Ciara Conlon1, Thérèse McDonnell1, Michael Barrett2, Fergal Cummins3, Conor Deasy4, Conor Hensey5, Eilish McAuliffe1, Emma Nicholson6. 1. UCD Centre for Interdisciplinary Research Education and Innovation in Health Systems, UCD School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland. 2. Children's Health Ireland at Crumlin, Dublin; Women's and Children's Health, School of Medicine, University College Dublin; National Children's Research Centre, Dublin, Ireland. 3. REDSPOT, Emergency Department, Limerick University Hospital, Limerick, Ireland. 4. Cork University Hospital, Cork, Ireland. 5. Children's Health Ireland at Temple Street, Dublin, Ireland. 6. UCD Centre for Interdisciplinary Research Education and Innovation in Health Systems, UCD School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland. emma.nicholson@ucd.ie.
Abstract
BACKGROUND: The COVID-19 pandemic and subsequent public health guidance to reduce the spread of the disease have wide-reaching implications for children's health and wellbeing. Furthermore, paediatric emergency departments (EDs) have rapidly adapted provision of care in response to the pandemic. This qualitative study utilized insight from multidisciplinary frontline staff to understand 1) the changes in paediatric emergency healthcare utilization during COVID-19 2) the experiences of working within the restructured health system. METHODS: Fifteen semi-structured interviews were conducted with frontline staff working in two paediatric EDs and two mixed adult and children EDs. Participants included emergency medicine clinicians (n = 5), nursing managerial staff (n = 6), social workers (n = 2) and nursing staff (n = 2). Thematic Analysis (TA) was applied to the data to identify key themes. RESULTS: The pandemic and public health restrictions have had an adverse impact on children's health and psychosocial wellbeing, compounded by difficulty in accessing primary and community services. The impact may have been more acute for children with disabilities and chronic health conditions and has raised child protection issues for vulnerable children. EDs have shown innovation and agility in the structural and operational changes they have implemented to continue to deliver care to children, however resource limitations and other challenges must be addressed to ensure high quality care delivery and protect the wellbeing of those tasked with delivering this care. CONCLUSIONS: The spread of COVID-19 and subsequent policies to address the pandemic has had wide-reaching implications for children's health and wellbeing. The interruption to health and social care services is manifesting in myriad ways in the ED, such as a rise in psychosocial presentations. As the pandemic continues to progress, policy makers and service providers must ensure the continued provision of essential health and social services, including targeted responses for those with existing conditions.
BACKGROUND: The COVID-19 pandemic and subsequent public health guidance to reduce the spread of the disease have wide-reaching implications for children's health and wellbeing. Furthermore, paediatric emergency departments (EDs) have rapidly adapted provision of care in response to the pandemic. This qualitative study utilized insight from multidisciplinary frontline staff to understand 1) the changes in paediatric emergency healthcare utilization during COVID-19 2) the experiences of working within the restructured health system. METHODS: Fifteen semi-structured interviews were conducted with frontline staff working in two paediatric EDs and two mixed adult and children EDs. Participants included emergency medicine clinicians (n = 5), nursing managerial staff (n = 6), social workers (n = 2) and nursing staff (n = 2). Thematic Analysis (TA) was applied to the data to identify key themes. RESULTS: The pandemic and public health restrictions have had an adverse impact on children's health and psychosocial wellbeing, compounded by difficulty in accessing primary and community services. The impact may have been more acute for children with disabilities and chronic health conditions and has raised child protection issues for vulnerable children. EDs have shown innovation and agility in the structural and operational changes they have implemented to continue to deliver care to children, however resource limitations and other challenges must be addressed to ensure high quality care delivery and protect the wellbeing of those tasked with delivering this care. CONCLUSIONS: The spread of COVID-19 and subsequent policies to address the pandemic has had wide-reaching implications for children's health and wellbeing. The interruption to health and social care services is manifesting in myriad ways in the ED, such as a rise in psychosocial presentations. As the pandemic continues to progress, policy makers and service providers must ensure the continued provision of essential health and social services, including targeted responses for those with existing conditions.
Entities:
Keywords:
COVID-19; Paediatric emergency medicine, psychosocial, mental health; Public health restrictions
Authors: Thérèse McDonnell; Emma Nicholson; Ciara Conlon; Michael Barrett; Fergal Cummins; Conor Hensey; Eilish McAuliffe Journal: Int J Environ Res Public Health Date: 2020-09-15 Impact factor: 3.390
Authors: Emma Nicholson; Thérèse McDonnell; Ciara Conlon; Michael Barrett; Fergal Cummins; Conor Hensey; Eilish McAuliffe Journal: Int J Environ Res Public Health Date: 2020-12-11 Impact factor: 3.390
Authors: Megan Cox; Georgina Phillips; Rob Mitchell; Lisa-Maree Herron; Sarah Körver; Deepak Sharma; Claire E Brolan; Mangu Kendino; Osea K Masilaca; Gerard O'Reilly; Penisimani Poloniati; Berlin Kafoa Journal: Lancet Reg Health West Pac Date: 2022-07-07