{"id":2829,"date":"2020-04-16T14:04:34","date_gmt":"2020-04-16T14:04:34","guid":{"rendered":"\/?p=2829"},"modified":"2020-04-16T14:04:34","modified_gmt":"2020-04-16T14:04:34","slug":"the-role-of-mobile-healthcare-in-supporting-nhs-resilience-in-the-covid-19-crisis","status":"publish","type":"post","link":"https:\/\/www.vanguardhealthcare.co.uk\/sv_se\/the-role-of-mobile-healthcare-in-supporting-nhs-resilience-in-the-covid-19-crisis\/","title":{"rendered":"Mobil sjukv\u00e5rds roll f\u00f6r att st\u00f6dja NHS-resiliens i covid-19-krisen"},"content":{"rendered":"

Medan byggandet av storskaliga, tillf\u00e4lliga f\u00e4ltsjukhus f\u00e5r de flesta rubrikerna f\u00f6r tillf\u00e4llet, p\u00e5g\u00e5r ocks\u00e5 en enorm m\u00e4ngd arbete bakom kulisserna p\u00e5 NHS-truster och sjukhus \u00f6ver hela landet f\u00f6r att f\u00f6rb\u00e4ttra motst\u00e5ndskraften, och i vissa fall Vanguard:s flotta mobila sjukv\u00e5rdsinr\u00e4ttningar har spelat en nyckelroll.<\/p>\n

NHSE har beordrat alla sjukhus att frig\u00f6ra kapacitet genom att skriva ut icke-kritiska patienter och upph\u00f6ra med alla planerade och elektiva procedurer senast den 15 april, f\u00f6r att f\u00f6rbereda sig f\u00f6r den f\u00f6rv\u00e4ntade \u00f6kningen av Covid-19-relaterade intagningar. Hittills har \u00f6ver 30 000 s\u00e4ngplatser, motsvarande \u00f6ver 50 nya sjukhus, frigjorts eller skapats p\u00e5 befintliga NHS-sjukhus f\u00f6r patienter som \u00e4r infekterade med coronavirus. Detta representerar en fenomenal prestation och visar hur lyh\u00f6rd NHS kan vara i en st\u00f6rre situation.<\/p>\n

M\u00e5nga sjukhus har beh\u00f6vt \u00e5teranv\u00e4nda internt utrymme och omdisponera resurser p\u00e5 olika s\u00e4tt f\u00f6r att frig\u00f6ra ytor inom sjukhuset f\u00f6r Covid-19-patienter. Men att omvandla befintliga utrymmen till en avdelning eller en anl\u00e4ggning som \u00e4r l\u00e4mplig f\u00f6r detta \u00e4ndam\u00e5l \u00e4r inte n\u00f6dv\u00e4ndigtvis s\u00e5 enkelt eller snabbt att g\u00f6ra. Framf\u00f6rallt har det kr\u00e4vt en noggrann planering med h\u00e4nsyn till hela sjukhusets egendom och resurser.<\/p>\n

Svarar p\u00e5 utmaningen<\/strong><\/p>\n

V\u00e4gledning utf\u00e4rdad av regeringen<\/a> i mars f\u00f6r chefer och fastighetsteam som vill omvandla en befintlig anl\u00e4ggning till en tillf\u00e4llig covid-19-avdelning f\u00f6r att hysa intuberade patienter, ins\u00e5g den hastighet med vilken sjukhusen m\u00e5ste anpassa sig och var l\u00e4mpligt pragmatisk. Den anger att vid identifiering av l\u00e4mpliga platser b\u00f6r befintliga trafikfl\u00f6den beaktas och alla genomfartsv\u00e4gar f\u00f6r icke-Covid-19-trafik b\u00f6r undvikas. Logistiska fl\u00f6den, ren och smutsig avfallshantering m\u00e5ste ocks\u00e5 beaktas.<\/p>\n

