Response to the COVID-19 Pandemic Among Posthospital Brain Injury Rehabilitation Providers.

Autor:	Malec JF; Foundation for the Advancement of Brain Rehabilitation, Philadelphia, Pennsylvania; Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana; Mayo Clinic, Rochester, Minnesota. Electronic address: jfmalec@iupui.edu., Salisbury DB; Pate Rehabilitation, Dallas, Texas., Anders D; On With Life, Ankeny, Iowa., Dennis L; Shepherd Center, Atlanta, Georgia., Groff AR; Learning Services, Raleigh, North Carolina., Johnson M; Rehab Without Walls, San Jose, California., Murphy MP; ReMed, Paoli, Pennsylvania., Smith GT; Progressive Rehabilitation Associates, Portland, Oregon.
Jazyk:	angličtina
Zdroj:	Archives of physical medicine and rehabilitation [Arch Phys Med Rehabil] 2021 Mar; Vol. 102 (3), pp. 549-555. Date of Electronic Publication: 2020 Nov 27.
DOI:	10.1016/j.apmr.2020.10.137
Abstrakt:	Rehabilitation after significant acquired brain injury (ABI) to address complex independent activities of daily living and return to family and community life is offered primarily after initial hospitalization in outpatient day treatment, group home, skilled nursing, and residential settings and in the home and community of the person served. The coronavirus 2019 pandemic threatened access to care and the health and safety of staff, persons served, and families in these settings. This article describes steps taken to contain this threat by 7 leading posthospital ABI rehabilitation organizations. Outpatient and day treatment facilities were temporarily suspended. In other settings, procedures for isolation, transportation, cleaning, exposure control, infection control, and use of personal protective equipment (PPE) were reinforced with staff. Visitation and community activities were restricted. Staff and others required to enter facilities were screened with symptom checklists and temperature checks. Individuals showing symptoms of infection were quarantined and tested, as possible. New admissions were carefully screened for infection and often initially quarantined. Telehealth played a major role in reducing direct interpersonal contact while continuing to provide services both to outpatients and within facilities. Salary, benefits, training, and managerial support were enhanced for staff. Despite early outbreaks, these procedures were generally effective, with preliminary initial infections rates of only 1.1% for persons served and 2.1% for staff. Reductions in admissions, services, and unanticipated expenses (eg, PPE, more frequent and thorough cleaning) had a major negative financial effect. Providers continue to be challenged to adapt rehabilitative approaches and to reopen services. (Copyright © 2020. Published by Elsevier Inc.)
Databáze:	MEDLINE
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