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Covid-19 HSE Clinical Guidance and Evidence

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About - HSE Repository for Interim Clinical Guidance intended for the Clinical Community

This site provides a national easily-accessible repository of clinical guidance to equip the clinical community in Ireland with the requisite information whilst working within the current COVID-19 environment. 

The site contains and enables access to:

  • HSE Interim Clinical Guidance to provide nationally consistent advice to the clinical community in response to the COVID-19 national health emergency, and as core services resume is inclusive of guidance for the provision of both COVID-19 care and non COVID care in a COVID environment.  Guidance is based on best available knowledge at the time of completion, written by clinical subject matter experts (SMEs) working with the HSE.  These SMEs have both expertise and experience of treating patients for the specific health conditions covered by the guidance.
  • Summaries of Evidence prepared by the HSE National Library Evidence team and other stakeholders (these are statements of emerging evidence and do not replace clinical judgement or guidance)
  • An online facility to request additional published COVID-19 evidence in relation to specific clinical questions

Interim Clinical Guidance published on this site is under the governance of CCO CAG.  This guidance takes into consideration advice provided by NPHET relating to the current COVID-19 health emergency. 

The content of the site is not meant to replace clinical judgment or specialist consultation, but rather strengthen clinical management of patients and provide up-to-date and relevant guidance.  The guidance is iterative in nature and is subject to ongoing review to ensure alignment with emerging evidence and updates to national guidelines.  This guidance must be read in conjunction with the National HSE Infection Prevention and Control (IPC) Guidance for Possible or Confirmed COVID-19 

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Latest - Summaries of Evidence

Updated page:18/09/20
What are the psychological, psychosocial and educational interventions that support the return to school of children in Ireland and across Europe? (Published Sept 18th 2020)

The impact of school closure on pupils is well documented and while the Mental Health Foundation notes that, while it is still too early to gauge the full impact, it has been positive for some but a very different experience for others. The negative consequences identified include bereavement, anxiety concerning sick or vulnerable family members, the particular concerns of the children of healthcare workers, the removal of the key protective factors and support structures afforded by school and an increase in exposure to stressful family situations, including financial uncertainties. Other impacts include social isolation, the loss of academic progress, a loss that is increased by social disadvantage, digital inequalities and the uncertainty caused by cancelled exams. There are the additional consequences of lack of exercise, changes in diet or the loss of free school meals and disruption to sleeping patterns. A very serious concern relates to those children placed at greater risk of violence and abuse, as well as a general recognition that the pupils who are likely to experience the greatest impact of school closures are those with pre-existing mental health conditions or special educational needs.

Bailey emphasises the vital role that schools play in connecting students with peers and mentors, channelling youthful energy into productive pursuits, developing academic skills, and relieving the pressure on overwhelmed parents. He also points out that remote learning is inferior to the learning that takes place in the school environment. 

Support for the mental health and well-being of pupils is a key element in the reopening of schools, with one author noting that school is the ideal setting for such support to be provided.  Some specific interventions have been documented: PREPaRE; Psychological First Aid; and one author recommends that school psychologists should have an understanding of the impairing effects of PTSD, assessment tools, treatment options, and school reintegration planning.  Another paper describes the role of teachers as first responders, and Henshaw refers to the recommendation of a Barnardo’s report that children be given time to talk about their experiences when they return to school and that the current situation represents a great opportunity to put mental health and well-being at the heart of education.

UNESCO notes that there is a need to protect the rights of children to education and that governments are currently engaged in balancing this right with the need to keep children safe and healthy.


LITERATURE REVIEWS CARRIED OUT FOR THE HEALTH SERVICE EXECUTIVE NATIONAL TELEHEALTH STEERING GROUP April – July 2020 (Published Aug 13th 2020)

Produced by the members of the National Health Library and Knowledge Service Evidence Team. These literature reviews collate the best available evidence at the time of writing and do not replace clinical judgement or guidance. Emerging literature or subsequent developments in respect of technologies may require amendment to the information or sources listed in the document. Although all reasonable care has been taken in the compilation of content, the National Health Library and Knowledge Service Evidence Team makes no representations or warranties expressed or implied as to the accuracy or suitability of the information or sources listed in this document. These literature reviews are the property of the National Health Library and Knowledge Service and subsequent re-use or distribution in whole or in part should include acknowledgement of the service.

Foreword

This collection of literature reviews was created between April and July 2020 by members of the National Health Library and Knowledge Service Evidence Team to support the Health Service Executive National Telehealth Steering Group. Each literature review relates to innovations in telemedicine as applicable to a specific condition or specialty and each is presented as a separate chapter. Additional studies relating to specific conditions or specialities may be added by the Evidence Team as individual chapters are revised and updated. Additional chapters relating to additional conditions or specialities may be added by the Evidence Team.

Using combinations of the subject headings and keywords set out in Appendix 1, the databases CINAHL, EMBASE and Medline were searched and search results filtered for studies published between 2015 and 2020, in English, relating primarily to adult populations and with an emphasis on systematic reviews and randomised controlled trials. Each chapter presents the evidence as illustrated below. Within each section, studies are arranged in reverse chronological order by year and, within a year, in alphabetical order by author surname. Please see Appendix 2 for an alphabetical list of sources referenced per condition or specialty. Please see Appendix 3 for an alphabetical list of all sources referenced.

Definitions: According to the OED, ‘telehealth’ is defined as the provision of health-care services remotely by means of telecommunications technology; the term was first recorded in 1975. ‘Telemedicine’ is defined as medicine practised with the assistance of telecommunications technology, often to provide care in remote locations or to reduce the need for hospital visits; the term was first recorded in 1968. ‘Mobile health’ is defined as health and medical services provided and accessed primarily using smartphones and mobile devices; the term was first recorded as such in 2000.

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