Ett annat nyckelkrav \u00e4r tillr\u00e4cklig ventilation och utsug, eftersom det stora antalet fl\u00e4ktar som anv\u00e4nds kan berika luften med syre och d\u00e4rigenom \u00f6ka f\u00f6rbr\u00e4nningsrisken. En rad andra planerings\u00f6verv\u00e4ganden m\u00e5ste ocks\u00e5 beaktas, s\u00e5som brands\u00e4kerhet med tanke p\u00e5 f\u00f6r\u00e4ndringen i layout och anv\u00e4ndning, s\u00e4rskilt om byggnadsarbete kr\u00e4vs f\u00f6r att omvandla utrymmet. F\u00f6rutom anslutningar f\u00f6r medicinsk gas och syrgas beh\u00f6ver s\u00e4ngutrymmen \u00e4ven ytterligare anslutningar och utrymme runt dem f\u00f6r utrustning som anv\u00e4nds intermittent i s\u00e4ngomr\u00e5det.<\/p>\n

Den senaste v\u00e4gledningen anger ocks\u00e5 att, d\u00e4r s\u00e5 \u00e4r m\u00f6jligt, ett utpekat frist\u00e5ende omr\u00e5de eller en flygel av v\u00e5rdinr\u00e4ttningen b\u00f6r anv\u00e4ndas f\u00f6r behandling och v\u00e5rd av patienter med Covid-19. Detta omr\u00e5de b\u00f6r helst ha en separat ing\u00e5ng och utg\u00e5ng och en separat mottagning och f\u00e5r inte anv\u00e4ndas som en genomfartsled av andra patienter, bes\u00f6kare eller personal, inklusive patienter som f\u00f6rflyttas, personal som g\u00e5r p\u00e5 matrast och personal och bes\u00f6kare som g\u00e5r in och ut i byggnad. Det m\u00e5ste ocks\u00e5 separeras fr\u00e5n icke-segregerade omr\u00e5den med st\u00e4ngda d\u00f6rrar.<\/p>\n

Anv\u00e4nda flexibla v\u00e5rdl\u00f6sningar<\/strong><\/p>\n

Som Vanguard:s mobil teatrar<\/a> och avdelningar<\/a> \u00e4r frist\u00e5ende enheter, de \u00e4r s\u00e4rskilt l\u00e4mpade f\u00f6r att behandla infekterade patienter som kr\u00e4ver isolering, eller f\u00f6r att tillhandah\u00e5lla kritisk operation eller behandling borta fr\u00e5n Covid-19-omr\u00e5dena p\u00e5 sjukhuset. Dessutom uppfyller de redan relevanta standarder, s\u00e5 de kan snabbt \u00e5terst\u00e4llas f\u00f6r att ge ytterligare s\u00e4ngutrymmen.<\/p>\n

Vad som dock har framkommit under de senaste veckorna \u00e4r att sjukhuschefer med en Vanguard mobil teater, behandlingsanl\u00e4ggning, CSSD-enhet eller avdelning redan p\u00e5 plats, ser denna enhet som en viktig f\u00f6rl\u00e4ngning av sin egen kliniska fastighet och som nyckeln till Covid-19-kapaciteten planering inom sjukhuset.<\/p>\n

Enhetens extra externa kapacitet har gjort det m\u00f6jligt f\u00f6r vissa sjukhus att b\u00e4ttre koreografera sina f\u00f6r\u00e4ndringar \u00f6ver g\u00e5rden som helhet f\u00f6r att ge oavbruten v\u00e5rd f\u00f6r patienter i en situation som f\u00f6r\u00e4ndras dagligen.<\/p>\n

De senaste veckorna har Vanguard:s flotta av mobila avdelningar, operationssalar och endoskopi sviter<\/a> har \u00e5teranv\u00e4nts p\u00e5 ett antal olika s\u00e4tt som en del av sjukhusens Covid-19-planering, som en del av deras \u00f6vergripande plan f\u00f6r att \u00f6ka motst\u00e5ndskraften. Den resulterande l\u00f6sningen och den eventuella anv\u00e4ndningen av den mobila anl\u00e4ggningen har varit beroende av varje sjukhuss individuella behov, enhetens position inom varje plats och dess n\u00e4rhet till vissa avdelningar.<\/p>\n

