 10.5% of the cases. Sixty-two HCWs were infected by PICU patients. Twenty four HCW in this group had being during performed endotracheal intubation, 11 had performed cardiopulmonary resuscitation (CPR), 10 had providing aerosol therapy, 14 had providing non-invasive ventilation (NIV) and 50 had performed different patient care procedures. Fifteen infected HCWs were admitted to intensive care units. Oxygen supplements supported all patients, five of HCWs via nasal cannula, seven of HCWs needed via a non-rebreathing mask, five of HCWs via nasal cannula (HFNC), five of HCWs via NIV, three of HCWs via invasive mechanical ventilation, respectively.
Conclusions
Infections with SARS-CoV 2 were more likely to occur with insufficient use of PPE during patient contact, negligence of masks in the workplace and lack of social distancing.
LEARNING FROM EXCELLENCE: IMPROVING STAFF MORALE, TEAM WORKING, AND PATIENT SAFETY IN A PAEDIATRIC UNIT FOLLOWING MASS STAFF REDEPLOYMENT DURING THE COVID-19 PANDEMIC.
Abstract
Background and Aims
Safety in health care is paramount to patient care, ‘learning from errors’ historically being the typical teaching model. A new model 1 aims to teach through everyday successes2 and has been shown to be effective to patient safety.3Gratitude towards staff increases morale and reduces burnout, pertinent in the current climate. Our aim implementing this project was to increase appreciation reports 80% over 6 months. 
Methods
Electronic submission methods (email, survey monkey, QR code) were added to complement existing hand-written reporting. Reports were collated and learning distributed to department via newsletter every month. Nominated individuals received certificates with their feedback within a week of reports being submitted. Multiple PDSA cycles have already happened including changing giving feedback as written cards to E-certificates, to make feedback more timely in keeping with evidence that this makes it more valuable.
Results
Report numbers increased significantly (>400%) following project implantation. Recipients consistently reported the experience as positive and morale boosting. Recipients also reported being more likely to submit their own reports, causing a positive spiral effect. Subjectively there is better communication and recognition of good work between and within teams.
Conclusions
Reporting excellence fosters conversation, positivity, and enables department-wide learning. During our project, appreciation reports have increased over 400% comparative to last year, partly due to implementation of easy-to-access electronic methods including QR codes allowing on-shift reporting. Response from report recipients has been positive and leads to onward nomination of other colleagues. A staff survey will be completed after 6 months to qualitatively assess responses to the project.
CHANGING TRENDS IN PICU ADMISSIONS BEFORE AND AFTER THE COVID-19 PANDEMIC
Abstract
Background and Aims
During the COVID-19 pandemic, admissions to paediatric intensive care units (PICU) have declined. The aim of this study is to describe and compare the admissions in a tertiary PICU one year before and after the COVID-19 outbreak.
Methods
Retrospective, observational study using a prospective registry to compare PICU admissions in the pre-COVID (March 2019 to February 2020) and the post-COVID period (March 2020 to February 2021). Clinical and demographic characteristics from both periods were collected.
Results
Admissions decreased from 354 in the pre-COVID to 296 in the post-COVID period. Patients in the post-COVID period were older with a median age of 3.13 (IQR 9.16) vs 2.15 years (IQR 8.21) (p=0.058). There were no differences in gender, PELOD or PMODS score. Respiratory causes of admission declined from 127 (35.87%) in the pre-COVID period to 63 (21.28%), p<0.001. Bronchiolitis decreased from 47 in the pre-COVID period (37.00%) to 9 (14.28%) (p<0.001). There was not any VRS admission in the post-COVID period (41 in the pre-COVID period, 32.20% of the respiratory admissions). Cardiac surgery admissions decreased from 98 (27.68%) to 76 (25.67%), p=0.594. Gastrointestinal/Hepatic causes of admission increased from 3/354 to 11/296 (p=0.014). No differences were found in the type of admission (medical, elective or urgent surgery).
Conclusions
Total PICU admissions decreased in the post-COVID period compared to pre-COVID. Respiratory admissions declined in the post-COVID period with a sharp fall in the number of bronchiolitis.