Akutkirurgi och n\u00f6dv\u00e4ndig behandling<\/strong><\/p>\n

Eftersom snabbhet \u00e4r avg\u00f6rande uppmuntras sjukhusen att identifiera de omr\u00e5den som kan konverteras effektivt med ett minimum av \u00e4ndringar, s\u00e5som befintliga avdelningar, teatrar och kateteriseringslabb, inklusive f\u00f6rberedelse- och skrubbomr\u00e5den. P\u00e5 grund av kravet p\u00e5 medicinska gaser i r\u00f6r och ytterligare syre, finner m\u00e5nga sjukhus att den optimala platsen f\u00f6r att l\u00e4gga till Covid-19-kapacitet \u00e4r inom en befintlig operationsavdelning.<\/p>\n

NHS har starkt uppmuntrats av sin strategiska incidentdirekt\u00f6r, professor Keith Willett, att se till att n\u00e4r de ser tillbaka efter denna kris, att de inte har gjort lika mycket skada p\u00e5 icke-Covid-patienter som beh\u00f6ver akut v\u00e5rd, som de har gjort mot positiva till att st\u00f6dja Covid-19-patienter.<\/p>\n

Som ett resultat av detta anv\u00e4nder ett antal sjukhus med en Vanguard mobil teater eller avdelning p\u00e5 plats den mobila anl\u00e4ggningen f\u00f6r att dekantera befintligt internt kirurgiskt eller kliniskt utrymme. Exempel p\u00e5 ingrepp som nu genomf\u00f6rs i Vanguard:s mobila enheter \u00e4r akutkirurgi, akut v\u00e5rd som cancerbehandling och behandling av traumapatienter.<\/p>\n

Ett sjukhus anv\u00e4nder sin operationssalar f\u00f6r akut plastarbete och dermatologi, medan ett annat anv\u00e4nder sin f\u00f6r akut obstetrik. Nyckeln till detta har varit flexibiliteten hos dessa anl\u00e4ggningar genom att de kan \u00e5teranv\u00e4ndas mycket snabbt, beroende p\u00e5 \u00f6nskad anv\u00e4ndning.<\/p>\n

En annan f\u00f6rdel \u00e4r enheternas mobila karakt\u00e4r, eftersom de relativt enkelt kan flyttas dit de beh\u00f6vs som mest. I Skottland \u00f6verv\u00e4ger en h\u00e4lsov\u00e5rdsn\u00e4mnd att flytta sin mobila teater till en annan sjukhusplats inom samma styrelse d\u00e4r behovet \u00e4r st\u00f6rre.<\/p>\n

COVID-19 och patientisolering<\/strong><\/p>\n

En mobil eller modul\u00e4r avdelning skulle kunna omvandlas till en andningsst\u00f6davdelning p\u00e5 niv\u00e5 1, medan mobila operationssalar har potential att \u00e5teranv\u00e4ndas som HDU- eller ITU-avdelningar eller anv\u00e4ndas f\u00f6r procedurer och behandlingar som drar nytta av den extra isoleringen.<\/p>\n

Vissa enheter anv\u00e4nds ocks\u00e5 f\u00f6r att isolera patienter som uppvisar misst\u00e4nkta covid-19-symtom men som v\u00e4ntar p\u00e5 ytterligare bed\u00f6mning. Ett st\u00f6rre regionalsjukhus har tillf\u00e4lligt anv\u00e4nt sin mobila anl\u00e4ggning som en kirurgisk observationssvit f\u00f6r att hj\u00e4lpa till att lindra trycket i andra delar av sjukhuset, medan andra anv\u00e4nder mobila teatrar och avdelningar f\u00f6r kritisk dagkirurgi, f\u00f6r att h\u00e5lla patienter borta fr\u00e5n covid-19-zoner inom huvudsjukhuset.<\/p>\n

Extra flexibilitet<\/strong><\/p>\n

Eftersom Vanguard:s mobila sjukv\u00e5rdsinr\u00e4ttningar redan uppfyller de flesta av de relevanta standarderna, kan de \u00e5teranv\u00e4ndas f\u00f6r att tillgodose en \u00e4ndrad anv\u00e4ndning n\u00e4r situationen f\u00f6r\u00e4ndras, oavsett om det handlar om att l\u00e4gga till ITU-s\u00e4ngutrymmen eller ytterligare behandlingskapacitet, utan att m\u00f6ta m\u00e5nga av de vanliga problemen i samband med konvertering en befintlig anl\u00e4ggning eller att bygga en ny byggnad eller avdelning.<\/p>\n

Vissa sjukhus har identifierat behovet av ytterligare utrymme f\u00f6r andra \u00e4ndam\u00e5l, till exempel f\u00f6r att st\u00f6dja personal genom att tillhandah\u00e5lla v\u00e4lbeh\u00f6vliga rastplatser, eller tillhandah\u00e5lla omkl\u00e4dningsrum som m\u00e5ste placeras separat, antingen fr\u00e5n infekterade eller icke-infekterade patienter. Vanguard har ocks\u00e5 kunnat donera ett antal reservventilatorer till NHS.<\/p>\n

I m\u00e5nga fall har Vanguards erfarna kliniska st\u00f6dpersonal omplacerats, antingen inom enheten eller till andra omr\u00e5den p\u00e5 sjukhuset, inklusive covid-19-zoner, f\u00f6r att ge st\u00f6d till sjukhuset d\u00e4r det beh\u00f6vs som mest. Skulle en ombyggd salong beh\u00f6vas f\u00f6r att \u00f6ka den kirurgiska kapaciteten, kan den mycket snabbt \u00e5terst\u00e4llas till en fullt bemannad operationssalar.<\/p>\n

Framtida kapacitet<\/strong><\/p>\n

Det \u00e4r oundvikligt att n\u00e4r den omedelbara krisen v\u00e4l \u00e4r \u00f6ver kommer patienter att m\u00f6ta l\u00e5nga v\u00e4ntelistor f\u00f6r ingrepp som har skjutits upp eller st\u00e4llts in under krisen. D\u00e4rf\u00f6r \u00f6verv\u00e4ger ett antal sjukhus redan hur de ska hantera den f\u00f6rv\u00e4ntade \u00f6kningen av efterfr\u00e5gan p\u00e5 kirurgi, diagnostik och olika behandlingsformer.<\/p>\n

Det \u00e4r vettigt att i f\u00f6rv\u00e4g planera f\u00f6r anv\u00e4ndningen av flexibla sjukv\u00e5rdsinr\u00e4ttningar som snabbt kan s\u00e4ttas in f\u00f6r att ge ytterligare kapacitet och f\u00f6rb\u00e4ttra motst\u00e5ndskraften inom sjukhus, och som kan tas bort eller flyttas n\u00e4r det inte l\u00e4ngre beh\u00f6vs f\u00f6r att forts\u00e4tta ge st\u00f6d d\u00e4r det beh\u00f6vs som mest.<\/p>","protected":false},"excerpt":{"rendered":"

Medan byggandet av storskaliga, tillf\u00e4lliga f\u00e4ltsjukhus f\u00e5r de flesta rubrikerna f\u00f6r tillf\u00e4llet, p\u00e5g\u00e5r ocks\u00e5 en enorm m\u00e4ngd arbete bakom kulisserna p\u00e5 NHS-truster och sjukhus \u00f6ver hela landet f\u00f6r att f\u00f6rb\u00e4ttra motst\u00e5ndskraften, och i vissa fall Vanguard:s flotta mobila sjukv\u00e5rdsinr\u00e4ttningar har spelat en nyckelroll.<\/p>","protected":false},"author":1,"featured_media":1346,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[2,115],"tags":[5,122,138],"class_list":["post-2829","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","category-products-and-services","tag-mobile","tag-operating-theatre","tag-ward"],"acf":[],"yoast_head":"\nThe role of mobile healthcare in supporting NHS resilience in the COVID-19 crisis - Vanguard Healthcare Solutions<\/title>\n<meta name=\"description\" content=\"The role of mobile healthcare in supporting NHS resilience in the Covid-19 crisis by providing additional capacity and flexibility\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.vanguardhealthcare.co.uk\/sv_se\/the-role-of-mobile-healthcare-in-supporting-nhs-resilience-in-the-covid-19-crisis\/\" \/>\n<meta property=\"og:locale\" content=\"sv_SE\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The role of mobile healthcare in supporting NHS resilience in the COVID-19 crisis - 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